• Proceedings of The Korean Cleft Lip And Palate Association
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• 2002.05a
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• pp.22-22
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• 2002

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.80-86
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• 2024

Background Among the cleft types, bilateral cleft lip and palate (BCLP) generally requires multiple surgical procedures and extended speech therapy to achieve normal speech development. This study aimed to describe speech outcomes in 5-year-old Korean children with BCLP and examine whether normal speech could be achieved before starting school. Methods The retrospective study analyzed 52 children with complete BCLP who underwent primary palatal surgery at a tertiary medical center. Three speech-language pathologists made perceptual judgments on recordings from a speech follow-up assessment of 5-year-old children. They assessed the children's speech in terms of articulation, speech intelligibility, resonance, and voice using the Cleft Audit Protocol for Speech-Augmented-Korean Modification. Results The results indicated that at the age of five, 65 to 70% of children with BCLP presented articulation and resonance within normal or acceptable ranges. Further, seven children with BCLP (13.5%) needed both additional speech therapy and palatal surgery for persistent velopharyngeal insufficiency and speech problems even at the age of five. Conclusion This study confirmed that routine follow-up speech assessments are essential as a substantial number of children with BCLP require secondary surgical procedures and extended speech therapy to achieve normal speech development.

• Journal of the korean academy of Pediatric Dentistry
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• v.11 no.1
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• pp.113-120
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• 1984

The author surveyed the tooth development of 50 cleft affected children(M: 34, F:16). The following results were obtained. 1. The difference between the chronologic age and dental age was 0.61 years in the cleft group and 0.15 years in the control group. The delay in tooth development was observed in the cleft group. 2, In the cleft group, there was no difference in the delay of tooth development between the boys and the girls. 3. In the cleft group, there was no difference in the delay of tooth development between the maxilla and the mandible. 4. The delay of tooth development was more severe in the bilateral cleft group than in the unilateral cleft group. 5. In the unilateral cleft, there was no difference in tooth formation between the cleft side and corresponding side.

• The Korean Journal of Pain
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• v.33 no.1
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• pp.81-89
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• 2020

Background: For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. Methods: Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 ㎍/kg dexmedetomidine (maximum volume 4 mL/side). Results: The modified children's hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. Conclusions: Addition of dexmedetomidine 0.5 ㎍/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.

• The Journal of the Korean dental association
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• v.9 no.9
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• pp.557-560
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• 1971

The authors had treated 27 cleft lip and cleft palate patients including 16 male patients and 11 female patients. There were 17 cases of unilateral cleft lip patients, 4 cases of bilateral cleft lip patients, and 6 cases with cleft lip and cleft palate patients. We had accomplished that the surgical plastic closures of cleft lips and cleft palates had been performed by using of Millard's, Hagedorn's, Meyer's, LeMesurier's, Wunderer's, Lindemann's methods and Veau's Method with Z-plasty.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.5.1-5.5
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• 2019

Background: The present study aimed to determine whether laypeople and professionals rate the facial appearance of individuals with repaired complete unilateral or bilateral cleft lip and palate (UCLP, BCLP) similarly based on viewing full facial images. Methods: The study followed a cross-sectional analytical design where five young patients aged 10 to 14 years, who had completed all stages of their unilateral or bilateral cleft lip and palate treatment (bilateral: three, unilateral: two), were evaluated by two groups. The assessment was done by laypeople and 97 qualified professionals (33 orthodontists, 32 plastic surgeons, and 32 oral and maxillofacial surgeons). Professionals were not involved in any stage of the patients' treatment. Results: The facial appearance assessment of the professional groups on different facial aesthetics was significantly lower than that of laypeople, and they had higher perceived need for further treatment. On the other hand, laypeople had higher aesthetic ratings and lower perceived need for further treatment. Differences were also observed between the assessments of the professional groups. Participants who had lower aesthetic assessments of the repair tended to report a higher influence of cleft lip and palate on social activities and professional life. Conclusion: Differences in perception exist between healthcare professionals and laypeople. The discrepancies between the professional groups could be attributed to different treatment modalities and protocols.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.400-406
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• 2017

Background The purpose of this study was to evaluate changes in nasal growth after the implementation of a preoperative nasal retainer in patients with bilateral incomplete cleft lip. Methods Twenty-six infants with bilateral incomplete cleft lip and cleft palate were included in the study. A preoperative nasal retainer was applied in 5 patients from the time of birth to 2.6-3.5 months before primary cheiloplasty. Twenty-one patients who were treated without a preoperative nasal retainer were placed in the control group. Standard frontal, basal, and lateral view photographs were taken 3 weeks before cheiloplasty, immediately after cheiloplasty, and at the 1- and 3-year postoperative follow-up visits. The columella and nasal growth ratio and nasolabial angle were indirectly measured using photographic anthropometry. Results The ratio of columella length to nasal tip protrusion significantly increased after the implementation of a preoperative nasal retainer compared to the control group for up to 3 years postoperatively (P<0.01 for all time points). The ratios of nasal width to facial width, nasal width to intercanthal distance, columellar width to nasal width, and the nasolabial angle, for the two groups were not significantly different at any time point. Conclusions Implementation of a preoperative nasal retainer provided significant advantages for achieving columellar elongation for up to 3 years postoperatively. It is a simple, reasonable option for correcting nostril shape, preventing deformities, and guiding development of facial structures.

• The Journal of the Korean dental association
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• v.12 no.3
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• pp.183-188
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• 1974

The authors had treated 68 case of cleft lip and cleft palate patients including 44 male patients and 24 female patients. There ware 55 cases of unilateral cleft lip patients and 13 cases of bilateral cleft lip patients, and 37 cases with together cleft lips and cleft palates among 68 cases were observed. We had accomplished that 'Plastic Cheiloplasty', surgical closures of cleft lips and cleft palates had been performed by using of Millard's, Hagedorn's, LeMesurier's and Veau's methods with Z-plasty.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.563-569
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• 2006

Purpose: In the correction of cleft lip, there have been various methods to minimize recurrence of the nasal deformity after primary nasal surgery. After cheiloplasty and primary nasal surgery, we tried to elongate the columella of the cleft side, to stretch the vestibular lining of cleft side, and to elevate the alar cartilage of the cleft side with a molding prong. Methods: We had fifteen cleft lip patients; 12 unilateral cases(6.3-8.2 months), and 3 bilateral cases(3 - 7.5 months). Immediately after primary repair of the cleft lip, the toboggan shaped molding prong was located to deep inside of vestibular web of the cleft side. It was persistently suspended by a silicone tube which was connected to the prong and the frontal scalp. The results were analyzed with $Photoshop^{(R)}$ photogrammetrically for 6 - 48 months with on average of 20.6 months. We measured the proportion index of columellar length-interalar distance for three times(preoperation, immediate postoperation, and postoperation) on the nasal base views. Results: In unilateral, the index had a significant increase statistically between preoperation(10.73) and immediate postoperation(23.96). It is supposed that columellar length was reconstructed to 105.80% of normal side. But, it was decreased to maintain 87.7% of normal side in postoperation(20.54). The results were similar in bilateral. The linear scars by suture penetrating nose skin were not discernable. Conclusion: In summary, placement of the molding prong could elongate the reconstructed columella with some relapse postoperatively.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.1
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• pp.11-22
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• 2005

There ate anteroposterior$\cdot$vertical maxillary underdevelopment, transverse maxillary deficiency and wide cleft alveolus$\cdot$oroanual fistula among cleft lip ant palate related maxillary deformities. For treatment of these deformities, ones have used conventional treatment methods, there were often unsatisfactory results to patients and operators both. Since llizarov introduced effective technique of bone lengthening and augmentation for a variety of limb defotmities, application of distraction osteogenesis on maxillofacial area has been used to solve those disadvantages of conventional methods. Authors introduced following three cases about use of distraction osteogenesis. The first case is the application of RED(rigid external distraction) II system for the treatment of the anteroposterior$\cdot$vertical maxillary hypoplasia after several times of surgery and end of development in bilateral cleft lip and palate patient. The second case is the application of the USPD(unilateral segmental palatal distraction) for the resolution of the unilateral posterior crossbite and transverse dental arch asymmetry after alveolorraphy in growing unilateral cleft lip and palate patient. The third case is the application of transport distraction osteogenesis far closure of the wide clef alveolus and oroantral fistula in growing bilateral cleft lip and palate patient. There were satisfactory results in these cases. Particularly, in comparison with the decreases of relapse rates, the reduction of the hospitalization time and post-operative discomfort owing to minimal surgical intervention.