학술논문
편측성 구순구개열 환자에서 소분절 재위치술을 포함한 구순구개열 악교정 수술과 심측두근막을 이용한 휘파람 변형의 교정
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- 영문명
- Cleft Orthognathic Surgery Involving Surgical Repositioning of Lesser Segment and Correction of Whistle Deformity Using Deep Temporal Fascia in a Patient with Unilateral Cleft
- 발행기관
- 대한구순구개열학회
- 저자명
- 박영욱
- 간행물 정보
- 『대한구순구개열학회지』제26권 제2호, 44~49쪽, 전체 6쪽
- 주제분류
- 의약학 > 일반외과학
- 파일형태
- 발행일자
- 2023.12.31
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국문 초록
A 24-year-old male patient with a complete cleft lip and palate had secondary deformities, including maxillary deficiency. Preoperative photographs showed a deficient lip tubercle on the cleft side, facial asymmetry, maxillary canting, and a vertically elongated flat chin. Computed tomography also revealed an anterior cross-bite and maxillary discontinuity due to untreated alveolar cleft. Cleft orthognathic surgery was performed via circumvestibular and peri-fistular incisions. After an inferior turbinectomy, a modified LeFort I osteotomy was completed in two segments, which were then advanced. The alveolar gap was surgically closed through differential segmental repositioning of the lesser segment. The nasal mucosa was sutured water-tight, and iliac cancellous bone was placed along the cleft nasal floor. The final occlusion was achieved through BSSRO (Bilateral Sagittal Split Ramus Osteotomy) and mandibular set-back. An advancement genioplasty was performed for the desired chin morphology. Six months later, the whistle deformity was corrected using a deep temporal fascial graft, and the titanium osteofixation devices were removed. Postoperatively, the patient's anterior facial balance was objectively improved, and an esthetic facial profile was achieved.
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