• 대한구순구개열학회지
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• 제10권2호
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• pp.67-74
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• 2007

After Tennison introduced a triangular flap method which, for the first time, preserved the Cupid's bow, Randall gave this method a sound mathematical basis. This method is also called as an inferior triangular cheiloplasty which is characterized by making a small triangular flap from the lateral border of cleft destined to be fitted into an incision on the medial side of cleft. He postulated that the height obtained was equal to the sum of the median of the two triangles used in the cheiloplasty. Using this technique, a 22 month-old male patient with incomplete unilateral cleft lip was corrected primarily. The deviation of the columella and flattening of the nostril on the cleft side were minimal. The operation was done under general anesthesia and patient was healed uneventfully. We tried to improve the symmetry and esthetic feature of philtrum, nostril sill, alar-facial groove, preventing the notch formation on the nostril floor, and to reconstruct the muscle sling in the upper part of lip. The shape of Cupid's bow was restored, and the symmetry of columella was regained as a result. In summary, the inferior triangular cheiloplasty is effective to correct the primary unilateral cleft lip, results in the restoration of favorable anatomy and function.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.353-360
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• 2009

양측 구순열의 코-입술 동시 수술의 원칙이 확립되었고 기법은 계속 진화하고 있다. 이에 따라 예전에 전형적으로 보이던 양측 구순열비의 오점들이 더 이상 명확히 보이지 않게 되고 있다. 외과의사들은 양측 구순열비 교정에 대한 원칙을 숙지하고 술전 악정형치료를 효과적으로 유도하고 성장이라는 4차원적 변화를 예견하는 3차원적 설계와 코-입술 동시 수술의 기법을 채득하여 환자를 치료하여야 한다. 또한 수술후 정기적인 관찰과 평가는 외과의사의 의무가 되어야 하고 문제가 분명해 질 때는 적절히 수정하여야 한다. 이번에 소개한 Mulliken의 치료법은 단순히 기법만을 중시하는 것이 아니라 원칙과 의무, 성장을 고려하는 4차원적 치료이다. 저자들은 이 치료법이 환자들과 외과의사들에게 많은 도움이 되기를 바란다.

• 대한구순구개열학회지
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• 제6권1호
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• pp.27-34
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• 2003

본 교실에서는 상악골의 열성장을 보이는 구순구개열환자에서 RED 장치를 이용한 골신장술을 통하여 상악골의 점진적인 전방이동을 실시하고 약 3년정도의 추시기간을 포함하는 현재까지 특별한 기능 장애없이 양호한상, 하악관계 및 안모를 보이는 증례를 문헌고찰과 함께 보고하는 바이다.

• 대한구순구개열학회지
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• 제8권1호
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• pp.11-22
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• 2005

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.

• 대한구순구개열학회지
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• 제5권2호
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• pp.95-108
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• 2002

언어 발달의 조기 단계를 이해하기 위한 일환으로 crying은 언어전 발달의 기초 단계로서 여러 학문적 분야에서 많은 연구가 있어왔다. 그러나 구순구개열(CLP))환아의 경우는cry-producing/control mechnism에 variation이 많은 이유로 이 분야의 연구는 거의 없는 실정이다. 이에 본 연구에서는 다음과 같은 의문점을 가지고 CLP환아의 cry feature에 대한분석을 하였다. 첫째, 정상아와 CLP환아의 cry에 전형적인 차이가 있는가? 둘째, CLP환아의 술전, 술후 cry feature에 변화가 있는가? 셋째, cry분석이 CLP환아의 이후 speech disorder에 대한 언어전 평가로서의 가치가 있는가? 넷째, 특정 parameter가 언어전 평가에 적절한 도구로 작용할 수 있는가? 생후 15개월 이내의 CLP 환아 3명과 유사한 나이대의 정상아 8명의 cry에 대한 공기역학 및 음향음성학적 분석을 통해 CLP 환아와 정상아, CLP환아의 술전, 술후 cry특성을 비교 분석하였다. 결과는 다음과 같다. 1 공기역학적 분석 1) airflow는 CLP 환아의 경우 정상아보다 약간 높았고 술 후 약간 증가하였다. 2)폐활량을 나타내는volume에서는 정상아보다 술전 CLP환자의 경우 보상적으로 더 큰 수치를 보였고 술후 약간 증가하였다. 3)강도를 나타내는 parameter(SPL)에서는 정상아 보다 술전 CLP환자의 계측치가 약간 작았으나 술 후 증가하는 양상을 보였다. 2. 음향음성학적 분석 1)기저 주파수 분석시 정상아에 비해 술 전 CLP환자의 경우 계측치가 약간 낮았으나 술 후 증가하여 정상군의 계측치에 근접하였다. 2)강도를 나타내는energy 측정시 정상아에 비해 술 전 CLP계측치가 보상성으로 약간 큰수치를 나타내었고 술 후 약간 더 증가하였다. 3) Shimmer에서는CUI환자의 술후계측치가술전에 비해 현저히 감소하여 정상군의 수치에 근접하였다.

• 대한구순구개열학회지
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• 제12권2호
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• pp.73-84
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• 2009

The treatment of cleft lip and palate must be based on a complete knowledge of the anatomy, physiology and growth of the involved deformity, because of not only the appearance but also impaired functions such as phonation, mastication, respiration and lingual posture of the maxillomandibular complex. Delaire has long studied all these aspects, and has published many numbers of articles and constructed a philosophy concerning the significance and interrelationship of the various structures. The results obtained from its application seem to be particularly valid from a clinical point of view, although it has not all been scientifically supported by experimental data. For these reasons, Delaire's primary unilateral and bilateral cheilorhinoplasty procedures are particulary good, as is his secondary gingivoalveoloplsty procedure during the course of the surgical repair of the hard palate. In order to understand Delaire's philosophy, it is necessary to consider the normal and pathologic anatomy of the structures involved in the deformity, the role of some structures, such as nasal septum, musculature, and tongue, and some functions, such as dental occlusion or nasal respiration, which play important roles in maxillary and particularly premaxillary growth. Despite of important concept and meanings, Delaire's philosophy has not been introduced widely to our Korean cleft surgeons yet. So authors will summarize the basic concepts of Delaire's philosophy according to already published literatures and lectures based on our previous treatment outcomes.

• 대한구순구개열학회지
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• 제15권2호
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• pp.61-68
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• 2012

Cleft lip and palate is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation advancement flap method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, Millard's rotation advancement flap method has its advantage in designing the flap using the patient's anatomic landmarks. For performing this rotation advancement technique, skillful operation is needed to obtain esthetically satisfactory results. Vomer flap sometimes is used to repair anterior hard palate in complete cleft lip and palate patients. Vomerine tissue is readily available in the vicinity of the palatal defect and elevation of the vomerine flap is relatively simple procedure. In this article, we will introduce the comprehensive vomer flap technique conjunction with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with Millard's rotation advancement method and vomer flap.

• 대한구순구개열학회지
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• 제10권2호
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• pp.81-88
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• 2007

Cleft lip and palate (CLP) is one of the most prevalent congenital craniofacial anomalies. It has a significantly greater incidence of dental abnormalities in number, size, shape, and eruption of the teeth. Knout-out mouse model can identify several genes which play an important role in tooth agenesis. Since disruption of these genes has been confirmed to result in tooth agenesis in humans, CLP associated with hypodontia may be the best models for isolated tooth agenesis. According to the studies of dental abnormalities in CLP, the severity of dental defect is known to be influenced by the CLP phenotype. The cumulative data obtained from mouse and human genetic studies indicated that MSX1, PAX9 and AXIN2 are considered as candidate genes in non-syndromic hypodontia, while Shh, Pitx2, Irf6, p63 and EDA pathway genes are involved in syndromic one. We expect that genetic approach of CLP can offer the basis for tooth regeneration and be a new target in hypodontia therapy.

• 대한구순구개열학회지
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• 제5권1호
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• pp.21-25
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• 2002

Cleft lip and palate are most common congenital deformity to affect the orofacial region. Cleft lip and palate are caused by abnormal development of primary and secondary palate. It's causative mechanism is not completely understood, but genetic and environmental factors play an important role. Many epidemiologic surveys have been done extensively about incidence, racial influence, sex ratio, parent age, associated syndrome, and genetic factors. These researches are useful to dissolve many problems in prevention and treatment of cleft lip and palate. We performed epidemiologic survey of cleft lip and palate who visited the department of Oral & Maxillofacial surgery, Guro Hospital of Korea University from 1995 to 2001.

• 대한구순구개열학회지
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• 제6권2호
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• pp.59-67
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• 2003

A cephalometric study was performed to reveal differences between skeletal Class III malocclusion patients and cleft lip and palate patients, The material for this study consisted of 16 males (mean age 19.8, range 17-29) and 9 females(mean age 19.4, range 16-27) with cleft lip and palate, and 222 Skeletal Class III malocclusion patients(males 106, females 116), Cephalometric tracing and measurements were done by one investigator. Results were followed: 1. Cleft lip and palate group had more retrusive maxilla than the skeletal Class III malocclusion group. 2, Cleft lip and palate group had smaller effective maxillary and mandibular length than skeletal Class III malocclusion group, and the difference was more prominent in the mandible than in the maxilla. 3. Dental compensation was not observed in the upper incisors of cleft lip and palate group and in the lower incisors it was smaller than skeletal Class III group. 4, In the Gonial angle and lower anterior facial height values, there was no significant difference between cleft lip and palate and skeletal Class III malocclusion group. These results can be used in orthodontic treatment planning and orthognathic surgery for the cleft lip and palate patients.