• Title/Summary/Keyword: 기형교정

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The study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital during last 11 years (1988.3-1999.2) (최근 11년간 서울대학교병원 교정과에 내원한 순구개열 환자의 내원 현황에 관한 연구(1988.3 - 1999.2))

  • Yang, Won-Sik;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.467-481
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    • 1999
  • Cleft lip and/or palate is one of the most common congenital craniofacial anomalies. According to previous epidemiologic studies, incidence of cleft lip and/or palate has been increasing nowadays. However, there is no report about epidemiologic study of cleft lip and/or palate patients who visited dept. of orthodontics in Korea. So the purpose of this study was to provide the epidemiological characteristics and important basic clinical data for the diagnosis and the treatment of the cleft lip and/or palate patients. With the orthodontic and cleft charts, diagnostic models and X-ray films from 250 patients with cleft lip and/or palate who visited Dept. of Orthodontics, Seoul National University Dental Hospital during the last 11 years, the authors investigated patient's visiting yew, types of cleft, patient's gender, and Angle's classification of malocclusion, and surgery timing. The results were as follows ; 1. The number of cleft patients who visited Dept. of Orthodontics, SNUDH increased during 1988-1990 and then it declined until 1992. From 1993 to 1996, it showed a stationary trend. After 1997 it showed an overwhelmingly increasing trend. 2. In the cleft type, the ratio of cleft lip cleft lip and alveolus cleft palate : cleft lip and palate was 7.6:19.2:9.6:63.6. In cleft position, unilateral clefts were more than bilateral ones (cleft lip 79:21, cleft lip and alveolus 77:23, cleft lip and palate 75.5:24.5). In cleft side, left clefts were mote than right clefts (cleft lip 53.3:46.7 cleft lip and alveolus 59.5:40.5, cleft lip and palate 59.2:40.8). 3. In gender ratio, males were more than females in cleft lip (57.9:42.1), cleft lip and alveolus (68.8:31.2) and cleft lip and palate (76.1:23.9). But in cleft Palate females were more than males as 41.7: 58.3. 4. In the age groups, 7-12 year group was the most abundant as $52\%$, and then 0-6 year group ($20.4\%$), 13-18 year group ($17.2\%$), more than 18 yew group ($10.4\%$) were followed as descending order. 5. Most of the cleft lip repair surgeries were operated in 0-3 month ($60.3\%$) and 4-6 month ($17.9\%$). 6. The cleft palate repair surgeries were done in 1-2 year ($31.7\%$), 0-1 year ($25.6\%$), 2-3 year ($12.1\%$), more than 5 year ($11.6\%$) as descending order. 7. The lip scar revision surgeries were done before admission at elementary school in $60\%$. (4-6 you ($27.5\%$), 6-8 year ($19.6\%$), more than 10 year ($19.6\%$), 2-4 year ($13.7\%$) as descending order) 8. The rhinoplasties were done before admission at elementary school in $51.7\%$. (0-2 year ($7.1\%$), 2-4 year ($14.3\%$), 4-6 year ($21.4\%$), 6-8 year ($14.3\%$)). 9. The pharyngeal flap were done at 6 Y (72.5 months) after birth on average and there was even distribution of surgery timing. 10. In relationship between Angle's classification of malocclusion and cleft types, Class I was most abundant and Class III, Class II were followed as descending order in cleft lip group. But Class III was most abundant and Class I, Class II were followed as descending order in cleft lip and alveolus group, cleft palate group, and cleft lip and Palate group. The percentage of frequency in Class III malocclusion was overwhelmingly higher in cleft lip and palate group than any other groups. 11. Because the frequency of class III malocclusion was most prevalent in all age groups, anterior crossbite was the most common chief complaint of cleft patients.

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A National Survey for Korean Orthodontic Residents about a Present Condition in Management and Training Program for Cleft and Craniofacial Patients (구순구개열 및 두개안면기형 환자의 진료 및 교육현황에 관하여 치과교정과 전공의를 대상으로 한 기초설문 조사 결과)

  • Seo, Yu-Jin;Cho, Il-Sik;Baek, Seung-Hak
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.1
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    • pp.11-20
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    • 2012
  • A national wide survey was conducted to assess a present condition in management of cleft and craniofacial anomaly patients and training program of orthodontic residents in Korea. A questionnaire consisting of four categories and 19 question items was distributed to 131 residents of department of orthodontics of eleven dental university hospitals and nine medical university hospitals. The results were as follows:(1) 77.1% of residents are participating in treatment of cleft and craniofacial anomaly patients.(2) Only 47.3% of residents are willing to treat cleft and craniofacial anomaly patients in their future practice.(3) 64.9% of residents responded that they are currently treating one to ten cleft and craniofacial anomaly patients per resident.(4) Most university hospitals offer training programs focusing on embryopathogenesis, growth, and treatment, but training programs about speech and hearing, genetics, and psychosocial development are inadequate.(5) 37.4% of residents are willing to participate in fellowship program for cleft and craniofacial anomaly after finishing the training. Based on the results of this survey, the residents need motivation regarding treatment of cleft and craniofacial anomaly patients, and the educational programs need to be reinforced and reconstructed so that standardization among hospitals can be achieved.

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Treatment of Moderate Hallux Valgus with Proximal Chevron Metatarsal Osteotomy and Distal Soft Tissue Procedure (근위 중족골 갈매기형 절골술과 원위 연부조직 교정술을 이용한 중등도 무지 외반증의 치료)

  • Ahn, Jae-Hoon;Kim, Whoan-Jeang;Kim, Ha-Yong;Choy, Won-Sik;Kang, Sung-Il
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.39-44
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    • 2007
  • Purpose: The authors intended to analyze the operative results of moderate hallux valgus with proximal chevron metatarsal osteotomy and distal soft tissue procedure. Materials and Methods: Seventy feet of fifty-seven patients were followed for more than 1 year after the proximal chevron metatarsal osteotomy. The mean age was 47.2 years, and the mean follow up period was 2 years and 3 months. Clinically preoperative and postoperative AOFAS MP-IP scale and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. Results: Additional Akin osteotomy was performed 48 out of 70 feet. Clinically AOFAS MP-IP scale was increased from 60.4 points preoperatively to 89.8 points postoperatively. Ninety-four percents of the patients were satisfied with the results. Radiologically hallux valgus angle was decreased from $34.8^{\circ}$ preoperatively to $12.8^{\circ}$ postoperatively. The intermetatarsal angle was decreased from $15.7^{\circ}$ preoperatively to $8.0^{\circ}$ postoperatively. Hallux valgus interphalangeal angle was increased from $7.4^{\circ}$ preoperatively to $9.8^{\circ}$ postoperatively. There were 3 recurrences, 1 hallux varus and 3 minor wound infections. There were no nonunion or malunion of the 1st metatarsal. Conclusion: Proximal chevron metatarsal osteotomy with distal soft tissue procedure and additional Akin osteotomy appears to be safe and satisfactory procedure.

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ACUTE AIRWAY OBSTRUCTION IN AN INFANT WITH TREACHER COLLINS SYNDROME: REPORT OF A CASE (Treacher Collins 증후군 환아에서 급성 기도 폐색)

  • Ryu, Sun-Youl;Seo, Il-Young;Hwang, Ung;Kim, Sun-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.422-427
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    • 2004
  • Treacher Collins syndrome is inherited as an autosomal dominant trait with variable penetrance. It shows a marked variability even in the same family. This syndrome is developmental defect affecting the branchial arches. It is not usually associated with acute respiratory distress, but has symptoms of microtia, hypoplastic zygomatic bones, hypoplastic mandibular rami, and bilateral coloboma. It usually requires an emergency operation immediately after the birth. We experienced an infant with Treacher Collins syndrome who showed retrognathia, glossoptosis, microtia, and cleft palate. Intermittent cyanosis, depression of the chest, respiratory difficulty associated with airway obstruction, and swallowing difficulty were also observed. To relieve severe upper airway obstruction caused by retrognathia and glossoptosis, we simultaneously performed tongue-lip adhesion and subperiosteal release of the floor of the mouth. The respiratory and swallowing difficulties were relieved and the tongue repositioned anteriorly. We report the present case with a review of the literature.

A Case of Vascular Ring Associated with Tracheitis Due to Type b Haemophilus influenzae (헤모필루스 인플루엔자 기관염이 확인되면서 진단된 혈관륜 1례)

  • Kim, Su Hyun;Chung, Yoon Sook;Oh, Sung Hee;Kim, Nam Su;Kim, Hyuck
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.261-266
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    • 2002
  • Vascular ring, originating from abnormal regression of the aortic arch during fetal life, can cause prolonged and recurrent respiratory symptoms and dysphagia when the diagnosis is delayed. We report a 4 month old girl with vascular ring, who had been treated for persistent respiratory symptoms including stridor, wheezing, and dyspnea soon after birth. Initially her respiratory symptoms were thought to be due to bronchiolitis, for which respiratory syncytial virus was confirmed by immunofluorescent staining. Her clinical course was again complicated with tracheitis and pneumonia due to Haemophilus influenzae type b. The possibility of anatomical anomaly was investigated when it was felt to be difficult to insert a suction catheter deep down through a endotracheal tube which was placed for adequate ventilatory management. A three-dimensional chest CT revealed a vascular ring consisting of a double aortic arch. For 5 months following surgery, her respiratory symptoms have slowly been improving. She developed another episode of pneumonia which was milder than the one which occurred before the surgery.

Corrective Surgery of Congenital Cardiac Anomalies in the Noonan syndrome - Report of two cases - (Noonan 증후군에 동반된 심기형의 수술적 교정 - 2례 보고 -)

  • 이선희;이주현;심성보;박재길;곽문섭;김세화;오용석;윤호중;정욱성
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.552-555
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    • 2001
  • Noonan syndrome is characterized by a Turner-like phenotype and a normal karyotype associated with congenital abnormalities, such as short stature, variable mental retardation, hypertelorism, webbed neck, low posterior hair line, skeletal malformation and congenital cardiovascular defect. Two third of Noonan syndrome have cardiac anormalies, half with pulmonary stenosis. We have experienced two cases of pulmonary stenosis associated with other cardiac anomalies in Noonan syndrome. The first 31-year-old male patient had characteristic appearance of Noonan syndrome with severe infundibular pulmonic stenosis and patent foramen ovate. The second 28-year-old male patient had valvular and subvalvular Pulmonary stenosis with typical Noonan\`s face and stature. Pulmonary valvotomy and hypertrophied muscle bundles in the right ventricular cavity were resected in both cases. Patent foramen ovate was closed directly in the first case. Postoperative follow-up examinations revealed no symptoms and successful outcome.

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Congenital Thoracic Ectopic Kidney associated with Diaphragmatic Hernia in a 15-month-old Boy (선천성 횡격막 탈장과 동반된 이소성 흉강내 신장 1례)

  • Yang, Eu Jeen;Jeong, Yeon Jun;Hwang, Pyoung Han;Lee, Dae-Yeol;Kim, Min Sun
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.106-110
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    • 2014
  • Congenital thoracic ectopic kidney is a very rare developmental disorder and the rarest type of ectopic kidney. This condition is usually asymptomatic and detected incidentally on routine chest radiography. Most cases of thoracic ectopic kidney develop in adulthood and during the neonatal period, and congenital thoracic ectopic kidney rarely develops in children. Most patients are asymptomatic, and the treatment depends on the diagnosis. Herein, we report a rare case of ectopic thoracic kidney associated with a diaphragmatic hernia in a 15-month-old male infant, who presented with periodic severe irritability. The thoracic ectopic kidney was detected as a mass in the right base of the chest on routine chest radiography.

Reconstruction of Soft Tissue Deficit After Parotidectomy by Sternocleidomastoid Muscle Flap (이하선종양 적출술후 흉쇄유돌근을 이용한 함몰기형교정의 임상적 고찰)

  • Choi Hee-Yoon;Chung Hyo-Gyeong;Lee Young-Mann;Lew Jai-Mann
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.37-54
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    • 1987
  • The aim of surgery for all parotid masses is directed toward total removal of the tumor with adequate safe margins of adjacent normal tissue and preservation of the facial nerve whenever possible. Reconstructive procedures following parotidectomy for benign or low grade malignant lesions are most commonly necessary if soft tissue deficits appear at the angle of the mandible below the earlobe as a major cosmetic deformity. This is a report of Z4 cases with a diagnosis of parotid tumor who were treated using various surgical procedures at Department of Plastic and Reconstructive Surgery, Hanyang University Hospital over the period of 4 years from January, 1983 to December, 1986. Among 24 cases, 11 cases were reconstructed by Sternocleidomastoid muscle flap at the same time that extirpative surgery is outlined. The advantage of Sternocleidomastoid muscle flap is the coverage of the facial nerve, so adhesion between the facial nerve and skin was prevented. Absorption and loss of bulk was not found such as dermofat graft. It was a simple method. Neither donor site defect nor sternocleidomastoid muscle deformity was developed. Sternocleidomastoid muscle flap have been found satisfactory in maintaining filled-out soft tissue hollows with good result cosmetically and functionally.

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Acute Aortic Injury after Nuss Bar Removal -A case report- (너스바 제거 후 발생한 급성 대동맥 손상 -치험 1예-)

  • Lee, Yang-Haeng;Park, Jae-Min;Han, Il-Yong;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.868-871
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    • 2006
  • Nuss operation as a method for correction of pectus excavatum is safe and satisfactory, but its complication presents pneumothorax, displaced bar, wound infection, pericarditis, pleural effusion, hemothorax, cardiac injury etc. We report a rare case of acute ascending aortic rupture after displaced and adhered Nuss bar removal. The patient was a 30-years old man who received Nuss operation 3 years ago. Nuss bar was removed without resistance but massively bled at both operation wound, so immediately femoro-femoral CPB and median sternotomy was done and repaired proximal aortic arch under deep hypothermic total circulatory arrest. The patient was discharged without complication at postoperative 13 day.

A RETROSPECTIVE STUDY ON THE CLINICAL MANEFESTATIONS, ETIOLOGIC FACTORS OR SURGICAL CORRECTION METHODS OF THE MAXILLOFACIAL DEFORMITY PATIENTS (악안면 기형 환자들의 발현 양상, 원인 요소 및 외과적 교정 방법에 관한 역학적연구)

  • Hyeon, Chung-Hwan;Yim, Chang-Joon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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    • pp.233-242
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    • 1997
  • Recently the goal of orthognathic surgery has been focused on esthetic improvement of the patients. Also early corrective surgery was favorable selected by most of the oral and maxillofacial surgeons. We should consider the etiologic factor of the patient's dentofacial deformities when treatment is planned, because this is the major factor in estimating the predictability or stability of result. The more researches were carried on the etiologic factors of the dentofacical deformities, The more possibility of the early surgical correction will be increased. The authors analyzed about etiologic factors and epidemiologic studies of the forth patients who had received the orthognathic surgery. The analyzed results were as follows: 1. The predilection ration between male and female was 17:23, and 32 patients (80%) of 40 patients were aged twenties. 2. 26patients(65%) complained estetic problems as well as functional problems. 10 patients(25%) complained only esthetic problems, and 4 of 40 patients complained only functional problems. 3. Mandibular prognathism was found to be done most frequently(25, 39%). Facial asymmetry (13, 20%) and angle hypertrophy were found to be next in sequence. 4. Sagittal split ramus ostetomy was done most frequently(27, 35%). Lefort I osteotomy(13, 17%), angle reduction (12,16%), and genioplasty(11, 15%) were done also. 5. The number of the cases due to nonspecific etiologic factor was 22(55%), that of cases due to inhertied tendency was 12(30%), that of cases due to congenital anomaly was 3(7.5%), and that of cases due to trauma was 3(7.5%). 6. The number of patients who got only maxilliary surgery was 2(5%), that of patients who got only mandibular surgery was 23(57.5%), and that of patients who got simultaneous two jaw surgery was 15(37.5%).

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