DISTRACTION OSTEOGENESIS OF THE MIDFACE WITH A RIGID EXTERNAL DISTRACTOR (RED)

강성 외장형 신장기(Rigid External Distractor)를 이용한 중안면부의 골신장술

  • Oh , Jung-Hwan (Department of Oral and Maxillofacial Surgery, University of Cologne) ;
  • Alexander, Kuebler. (Department of Oral and Maxillofacial Surgery, University of Cologne) ;
  • Zoeller, Joachim E. (Department of Oral and Maxillofacial Surgery, University of Cologne)
  • 오정환 (독일 쾰른대학교 의학부 구강악안면외과) ;
  • ;
  • Published : 2002.04.30

Abstract

In recent, distraction osteogenesis has been used to correct skeletal malformations and discrepancies in the craniofacial area. It also seems to be considered as an alternative in the treatment of severe midfacial hypoplasia. There are some types of distractors for midfacial distraction such as subcutaneous distractors and rigid external distractors. We used a rigid external distractor for correction (RED) of craniofacial hypoplasia. Seven patients underwent a midfacial distraction osteogenesis with a rigid external distractor between April 2000 and July 2001. Three patients suffered from Apert's syndrome, three patients from Crouzon's syndrome, and one patient suffered from midfacial hypoplasia due to midfacial radiotheraphy during childhood. On average, the mean distance of distraction was 19.8mm ($10{\sim}25mm$) and the distraction lasted for 24 days. The patients showed no severe complications like infections, optic disturbance, or wrong distraction vectors. One patient complained pain on the site of the occipital fixation of the distractor. In one patient who underwent subtotal craniectomy 3 months before Le Fort III distraction, the distractor was dislocated as the cranial bone was too weak to support the distractor. This report reveals that the application of rigid external distractor and transfacial pull results in an exact control of the distraction vectors and an excellent correction of midfacial hypoplasia without any severe complications.

Le Fort III 골절단술 후 강성 외장형 신장기를 이용한 중안면부 골신장술은 적은 합병증으로 골편의 많은 전방 이동이 가능하고, 술후에도 신장 축방향을 조절할 수 있는 장점을 가지고 있으며, 견인 철선을 비외측부 안면 피부를 관통하여 견인하는 방법은 견인력이 회전 중심 가까이에 전달되며, 견인장치가 저작시에도 방해가 되지 않는 장점을 가지고 있는 유용한 방법이다. 본과에서는 두개안면부 저성장을 가진 환자에서 Le Fort III 골절단술 후 피부를 관통하여 견인하는 강성 외장형 신장기를 이용하여 적은 합병증으로 매우 심미적인 결과를 얻을 수 있었다. 중안면부의 골신장술을 이용한 치료법은 아직 장기적인 추적 조사가 필요하지만 많은 합병증을 유발하고 골편의 이동량이 제한되는 기존의 골절단술과 소형 금속판을 이용한 골접합술을 대체할 수 있는 유용한 방법으로 생각된다.

Keywords

References

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