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

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

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