Korean Journal of Cleft Lip And Palate (대한구순구개열학회지)

Korean Cleft Lip and Plate Association (대한구순구개열학회)
권호 표지

Distraction osteogenesis in patients with complete cleft lip and palate

완전 구순구개열을 가진 환자에서의 골신장술

  • Yi, J.K. (Dept. of Oral and Maxillofacial Surgery, Gachon University, Gil Medical Center) ;
  • Park, C.H. (Dept. of Oral and Maxillofacial Surgery, Gachon University, Gil Medical Center) ;
  • Na, J.I. (Dept. of Oral and Maxillofacial Surgery, Gachon University, Gil Medical Center) ;
  • Jeong, J.S. (Dept. of Oral and Maxillofacial Surgery, Gachon University, Gil Medical Center) ;
  • Koo, H.M. (Dept. of Oral and Maxillofacial Surgery, Gachon University, Gil Medical Center) ;
  • Eom, M.Y. (Dept. of Oral and Maxillofacial Surgery, Gachon University, Gil Medical Center) ;
  • Song, M.S. (Dept. of Oral and Maxillofacial Surgery, Gachon University, Gil Medical Center)
  • 이준규 (가천의과학대학교 길병원 구강악안면외과) ;
  • 박철휘 (가천의과학대학교 길병원 구강악안면외과) ;
  • 나주일 (가천의과학대학교 길병원 구강악안면외과) ;
  • 정종선 (가천의과학대학교 길병원 구강악안면외과) ;
  • 구현모 (가천의과학대학교 길병원 구강악안면외과) ;
  • 엄민용 (가천의과학대학교 길병원 구강악안면외과) ;
  • 송민석 (가천의과학대학교 길병원 구강악안면외과)
  • Published : 2005.12.30
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Abstract

Patients with cleft lip and palate usually show up maxillary hypoplasia. In these cases, a large amount of maxillary advancement is often needed to correct the severe deformity, but local soft-tissue scars around the maxilla restrict maxillary advancement and increase the relapse rate. Maxillary distraction osteogenesis is an effective method for facial and occlusal improvement in these patients. By gradually lengthening both the bones and the soft tissues, distracted midface can greatly increase postoperative stability and decrease the relapse rate. However, the maxillary extraoral appliances of the early days used were esthetically unappealing as well as difficult for the patient to manage. Recently, more inconspicuous intraoral distraction appliances have been developed and used with success. We acquired favorable result in two patients(bilateral 1 patient and unilateral 1 patient) with severe maxillary hypoplasia secondary to complete cleft lip and palate were treated with midface distraction using internal distractor (Zurich Pediatric Maxillary Distractor, KLS Martin, Tuttlingen, Germany). So, we report our experience with literatures.

골신장술을 시행할 때는 골절단 방법, 환자에 따른 견인장치의 종류, 골 신장의 리듬과 이동량, 견인장치의 위치와 방향, 회귀량을 줄이기 위한 유지방법과 기간의 선택에 신중을 기해야 한다. 이러한 사항에 대한 적절한 치료계획과 수술이 이루어진다면 골신장술은 기존의 악정형 수술로는 해결하기 힘든 구순구개열 환자의 상악골 열성장을 극복할 수 있는 효과적인 치료방법이 될 수 있을 것으로 사료된다. 본 교실에서는 양측성 구순구개열로 인한 상악골 열성장 환자에 골신장술을 적용한 증례를 체험하여 다소간의 지견을 얻었기에 문헌고찰과 함께 보고하는 바이다.

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