외상성 내안각격리증 환자에 있어 Hiraga 절개법을 이용한 내안각 고정술

Title
외상성 내안각격리증 환자에 있어 Hiraga 절개법을 이용한 내안각 고정술
Other Titles
Medial Canthopexy using Modified Hiraga's Incision for Correction of Traumatic Telecanthus
Author(s)
김용하이준호김태곤임종효
Keywords
Telecanthus; Transnasal wiring; Hiraga's method
Issue Date
201007
Publisher
대한성형외과학회
Citation
Archives of Plastic Surgery, v.37, no.4, pp.504 - 508
Abstract
Purpose: Traumatic telecanthus can result from naso- ethmoid-orbital fractures. Repair of the medial canthal tendon(MCT) using transnasal wiring is regarded as a choice of method to treat telecanthus, however, is often complicated by incomplete anchoring and drift of canthus, extrusion of wire, in-fracture of orbital bone, and eye damage. The authors introduced oblique transnasal wiring method through the Hiraga's epicanthopalsty incision instead of well-known classical bicoronal approach. Methods: Five patients with traumatic telecanthus were treated with this method. Though the Hiraga's epicanthoplasty incision, we could approach the operative field; the medial orbital wall and detached MCT. Oblique transnasal wiring was performed as following steps. After slit skin incision on the contralateral nasal recession area, drill holes were made from this point to the superior and posterior point of lacrimal sac of deformed eye. A 2-0 wire was double-passed through the holes and MCT. Traction was applied to ensure pulling the MCT and the wires were twisted in the contralateral nose, securing the MCT in the correct position. Results: All patients except 1 person showed improvement and rapid recovery. On average each canthus was moved 5.6mm medially. In all cases, there were no eyelashes disappear, lacrimal canaliculitis, lacrimal duct injury, or infections. Conclusion: The Hiraga's epicanthoplasty incision could give sufficient operative field to reattach the MCT in traumatic telecanthus patients. And the oblique transnasal wiring technique is effective for the Asians who have flat nose and exophthalmic eye. The authors conclude that this technique could be a simple, safe and scarless method to correct traumatic telecanthus.
URI
http://hdl.handle.net/YU.REPOSITORY/22175
ISSN
2234-6163
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의과대학 > 성형외과학교실 > Articles
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