Kim Gyeong Hoe, Baek Rong Min, Kim Baek Kyu
Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Arch Craniofac Surg. 2019 Aug;20(4):255-259. doi: 10.7181/acfs.2019.00276. Epub 2019 Aug 20.
Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.
颅面裂是一种罕见疾病，有多种变异形式，严重程度范围广泛。在颅面裂的几种分类系统中，泰西埃分类法因其简单性和以治疗为导向的方法而被最广泛使用。我们报告了一例泰西埃3号裂，伴有广泛的软组织和骨骼缺损，导致眼眶、上颌窦、鼻腔和口腔直接相通。我们使用为单侧唇裂修复设计的直线推进释放技术进行软组织重建。外侧黏膜瓣和内侧黏膜瓣的延伸、向外翻转的下眼睑的翻转瓣以及口轮匝肌周围的广泛剥离使得软组织重建成功且无并发症。通过这个病例，我们证明了直线推进释放技术可应用于严重颅面裂修复以及单侧唇裂修复。
