CORRECTION OF SECONDARY LIP DEFORMITIES IN CLEFT PATIENTS

구순열 환자의 이차 구순 성형술

Secondary deformities of the lip and nose in individuals with repaired unilateral and bilateral clefts may vary in severity, depending on the state of the original defect, the care taken in the initial surgical procedure, the pattern of the patient's facial growth, and the effectiveness of interceptive orthodontic technique. Because each patient has a unique combination of deformities, their surgical reconstruction usually requires the modification and combination of several surgical techniques. Residual lip deformities after primary repair may be esthetic or functional and include scars, skin shortage or excess(vertical and transverse), orbicularis oris muscle malposition or diastasis. The key to accurate repair of secondary cleft lip deformities is a precise diagnosis. This requires observation of the patient in animation and repose. The quality of the scar is not the only factor determining the overall appearance of the lip. Observing the patient in the animated position is critical to assess muscular function. Factors that require precise analysis include lip length, the appearance of the Cupid's bow and philtrum, and nasal symmetry. Only after this detailed analysis can a decision be made as to wether a major or minor deformity exists. We report successful cases using various techniques for the secondary lip deformities.

편측성 혹은 양측성 구순구개열환자에서 일차 구순 성형술후 나타나는 이차 구순 기형은 세심한 관찰을 통한 문제점에 대한 정확한 인식을 통해 상순, 홍순부, 피부와 근육등의 적절한 교정술로 심미성, 기능적 회복을 이룰 수 있다. 저자들은 이차 구순 기형으로 나타난 구륜근의 부정유합, 휘파람 변형과 부족한 입술등에 대해 적절한 성형술로 심미적, 기능적으로 양호한 결과를 얻었기에 보고하는 바이다.