1. Introduction : 개방형 비성형술은 직접적인 비소주에 대한 접근으로 진단과 기술상의 장점으로 인하여 과거 수년간 의심의 여지 없이 사용되었으며 또한 비익 연골을 쉽게 사용할 수 있어서 대부분의 경우에 사용되어져 왔다. 그러나 비개방형에 비해 개방형 비성형술의 경우 콧구멍과 비첨부의 비대칭 및 비익부의 길어짐 등의 불만을 호소하는 경우가 많았다. 그러나 개방형 비성형술의 경우 아직도 접근의 용이성 및 대칭성으로 많이 사용되고 있다. 2. Material & Methods : 이에 서울대학교 구강악안면외과에서 1999년부터 2001년까지 개방형 성형술을 시행 받은 환자를 대상으로 술후에 비익과 비첨부의 대칭 및 비공의 크기 정도를 평가해보고 개방형 비성형술의 좋은 결과에 대해 논해보고자 하였다. 3. Resulo : 술 후 환자의 만족도는 높은 편이었으나 양측의 대칭 정도에서는 조금씩 차이를 보여 비첨은 대개 이환측으로 변위되어 있었으며 비공의 크기에서도조금씩 차이를 나타내었다. 4. Conclusion : 지금까지는 주로 비순부의 평균치나 성장 방향을 연구하는데 주로 계측치들이 이용되었던 반면, 수술 후 일어날 수 있는 비부의 변화앙상을 나타내는 데에는 부족한 점이 많았고 특히 구순 구개열 환자에서 연령, 성별에 따른 표준자료의 부족으로 형태학적인 비교 연구 및 표준자료가 부족하였다. 따라서 이번 연구에서는 구순 구개열 환자의 술 전 및 술 후 의 변화 양상을 파악하는데 도움이 될 만한 차트를 만들었고 변화양상을 연구하는데 도움이 될만한 자료를 제시하는 바이다.

상악골의 열성장과 횡적 부조화, 그리고 광범위한 치조열 및 구강상악동 누공의 치료에 있어서 기존의 방법에 비해 골신장술을 사용하였을 경우, 본 증례들과 관련 문헌 고찰을 통하여, 견인량의 충분한 확보 및 회귀율의 최소화를 얻을 수 있으며, 또한 입원가료기간의 감소와 연조직 부조화의 해결을 볼 수 있어 구순구개열에 관련된 상악골 변형의 치료에 골신장술이 유용한 치료법이라 생각되어 보고한다.

The facial cleft and duplicated maxilla are lire congenital anomaly. After Rushton and Walker had reported a unilateral facial cleft with excess tooth and bone formation in 1937, few authors described similar cases. The etiology of this anomaly is not well understood, but considered embryologically as a neurocristopathy. A neurocristopathy is defined as a condition arising from aberrations in early migration, growth and differentiation of neural crest cells. This aberrations result in facial malformation such as facial clefts and loss or duplication of facial structures. We experienced a male newborn baby with bilateral facial cleft and duplicated maxilla. The cleft was surgically corrected when he was 5 months old. The function and appearance of lip are improved. Duplicated maxilla will be surgically removed. We report this case with review of literatures.

In alveolar deformity of cleft patient, the flap design is very important to make the functional and esthetic outcome. Especially in bilateral cleft alveolus with wide defect, deficiency of covering tissue is a greatest problem. Wound dehiscence may develop oronasal fistula of palatal and labial region and loss of the bone graft. We report 2 cases with bilateral cleft alveolus. In both case, bilateral buccal mucosal flap was used for closure of bilateral cleft alveolus with wide defect. The one was operated with iliac bone graft according to secondary grafting method, the other was closed without bone grafting. The patient was 3 years old. So, secondary alveolar bone graft will be required some years later for the establishment of bony continuity and esthetic advantage. In both cases, we found the entire soft tissue closure without the lack of covering flap. In these case, the closure of alveolus defect was accomplished successfully by the use of bilateral buccal mucosal flap. There was no complication, secondary fistula. The most important thing is the tension-free closure of the bilateral buccal mucosal flap. So, we report these cases with literatures.

Velopharyngeal incompetence(VPI) is that soft palate and muscle of posterolateral pharyngeal wall can not close velopharyngeal port properly. Thing that prior to treatment for patient with VPI is to evaluation about nasopharyngeal closing function. This data is important for making a treatment plan and assesment of treatment effect to improve nasopharyngeal closing function. There are two ways of VPI assessment. The one is subjective method by auditory finding, the other is objective method by using equipment for language test. Using only subjective way is not adequate for evaluation of VPI because of low trust, so doing both two methods simultaneously help to make a diagnosis and assessment exactly. CPAP is effective method to treat hypernasality. This new treatment technique intensify oropharyngeal muscle for nasopharyngeal closing by direct resistance training. Becase conventional treatments have limitation, so many research about treatment effectiveness of CPAP are being studied. This study aims that we compare our result from Korean VPI patients with result about treatment effect in other advanced country, to make CPAP Treatment Questionares and to find ways that improve oropharyngeal closing function an[1 maximally increase language treatment effect.

Velopharyngeal Insufficiency(VPI); the failure of velum, the lateral wall and the posterior pharyngeal wall to separate the nasal cavity from pharyngeal cavity during speech, can be caused by congenital conditions include cleft palate, submucous cleft palate and congenital palatal insufficiency. Speech problems of VPI are characterized by hypernasality, nasal air emission, increased nasal air flow and decreased intelligibility. These speech problems of VPI can be treated with the surgical procedure, the application of temporary prosthesis and speech therapy. Biofeedback technique with Nasometer is a speech treatment method of VPI that commonly used as one component of a comprehensive procedure for improvement of speech in patients with VPI. In this article describes a case of VPI treated by biofeedback technique with Nasometer; which showed satisfactory result in nasalance and formant analysis after the speech therapy during 9 months.