Y-형 전방 기저 설 피판과 장골 이식을 이용한 양측성 치조열의 이단계 재건술

• 영문명: Two stage reconstruction of bilateral alveolar cleft using Y-shaped anterior based tongue flap and iliac bone graft
• 발행기관: 대한구순구개열학회
• 저자명: 이종호 김명진 강진한 강나라 이종환 최원재 최진영
• 간행물 정보: 『대한구순구개열학회지』제3권 제1호, 23~31쪽, 전체 9쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2000.06.30

영문 초록

Objective: When an alveolar cleft is too large to close with adjacent mucobuccal flaps or large secondary fistula following a primary bilateral palatoplasty exists, a one-stage procedure for bone grafting becomes challenging. In such a case, we used the tongue flap to repair the fistula and cleft alveolus in the first stage, and bone grafting to the cleft defect was performed in the second stage several months later. The purpose of this paper is to report our experiences with the use of an anteriorly-based Y-shaped tongue flap to fit the palatal and labial alveolar defects and the ultimate result of the bone graft. Patients: A series of 14 patients underwent surgery of this type from January 1994 to December 1998. The average age of the patients was 15.8 years old (range: 5 to 28 years old). The mean period of follow-up following the 2nd stage bone graft operation was 45.9 months (range: 9 to 68 months). In nine of the 14 cases, the long-fork type of a Y-shaped tongue flap was used for extended coverage of the labial side alveolar defects with the palatal fistula; in the remaining cases the short-forked design was used. Results: All cases demonstrated a good clinical result after the initial repair of cleft alveolus and palatal fistula. There was no fistula recurrence, although partial necrosis of distal margin in long-forked tongue flap was occurred in one case. Furthermore, the bone graft, which was performed an average of 8 months after the tongue flap repair, was always successful. Occasionally, the transferred tongue tissue was bulging and interfering with the hygienic care of nearby teeth; however, these problems were able to be solved with proper contour-pasty performed afterwards. No donor site complications such as sensory disturbance, change in taste, limitations in tongue movement, normal speech impairments or tongue disfigurement were encountered. Conclusion: This two-stage reconstruction of a bilateral cleft alveolus using a Y-shaped tongue flap and iliac bone graft was very successful. It may be indicated for a bilateral cleft alveolus patient where the direct closure of the cleft defect with adjacent tissue or the buccal flap is not easy due to scarred fibrotic mucosa and/or accompanied residual palatal fistula

목차

Ⅰ. 서론

Ⅱ. 환자 및 방법

Ⅲ. 전방 기저 Y-형 설피판의 설계

Ⅳ. 결과

Ⅴ. 총괄 및 고찰

Ⅵ. 요약

키워드

alveolar cleft palatal fistula tongue flap bone graft