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구순열 비변형 이차 수술시 구륜근이 포함된 C-FLAP을 이용한 비익기저 함몰의 교정
홍기웅,김승홍,이기룡 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.1
Nearly all the repaired cleft lip patients have varying degree of nasal deformities. Cleft lip nose deformities consist of defects of the lower lateral cartilage on the cleft side, the nasal septum, the columella, the nasal tip, and the entire nasal pyramid. The maxillary cleft and hypoplasia, and malpositioning of the the maxillary segments also contribute to the asymmetry of nose. In the correction of cleft lip nose deformities, numerous methods such as composite graft, deepithelized alar-base flap, dermal-fat flap of nostril floor, scar tissue flap, bone & cartilage graft and silastic implant have been introduced and tried to augment nostril floor and alar base. But there have been no standardized satisfactory method in result. At secondary revision of cleft lip nose deformity, we transposed and sutured the C-flap containing deepithelized orbicularis oris myocutaneous flap to the levator labii superioris & alar nasi muscles beneath the depressed nostril floor & alar base to augment them. We could maintain the musclar function by interconnection and fixation of orbicularis oris muscle to alar facial muscles. So, we prevented volume loss of the inserted muscle to augment the nostril floor & alar base by minimizing the muscular fibrosis and atrophy. In basal view photograph and physical examination, We found superior aesthetic results in most of them who had C-flap containing orbicularis oris muscle, and in long term histologic findings of orbicularis oris muscle inserted into the alar facial muscle, we could only find mild fibrosis and atrophy of the muscle but the general structures were maintained.