대한소아치과학회지 (Journal of the korean academy of Pediatric Dentistry)

  • 제35권3호
  • /
  • Pages.539-547
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  • 2008
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  • 1226-8496(pISSN)
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  • 2288-3819(eISSN)
대한소아치과학회 (Korean Academy of Pediatric Dentistry)
권호 표지

Apert syndrome : 증례보고

APERT SYNDROME : CASE REPORT

  • 박광선 (강릉대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 박호원 (강릉대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 이주현 (강릉대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 서현우 (강릉대학교 치과대학 소아치과학교실 및 구강과학연구소)
  • Park, Kwang-Sun (Department of Pediatric Dentistry, Oral Science Research Center, College of Dentistry, Kangnung National University) ;
  • Park, Ho-Won (Department of Pediatric Dentistry, Oral Science Research Center, College of Dentistry, Kangnung National University) ;
  • Lee, Ju-Hyun (Department of Pediatric Dentistry, Oral Science Research Center, College of Dentistry, Kangnung National University) ;
  • Seo, Hyun-Woo (Department of Pediatric Dentistry, Oral Science Research Center, College of Dentistry, Kangnung National University)
  • 발행 : 2008.08.29
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초록

Apert syndrome은 관상봉합의 조기유합에 의한 첨두증(acrocephaly)과 합지증(syndactyly)이 함께 나타나는 선천성 유전 질환으로서, 1906년 Apert에 의해 보고된 증후군이다. 약 $65,000{\sim}160,000$ 당 1명꼴로 발생되며, FGFR2(fibroblast growth factor receptor 2)의 돌연변이로 생겨난다고 알려져 있고, 상염색체 우성 유전을 한다. 임상적으로 첨단두증(acrobrachycephaly)을 보이고, 특징적으로 손과 발의 합지증을 보이며, 높은 이마와 평평한 뒤통수, 후퇴된 중안면부, 안구돌출, 시력이상, 양안격리증, 밑으로 쳐진 안검열, 상악골 형성부전, 상대적인 하악 전돌의 양상 등을 보인다. 감소된 비강인두와 좁아진 후비공으로 인한 구호흡과 전방부 개교를 보이며, 이완시에 입술의 모양은 사다리꼴 형태를 보인다. 중이염이 흔하고, 청각장애를 유발하기도 하며, 정신지체가 높은 비율로 나타난다. 특징적인 구내소견으로 연구개열 또는 구개수열과 가성 경구개열, V자 모양의 악궁과 치열의 총생 등이 관찰되며, 전치부 개방교합과 구치부 교차교합을 동반한 Class III 부정교합을 보인다. 본 증례는 강릉대학교 치과병원 소아치과에 내원한 6세 3개월의 남아로 충치 치료를 받고 싶다는 것을 주소로 내원하였다. 이 환자에서 보이는 Apert syndrome의 특징적인 치과적 소견에 대해 보고하는 바이다.

Apert syndrome is an autosomal dominant condition characterized by craniosynostosis, midface hypoplasia, and syndactyly of the hands and feet. It occurs in about 1 of every 65,000 to 160,000 births and is caused by a mutation in the fibroblast growth factor receptor 2(FGFR2) gene. Apert syndrome typically produces acrobrachycephaly(tower skull). The occiput is flattened, and there is a tall appearance to the fore head. Ocular proptosis is a characteristic finding, along with hypertelorism and downward slanting lateral palpebral fissures. The middle third of the face is markedly retruded and hypoplastic, resulting in a relative mandibular prognathism. The reduced size of the nasopharynx and narrowing of the posterior choana can lead to mouth breathing, contributing to an open-mouth apprance. Three fourths of all patients exhibit either a cleft of the soft palate or a bifid uvula. The maxillary hypoplasia leads to a V-shaped arch and crowding of the teeth. A 6-year-old male patient visited to the Department of Pediatric dentistry, Kangnung National University of Dental Hospital. He visited the hospital to get treatment of carious teeth. The purpose of this report is to present a specific dental manifestations about the apert syndrome.

키워드

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