Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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RADIX AUGMENTATION USING TEMPORALIS FASCIA GRAFT

측두근막 이식을 이용한 비근증대술

  • Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Ryu, Jae-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Kim, Hyun-Syeob (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
  • 유선열 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 류재영 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 김현섭 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소)
  • Published : 2007.03.31
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Abstract

The temporalis fascia graft has been widely used in the correction of nasal deformities. The fascia can be used alone or combined for augmentation rhinoplasty. The fascia graft provides adequate coverage, contour, and bulk on the profile of the nose, as well as an inconspicuous donor site. A depressed radix area can be successfully corrected by the fascia graft. We present two cases of nasal radix augmentation by using temporalis fascia graft. Two male patients presented with the skeletal class III malocclusion and the depressed radix. A planned orthognathic surgery and the temporalis fascia graft to the radix were performed. The malocclusion and the profile of the patients were markedly improved after the operation. Not only the radix but also the nose was improved in its size and length. There was no noticeable resorption or displacement of the radix area at follow-up. The temporalis fascia graft could be an appropriate surgical technique in radix augmentation and nose lengthening.

측두근막은 비변형의 교정에 다양하게 이용될 수 있으며, 융비술에 단일 또는 복합 이식재로 사용될 수 있다. 측두근막 이식은 공여부가 눈에 띄지 않을 뿐만 아니라 코를 적절히 피개하고 외형을 좋게 하며 크기를 증대시켜 준다. 한편 비근부의 증대를 통해 코를 높이는 것은 물론 길이를 길게 할 수 있으며 넓은 내안각 사이의 외형을 개선해 줄 수 있다. 우리는 하악전돌증을 주소로 악교정수술을 받기 위해 내원한 2예의 남자 환자에서 계획된 악교정수술과 더불어 함몰된 비근부에 대하여 측두근막을 이용한 비근증대술을 시행하였다. 수술 후 치열안면변형의 해소는 물론 더욱 부드럽고 자연스럽게 개선된 안모를 관찰할 수 있었다. 환자의 측모도 더욱 개선되어 비근부가 높아졌을 뿐만 아니라 코의 길이가 길어진 효과도 얻을 수 있었다. 수술 후 비근부에서 주목할 만한 흡수 또는 변위 소견은 관찰되지 않았다. 함몰된 비근부에 대한 측두근막 이식을 이용한 비근증대술은 술식이 간단하면서도 비근부가 증대되고 코의 길이가 증가되는 적절한 수술방법임을 알 수 있었다.

Keywords

References

  1. Takato T, Yonehara Y, Mori Y et al : Use of cantilever iliac bone grafts for reconstruction of cleft lip-assosiated nasal deformities. J Oral Maillofac Surg 53 : 757, 1995 https://doi.org/10.1016/0278-2391(95)90325-9
  2. Becker DG, Pastorek NJ : The radix graft in cosmetic rhinoplasty. Arch Facial Plast Surg 3 : 115, 2001 https://doi.org/10.1001/archfaci.3.2.115
  3. McKinney P, Sweis I : A clinical definition of an ideal nasal radix. Plast Reconstr Surg 109 : 1416, 2002 https://doi.org/10.1097/00006534-200204010-00033
  4. Constantian MB : Four common anatomic variants that predispose to unfavorable rhinoplsty result : A study based on 150 consecutive secondary rhinoplasties. Plast Reconstr Surg 105 : 316, 2000 https://doi.org/10.1097/00006534-200001000-00049
  5. Miller TA : Temporalis fascia grafts for facial and nasal contour augmentation. Plast Reconstr Surg 81 : 524, 1988 https://doi.org/10.1097/00006534-198804000-00007
  6. Deva AK, Merten S, Chang L : Silicone in nasal augmentation rhinoplasty: A decade of clinical experience. Plast Reconstr Surg 102 : 1230, 1998 https://doi.org/10.1097/00006534-199809040-00052
  7. Johnson CM, Alsarraf R : The radix graft in cosmetic rhinoplasty. Arch Facial Plast Surg 3 : 120, 2001 https://doi.org/10.1001/archfaci.3.2.120
  8. Gunter JP, Rohrich RJ, Hackney FL : Dorsal augmentation: Onlay grafting using shaped autologous septal cartilage. Plast Reconstr Surg 86 : 39, 1990 https://doi.org/10.1097/00006534-199007000-00006
  9. Guerrerosantos J : Temporoparietal free fascia graft in rhinoplasty. Plast Reconstr Surg 74 : 465, 1984 https://doi.org/10.1097/00006534-198410000-00001
  10. Baker TM, Courtiss EH : Temporalis fascia grafts in open secondary rhinoplasty. Plast Reconstr Surg 93 : 802, 1994 https://doi.org/10.1097/00006534-199404000-00023
  11. Everton DM, Lepore ML, Yim DWS et al : Autologous fascia graft in head and neck plastic surgery. Arch Otolaryngol 110 : 458, 1984 https://doi.org/10.1001/archotol.1984.00800330040009
  12. Boyce RG, Nuss DW, Kluka EA : The use of autogenous fat, fascia, and nonvascularized muscle grafts in the head and neck. Otolaryngol Clin North Am 27 : 39, 1994
  13. Daniel, RK : Fascial grafts. In rhinoplasty: An atlas of surgical techniques. New York: Springer, 2002, p.267
  14. Lessard ML, Daniel RK : Surgical anatomy of septorhinoplasty. Arch Otolaryngol 111 : 25, 1985 https://doi.org/10.3109/00016489109136778
  15. Byrd HS, Hobar PC : Rhinolasty : A practical guide for surgical planning. Plast Reconstr Surg 91 : 642, 1993 https://doi.org/10.1097/00006534-199304000-00011
  16. Guyuron B : Precision rhinoplasty. Part I : The role of lifesize photographs and soft-tissue cephalometric analysis. Plast Reconstr Surg 81 : 489, 1988 https://doi.org/10.1097/00006534-198804000-00001
  17. Daniel RK, Farkas LG : Rhinoplasty : Image and reality. Clin Plast Surg 15 : 82, 1988
  18. Mowlavi A, Wilhelmi BJ : A clinical definition of an ideal nasal radix. Plast Reconstr Surg 111 : 943, 2003
  19. Daniel RK : Invited discussion : Silicone augmentation rhinoplasty in an oriental population. Ann Plast Surg 54 : 6, 2005 https://doi.org/10.1097/01.sap.0000149976.77083.5c
  20. Gryskiewicz JM, Rohrich RJ, Reagan BJ : The use of alloderm for the correction of nasal contour deformities. Plast Reconstr Surg 107 : 561, 2001 https://doi.org/10.1097/00006534-200102000-00040