Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제31권1호
  • /
  • Pages.74-81
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  • 2005
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

Midfacial degloving approach를 이용한 중안면 골절 환자의 치험례

MIDFACIAL DEGLOVING APPROACH IN MIDFACIAL BONE FRACTURE : THE REPORT OF CASES

  • 김현민 (가천의과대학교 길병원 구강악안면외과) ;
  • 정종철 (가천의과대학교 길병원 구강악안면외과) ;
  • 송민석 (가천의과대학교 길병원 구강악안면외과) ;
  • 장중희 (가천의과대학교 길병원 구강악안면외과) ;
  • 김남훈 (가천의과대학교 길병원 구강악안면외과)
  • Kim, Hyeon-Min (Department of Oral & Maxillofacial Surgery, Gachon Medical School, Gil Medical Center) ;
  • Jeong, Jong-Cheol (Department of Oral & Maxillofacial Surgery, Gachon Medical School, Gil Medical Center) ;
  • Song, Min-Seok (Department of Oral & Maxillofacial Surgery, Gachon Medical School, Gil Medical Center) ;
  • Jang, Jung-Hui (Department of Oral & Maxillofacial Surgery, Gachon Medical School, Gil Medical Center) ;
  • Kim, Nam-Hun (Department of Oral & Maxillofacial Surgery, Gachon Medical School, Gil Medical Center)
  • 발행 : 2005.02.28
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초록

Midfacial degloving approach는 중안면부에 대한 접근시 비교적 광범위한 수술시야의 확보가 가능하고, 술 후 중안모에 반흔을 남기지 않는 심미적 장점이 있다. 특히 중안면부의 광범 위한 골절과 비골 복합 골절을 동반한 중안면부 골절 수복에 이용되어 골절부에 대한 적절한 시야 확보로 정확한 관혈적 정복술이 가능하며 필요시에는 자가 늑골 등을 이용한 비 성형술이 가능하다는 장점이 있다. 이에 저자 등은 중안면부 복합골절의 치료시 midfacial degloving approach을 통해 중안면골의 관혈적 정복술 및 비 재건술을 시행한 증례에 대하여 문헌 고찰과 함께 보고하는 바이다.

In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.

키워드

참고문헌

  1. Casson PR, Bonanno PC, Converse JM: The midface degloving procedure. Plast Reconstr Surg 1974;53:102 https://doi.org/10.1097/00006534-197401000-00026
  2. 오재권, 류동목, 이상철, 김여갑, 이백수: Midfacial degroving approach을 이용한 양측성 상악골절제술의 치험례. 대한악안면 성형재건외과학회지 2001;23(6):578-582
  3. 차인호: 구강악안면외과 영역에서의 MIDFACIAL DEGROVING APPROACH의 유용성. 대한악안면성형재건외과학회지1998;20 (3):214-216
  4. Maniglia AJ, Philips DA: Midfacial degloving for the management of nasal, sinus, and skull-base neoplasms. Otolaryngol Clin North Am 1995;29(6):1127-1143
  5. Kazuhiko K, Kiyoshi M, Hideo K, Susumu O, Koji I, Shigeaki K: Degloving transfacial approach with Le Fort I and nasomaxillary osteotomies : alternative transfacial approach. Neurosurgery 2002;50(4):813-821 https://doi.org/10.1097/00006123-200204000-00023
  6. Allen GA, Siegel GJ: The sublabial approach for extensive nasal and sinus resection. Laryngoscope 1981;91:1685-1640
  7. Howard DJ, Lund VJ: The midfacial degroving approach to sinonasal disease. J laryngol Otol 1992;106: 1059-1062 https://doi.org/10.1017/S0022215100121759
  8. Krause GE, Jafek BW: A modification of the midface degloving technique. Laryngoscope 1999;109(11):1781-1784 https://doi.org/10.1097/00005537-199911000-00011
  9. Price JC, Holliday MJ, Johns ME, Kennedy DW, Richtsmeier WJ, Mattox DE, et al: The versatile midface degroving approach. Laryngoscope 1988;98:291-295
  10. Berghaus A, Jovanivic S: Technique and indications of extended sublabial rhinotomy('midfacial degroving'). Rhinology 1991;29:105-110
  11. 김진수, 김재승, 이원필: Degloving technique을 이용하여 양측성 상악골 절제술로 치료한 법랑아세포암종의 치험례. 대한구강악안면외과학회지 1988;14:155-162
  12. DeFries HO, Deeb ZE, Hudkins CP: A transfacial approach to the nasal-paranasal cavities and anterior skull base. Arch Otolaryngol Head Neck Surg 1988;114:766-769 https://doi.org/10.1001/archotol.1988.01860190070026
  13. Harrison DFN: Lateral rhinotomy : A neglected operation. Ann Otol 1977;86: 756-759
  14. Frodel JL, Marentette LJ: The coronal approach. Anatomic and technical considerations and morbidity. Arch Otolaryngol Head Neck Surg 1993;119:201-207 https://doi.org/10.1001/archotol.1993.01880140091014
  15. Abubaker AO, Sotereanos G, Patterson GT: Use of the coronal surgical incision for reconstruction of severe craniomaxillofacial injuries. J Oral Maxillofac Surg 1990;48:579-586 https://doi.org/10.1016/S0278-2391(10)80470-7
  16. Baumann A, Ewers R: Midfacial degroving: an alternative approach for traumatic corrections in the midface. Int J Oral Maxillofac Surg 2001;30:272-277 https://doi.org/10.1054/ijom.2001.0106
  17. Maniglia AJ: Indications and technique of midfacial degroving. Arch Otolaryngol Head Neck Surg 1986;112:750-752 https://doi.org/10.1001/archotol.1986.03780070062013
  18. Lund VJ: Surgical management of midfacial tumors: transfacial degroving, midfacial degroving, or endoscopic approach. Curr Opin Otolaryngol Head Neck Surg 2001;9(2): 95-99 https://doi.org/10.1097/00020840-200104000-00007
  19. 김일규, 장금수, 최진호, 오남식, 류승현, 김재우 외: 구강악안면 영역의 수술 시 악하 기관 삽관술의 유용성에 대한 임상적 고찰. 대한악안면성형재건외과학회지 2003;25(2):166-171
  20. Porter JP : Grafts in Rhinoplasty: alloplastic vs autogenous. Arch Otolaryngol Head Neck Surg 2000;126(4):558-561
  21. Gurley JM, Pilgram T, Perlyn CA, Marsh JL: Long-term outcome of autogenous rib graft nasal reconstruction. Plast Reconstr Surg 2001; 108(7):1895-1905 https://doi.org/10.1097/00006534-200112000-00007