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하악골 신장술의 초음파적 변화
SONOGRAPHIC CHANGE OF MANDIBULAR DISTRACTION OSTEOGENESIS

김철환   (단국대학교 치과대학 구강악안면외과학교실UU0000336  );
  • 초록

    Distraction osteogenesis was pioneered by Ilizarov in the treatment of injured extremities. Its subsequent application to Oral and Maxillofacial Surgery has opened a new chapter in the treatment of facial deformity. Careful monitoring of the period of distraction and consolidation of the callus is important and has been well described. Complications, such as infection, haematoma and premature ossification, are difficult to diagnose and can compromise the outcome after the surgery. Too slow rate of distraction results in premature fusion of cortices and too rapid information of bone 'cyst' within the callus distraction. I experienced 2 patients of congenital unilateral mandibular hypoplasia, so called Hemifacial Microsomia. After distraction surgery, I evaluated callus formation of mandibular distraction with Ultrasound Sonography during distraction and consolidation period. Plain radiography, although it enables accurate measurement of the distraction gap, did not give sufficient detail to allow assessment of early stages of bone formation, But, ultrasound monitoring could enable continuous monitoring of the distraction gap without exposure to ionizing radiation and allow detection of fine detail, which may influence manipulation of the callus.


  • 주제어

    Distraction Osteogenesis .   Ultrasonography .   Hemifacial microsomia.  

  • 참고문헌 (28)

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    2. Troulis MJ, Glowacki J, Perrott DH, et al.: Effects of latency and rate on bone formation in a porcine mandibular distraction model. J Oral Maxillofac Surg 2000;58:507 
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    22. Moore MH, Guzman-Stein G, Proudman TW, et al.: Mandibular lengthening by distraction for airway obstruction in Treacher-Collins syndrome. J Craniofac Surg 1994;5:22-26 
    23. Huppertz R, Pfeil J, Kaps HP: Sonographische Verlaufskontrollen yon Verl-ingerungsosteotomien. Orthop 1990;128:90 
    24. Stelnicki EJ, Hollier LH, Lee, C, Lin, WY, Grayson B, McCarthy JG: Distraction osteogenesis of costochondral bone grafts in the mandible. Plast Reconstr Surg 2002;109:925 
    25. Hughes TH, Mafulli N, Green V, et al.: Imaging in bone lengthening. Clin Orthop 1994;308:50 
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    27. Bail H, Windhagen H, Kolbeck S, et al.: Ultrasound measurements is a strong predictor of torsional bone regenerate stiffness in distraction osteogenesis, Orthopaedic Research Society, San Francisco, CA (1997) February 9-13, Presented at the 43rd Annual Meeting 
    28. ILizarov GA, Soybelman LM: Some clinical and experimental data on the bloodless lengthening of lower limbs. Exp Khir Anes 1969;4:27 

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