Abstract
Tennison was the first to recognize and to preserve the Cupid's bow by lowering the peak in the margin of the cleft. Randall had modified the Tennison's repair based on accurate measurements. Bardach's technique evolved from the basic concept of triangular flap cleft lip repair described by Tennison-Randall method. Precise measurements are used to define the dimensions of the equilateral triangular flap, which is created on the cleft side and is inserted into an equilateral triangular defect on the noncleft side. Two symmetrical vertical distances on either side of the cleft are thus formed. It is essential that the incisions in the skin correspond precisely with those on the muscles and mucosa, and that all layers are sutured with the use of the triangular flap, thus preventing vertical scar contracture. This procedure produces a symmetric, balance lip with a well-defined Cupid's bow, a symmetric vermilion, and a properly aligned orbicularis oris muscle. We had treated three patients with unilateral incomplete cleft lip by using Bardach's triangular flap method. The operation scars could be reduced comparing to Millard method because Bardach's method did not use the columella base and the alar base incision. And the flap design was more simple and accurate comparing to Tennison-Randall method. On the other hand, the postoperative scars on the philtrum pointed as a disadvantage of triangular flap method were cosmetically acceptable because the three patients had incomplete cleft lip. We have experienced that Bardach's triangular flap is a recommendable technique for the repair of unilateral incomplete cleft lip.
우리는 3예의 편측성 불완전 구순열 환아에서 Bardach 삼각피판법을 사용하여 구순열을 수복하였다. Millard법에 비해 비주기저부와 비익기저부에 부가적인 절개를 가하지 않으므로 술후 반흔을 줄일 수 있었다. 또한 Tennison-Randall법에 비해 간단하면서도 정교한 계측에 의한 작도가 가능하였다. 한편 삼각피판법의 단점으로 지적되고 있는 인중 부위의 술후 반흔은 3예 모두 불완전 구순열이었기 때문에 삼각피판의 길이가 짧아 심미적으로 허용할 만하였다. Bardach 삼각피판법은 편측성 불완전 구순열의 수복에 추천할 만한 술식임을 경험하였다.
