전비중격연장이식술을 이용한 일측 구순열비변형교정술: 다공성 고밀도폴리에틸렌 판과 비중격연골의 사진계측학적 비교

Complete Septal Extension Graft using Porous High-Density Polyethylene Sheet or Septal Cartilage in Unilateral Cleft Lip Nasal Deformities: Photogrammetric Analysis

  • 한기환 (계명대학교 의과대학 성형외과학교실) ;
  • 정진욱 (계명대학교 의과대학 성형외과학교실) ;
  • 박무식 (계명대학교 의과대학 성형외과학교실) ;
  • 김준형 (계명대학교 의과대학 성형외과학교실) ;
  • 손대구 (계명대학교 의과대학 성형외과학교실)
  • Han, Ki-Hwan (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Jeong, Jin-Wook (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Park, Mu-Sik (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Kim, Jun-Hyung (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Son, Dae-Gu (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine)
  • 투고 : 2010.02.06
  • 심사 : 2010.06.09
  • 발행 : 2010.07.10

초록

Purpose: Complete septal extension grafts have been widely used in rhinoplasty for effective projection of the short retruded columella in Asian patients. Autologous septal cartilages and porous high-density polyethylene sheets are frequently used as septal extension grafts. This study was conducted to compare the postoperative results of porous polyethylene sheets and septal cartilages used for correction of unilateral cleft lip nasal deformities by using photogrammetric analysis. Methods: This study investigated a total of 49 patients with cleft lip nasal deformities who underwent corrective surgery, and were followed up for at least 6 months. Septal cartilages were used in 39 patients, and porous polyethylene sheets were used in 10 patients. In all patients, through the open rhinoplasty, complete septal extension grafts were sutured to the caudal margin of the septal cartilage, and the alar cartilage was sutured with suspension. The cleft side alar cartilage was overcorrected by approximately 3 - 5 mm. Postoperative outcomes were evaluated by using photogrammetric analysis. Five indices and 4 angles were measured on their photographs taken before and after the surgery. In patients with unilateral cleft lip nasal deformities, symmetry was also evaluated by means of columellar length index. Results: The postoperative values obtained in photogrammetric analysis showed improvements in comparison with the preoperative ones. The polyethylene group produced more improved outcomes than the septal cartilage group but also resulted in more complications at the same time. Conclusion: The results of this study indicates that complete septal extension grafts are efficient for the correction of unilateral cleft lip nasal deformities. However, since postoperative complications occur more frequently in the polyethylene group than in the septal cartilage group, caution is advised in using porous high-density polyethylene sheets in patients with cleft lip nasal deformities.

키워드

참고문헌

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