대한두개안면성형외과학회지 (Archives of Craniofacial Surgery)

  • 제23권5호
  • /
  • Pages.211-219
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  • 2022
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  • 2287-1152(pISSN)
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  • 2287-5603(eISSN)
대한두개안면성형외과학회 (Korean Cleft Palate-Craniofacial Association)
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Open rhinoplasty in secondary cleft nose deformity with suture techniques

  • Lee, Chong Kun (Department of Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital) ;
  • Min, Byung Duk (Department of Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital)
  • 투고 : 2022.09.05
  • 심사 : 2022.10.20
  • 발행 : 2022.10.20
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초록

Background: Correction of secondary cleft nose deformity is one of the most important portions in the management of cleft lip patients. Various techniques have been introduced to achieve adequate shape, balance, and symmetry of anatomical landmarks. None of these methods can claim to universally solve all aspects of the problems encountered in secondary cleft deformity surgery. Some authors overlook the aspect of functional rehabilitation with regard to nasal respiratory pathway problems, which is present in over 90% of the patients. This study aimed to evaluate the aesthetic and functional improvements of the authors' non-destructive technique. Methods: With over 15 years of experience, open rhinoplasty was performed, which included total remodeling of the deformed lower lateral cartilage using several suture fixation techniques without any graft or implantation with septo-turbinoplasty. A total of 150 questionnaires were sent by e-mail, but 55 completed questionnaires were returned. Surgical outcomes were evaluated using questionnaire responses, and outcomes were divided into five categories each for esthetic and functional analyses. Results: The satisfaction rate ranged from 75 % to 98%, which means "more or less," "very much," and "absolutely yes" in the esthetic and functional viewpoints. Conclusion: The results of this study strongly recommend performing the suture fixation technique and functional rehabilitation simultaneously for cleft lip/nose correction.

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참고문헌

  1. Richards AM, Withey SJ, Waterhouse N. The correction of secondary cleft lip deformities using dermofat grafts. Eur J Plast Surg 1997;20:40-4. https://doi.org/10.1007/BF01366526
  2. Cho BC, Park JW, Baik BS. Correction of severe secondary cleft lip nasal deformity using a composite graft: current approach and review. Ann Plast Surg 2002;48:131-7. https://doi.org/10.1097/00000637-200202000-00003
  3. Lee CK, Hur G. Total en bloc reconstruction of alar cartilage with conchal cartilage in seconday cleft lip nasal deformity. J Korean Soc Plast Reconstr Surg 2000;27:372-6.
  4. Mulliken JB. Primary repair of bilateral cleft lip and nasal deformity. Plast Reconstr Surg 2001;108:181-94. https://doi.org/10.1097/00006534-200107000-00028
  5. Tebbetts JB. Primary rhinoplasty: a new approach to the logic and the techniques. Saint Louis: Mosby; 1998.
  6. Regalado-Briz A. Cephalo-crural suture: a new way to deal with supratip fullness. Aesthet Surg J 2005;25:481-8. https://doi.org/10.1016/j.asj.2005.06.005
  7. Kaufman Y, Buchanan EP, Wolfswinkel EM, Weathers WM, Stal S. Cleft nasal deformity and rhinoplasty. Semin Plast Surg 2012;26:184-90.
  8. Edward PB, Laura AM, Edward IL, David YK, John CK. Secondary deformities of the cleft lip, palate, and nose. In: Neligan PC, editor. Plastic surgery. 4th ed. New York: Elsevier; 2017. p.652-3.
  9. Lim J, Oh J, Eun S. Flap reconstruction of soft tissue defect after resecting a huge hemangioma of the nose. Arch Craniofac Surg 2020;21:69-72. https://doi.org/10.7181/acfs.2019.00668
  10. Lee JH, Park JW, Cho BC, Baik BS. Correction of cleft lip nasal deformity using refined reverse-U incision and V-Y plasty. J Korean Cleft Palate-Craniofac Assoc 2002;3:28-36.
  11. Cheon YW, Park BY. Long-term evaluation of elongating columella using conchal composite graft in bilateral secondary cleft lip and nose deformity. Plast Reconstr Surg 2010;126:543-53. https://doi.org/10.1097/PRS.0b013e3181e0969a
  12. Koh IS, Sun H. A practical approach to nasal reconstruction in Asian patients. Arch Craniofac Surg 2021;22:268-75. https://doi.org/10.7181/acfs.2021.00465
  13. Chung JY, Lee JH, Park JW, Cho BC, Baik BS. Correction of severe cleft lip nasal deformity using composite graft. J Korean Cleft Palate-Craniofac Assoc 2001;2:91-6.
  14. Suh JM, Uhm KI. Change in nostril ratio after cleft rhinoplasty: correction of nostril stenosis with full-thickness skin graft. Arch Craniofac Surg 2021;22:85-92. https://doi.org/10.7181/acfs.2021.00010
  15. Basta MN, Goldstein JA, Wilson AJ, Taylor JA. A modified V-Y chondromucosal composite flap for correction of secondary cleft nasal deformity: photogrammetric analysis of a casecontrol study. Plast Reconstr Surg 2014;134:94-101.
  16. Wei J, Herrler T, Xu H, Li Q, Dai C. Double composite tissue Z-plasty technique for anatomical restoration of severe nasal deformity in secondary unilateral cleft lip. Ann Plast Surg 2017;79:359-64. https://doi.org/10.1097/SAP.0000000000001160
  17. McComb H. Primary correction of unilateral cleft lip nasal deformity: a 10-year review. Plast Reconstr Surg 1985;75:791-9. https://doi.org/10.1097/00006534-198506000-00003