편측성 구순구개열 환자에서의 악교정수술 치험례 - 증례보고

Orthognathic Surgery for Complete Unilateral Cleft Lip and Palate Patient: A Case Report

The final treatment goal for the cleft patients is recovery of normal function, establishment of facial esthetics and positive self-concept. Most of the cleft patients have mild to moderate midfacial deficiency as well as mandibular prognathism, which needs orthognathic surgery or distraction osteogenesis. However, for the case of cleft patients, there are much more things to be considered than non-cleft patients. Those are increased risk of maxillary segment necrosis due to the inadequate perfusion, inadequately treated alveolar cleft making the operation difficult and complex, concomitant nasal deformity, absence of adequate landmark for facial analysis, velopharyngeal insufficiency related with maxillary advancement, etc. In our case, the patient has the problem that is a combination of mild to moderate maxillary deficiency and mandibular prognathism. Therefore, we decided that the conventional orthognathic surgery was sufficient to correct the patient’s malocclusion and facial disharmony. There was no need of bone graft to the alveolar ridge of the affected side as the patient had already undergone successful alveoloplasty previously. We could get a satisfactory result with the conventional two jaw surgery. In this article, we reported a case previously well operated for cleft lip and palate with particular concerns about orthognathic surgical plan and intraoperative situation.