• Title/Summary/Keyword: Bilateral cleft

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CLINICAL STUDY OF AUTOGENOUS SECONDARY BONE GRAFTING IN CLEFT MAXILLA (구순구개열환자에서 자가입자망상골을 이용한 이차성 치조골이식에 관한 임상적 연구)

  • Kim, Jong-Ryoul;Jin, Sung-Jun;Cho, Yeong-Cheol;Pyo, Se-Jung;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.2
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    • pp.163-168
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    • 2001
  • Purpose : This study is conducted to evaluate the clinical success of secondary alveolar bone grafting using autogenous iliac particulate cancellous bone marrow in cleft maxilla. Materials and methods : We evaluated 107 cleft patients who had been admitted to the Dept. of Oral and Maxillofacial Surgery of Pusan National University Hospital from January 1, 1991 to January 31, 1999 and had been performed secondary alveolar bone grafting with autogenous particulated cancellous bone marrow from iliac crest. Results : 1. Men were 70 and women were 37, which shows 65.4% and 34.6% and the proportion of males to females was 1.9:1. Unilateral cases were 89(83.2%) and bilateral cases were 18(16.8%). 2. Age of bone grafting is widely distributed from 7 to 29, and the average was 13.2. 3. Success rate was 97.8% in unilateral cases, 94.4% in bilateral cases. Overall success rate was 96.7%. 4. We evaluated the bone graft contour by the percentage of bone attachment level adjacent to the alveolar cleft and the menial side showed 82.4% and the distal 87.7%. 5. The amount of notching the alveolar ridge at the grafted site through the ratio of notching length up to the most apical base to the length of proximal segment anatomic root was 0.19.

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CLINICAL STUDY OF CLEFT LIP AND CLEFT PALATE FOR 5 YEARS (최근 5년간 시행한 구순열 및 구개열에 대한 고찰)

  • Lee, Gi-Hyug;Yeo, Hwan-Ho;Kim, Su-Gwan;Kim, Su-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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    • pp.260-264
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    • 1997
  • The congenital deformities of cleft lip and cleft palate have been known to afflict man since prehistoric time. Efforts to correct these abnormities have evolved over the centuries as scientific knowledge has advanced. Although there is no agreement as to when the surgery should be performed, most surgeons adhere to "rule of 10" : the infant must be 10 week old weigh 10 Ibs, have a hemoglobin value 10gm/dl and have a white blood cell count no greater than 10 $thousands/mm^3$. Consensus favors performing initial palatal surgery in the child when he is between 18 and 24 months old. The timing of cleft alveolus surgery is usually between 10 and 11 years old. In the period from 1992 to 1996, 38 patients with cleft lip and cleft palate treated at the department of oral and maxillofacial surgery, Chosun university, dental hospital were analysed clinically. The obtained results were as follows. 1. The ratio of male to female was 1.92 : 1 (25/23) 2. The ratio of cleft lip, cleft palate and cleft lip & palate was 1.5 : 1 : 2.5 (12/8/18) 3. The ratio of unilateral to bilateral cleft lip was 5 : 1 (25/5) 4. The ratio of left to right side in unilateral cleft lip was 1.5 : 1 (15/10)

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RECENT TRENDS IN INCIDENCE AND MANAGEMENT OF CLEFT LIP AND PALATE (구순열과 구개열의 발생요인 및 치료 경향)

  • Yoon, Chun-Ju;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.4
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    • pp.295-309
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    • 2006
  • The present study was aimed to evaluate the incidence, etiological factors, and management of cleft lip and palate. Two hundred and twenty patients with cleft lip and/or cleft palate who were treated at Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, during the period between January 1994 and December 2003 were reviewed. The ratios of cleft lip : cleft lip with cleft palate : and cleft palate were 0.4:1.1:1. Males were more common than females in cleft lip (1.3:1) and cleft lip and palate (2.5:1), while females were more common than males in cleft palate (1:1.3). In the cleft side, left clefts were more prevalent than right clefts (cleft lip 1.3:1, cleft lip and palate 1.6:1). Unilateral clefts were more common than bilateral clefts in cleft lip (79:21). Cleft lip and cleft palate were more common in those with blood type A (34.5%) than those with other types. There was no significant relationship between birth season and frequency of clefts. The clefts were common in the first-born (48.8%), and in mothers aged between 25 and 29 (51.7%). Medication (24.7%) and stress (16.7%) during the first trimester were noted. Positive familial history was noted in 13 cases (5.9%). Thirty-two cases (15%) were associated with other congenital anomalies, in which tonguetie (40.6%) and congenital heart disease (21.9%) were most common. Among 100 patients with cleft palate, 77 patients had middle ear disease (77%), which occurred predominently in the incomplete cleft palate. Seventy-six among the 77 patients received myringotomy and ventilation tube insertion, and the remaining one received antibiotic medication only. Cleft lips were treated primarily at 3 to 6 months, and cleft palates were at 1 to 2 years. Treatment regimens included modified Millard method mainly in the cleft lip, and Wardill V-Y, Dorrance method, and Furlow method in the cleft palate. The percentage of palatal lengthening as type of cleft palate was greater in the incomplete cleft palate group (11.2%) than in the complete cleft palate group (9.6%). The percentage of palatal lengthening as operating method was no difference between the Furlow method (10.9%) and the push back method (10.7%). As postoperative complications, hypertrophic scar was most frequent in the cleft lip, and oronasal fistula in the cleft palate. In summary, it was shown that medication and stress during the first trimester of pregnancy were frequently associated with cleft lip and cleft palate, adequate timing and selection of method of operation are important factors to obtain morphologically and functionally good results. Furthermore prevention and treatment of middle ear disease are important in cleft palate patients because of its high co-occurrence.

EARLY ORTHOPEDIC TREATMENT IN CLEFT LIP AND PALATE PATIENT: A CASE REPORT (구순구개열 환아의 조기 악정형치료에 관한 증례)

  • Yoon, Tae-Won;Lim, Kwang-Ho;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.729-735
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    • 1996
  • Cleft lip and palate is the most common malformation in the craniofacial region. The patients with cleft lip and palate have functional problem such as, speech, feeding and respiratory as well as esthetic problem. So, treatment should be done by multidiciplinary team approach. The role of pediatric dentist in the team is advicement for feeding method, guidance of normal growth, caries control and preventive orthodontics. In cleft lip and palate patients, maxillary arch after cheiloplasty is usually collapsed by excessive tension of the scar. This collapse increase the difficulty of later orthodontic treatment. Therefore, the maxillary arch segments should be moved and retaind to normal position as soon as cheiloplasty is done to reduce the need and difficulty of orthodontic treatment. This concept is called by the early orthopedic treatment in cleft lip and palate. Also, this orthopedic appliance works as feeding applince to normal feeding and weight gain We reported two cases of early orthopedic treatment with favorable result in complete bilateral cleft lip and palate patients after cheiloplasty. Patients showed normal weight and their maxillary arch widths were increased.

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Double-layered reconstruction of the nasal floor in complete cleft deformity of the primary palate using superfluous lip tissue

  • Park, Young-Wook;Kwon, Kwang-Jun;Kim, Min-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.35.1-35.7
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    • 2015
  • After cleft lip repair, many patients suffer from nasolabial fistulas, asymmetrical nasal floor, or an indistinct nostril sill, as well as intraoral wound dehiscence and subsequent scar contracture of surgical wounds leading to vestibular stenosis. For successful primary nasolabial repair of complete cleft deformity of the primary palate, cleft surgeons need special care in reconstructing the sound nasal floor. Especially when the cleft gap is wide or when any type of nasoalveolar molding therapy was not performed, three-dimensional reconstruction of the nasal floor is critical for a balanced nasal shape. In this study, the author describes an effective method for reconstructing a double-layered nasal floor using two mucosal flaps from both sides of the fissured upper lip. This is a report of six patients with unilateral or bilateral complete cleft of the primary palate with a detailed description of the surgical technique and a literature review.

Congenital Cleft Lip Repair Based on Delaire Philosophy II: Functional Cheilo-rhinoplasty (Delaire 개념에 기반한 선천성 구순열의 치료 II: 기능적 구순비성형술)

  • Kim, Soung-Min;Seo, Mi-Hyun;Eo, Mi-Young;Lee, Suk-Keun;Myoung, Hoon;Lee, Jong-Ho;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.13 no.2
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    • pp.63-76
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    • 2010
  • After introduction of Delaire's basic philosophy, to consider the normal and pathologic anatomy, 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, on the Korean Journal of cleft lip and palate in 2009, Delaire's primary functional cheilorhinoplasty (FCR) in the unilateral and bilateral cleft lip patients was summarized and introduced according to already published literatures and lectures. This paper will be the second publishment of Delaire philosophy with Korean language.

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Late presenting bilateral squamosal synostosis

  • Diab, Jason;Anderson, Peter J.;Moore, Mark H.
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.106-108
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    • 2020
  • Premature fusion of one or other of the minor sutures can subtly influence the shape of the human skull. Although infrequently reported or not clinically recognized, it can such contribute to a variety of craniofacial dysmorphisms. We herein report a case of late presenting, isolated bilateral synostosis of the squamosal suture dysmorphologies whose presentation mimics aspects of sagittal synostosis.

Paraffinoma induced bilateral preauricular cheek skin defects

  • Heo, Jae-Woo;Kim, Baek Kyu
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.227-230
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    • 2018
  • "Paraffinoma" is a well-recognized complication of paraffin oil injection into various body parts for an aesthetic purpose. After a variable latency phase, paraffinoma can present as a wide range of clinical symptoms. This paper is a case report of surgical excision of the paraffinoma and subsequent reconstruction of the associated skin defect on bilateral preauricular cheeks, manifesting 50 years after a primary injection.

THE PREVALENCE OF CLEFT LIP AND/OR CLEFT PALATE IN KOREAN MALE ADULT (한국인 성인 남자에게 구순열 및 구개열의 유병률에 관한 연구)

  • Baik, Hyoung-Seon;Keem, Jae-Hoon;Kim, Dong-Jun
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.63-69
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    • 2001
  • Cleft lip and/or palate(CLP) is the most common congenital deformity in the craniofacial region. For a practical public health system for these patients it is necessary to have an understanding on the prevalence of CLP. However, it was difficult to estimate the exact number of CLP patients due to problems in sample selection, higher miscarriage and still birth rate, difficulty in classification, and adoptions to foreign countries. Therefore this study was to estimate the prevalence of CLP and the rate of orthodontic treatment, which is usually necessary in cleft lip and/or palate patients. The samples consisted of 218,322 Korean male adults from Seoul, Kwangju, Taegu and Pusan, all born in 1979. The screening method for recognizing the CLP patients was proceeded in steps and the results are as follows. 1. The prevalence of cleft lip and/or palate in Korean male adults born in 1979 was 0.65 out of the 1000 samples. 2. In the anteroposterior aspect of the 1000 samples, the prevalence of cleft lip, cleft lip and palate, and cleft palate was 0.26, 0.36 and 0.03 respectively. 3. In the transverse aspect of the 1000 samples, the prevalence of left, right and bilateral cleft was 0.35, 0.16, 0.12 respectively. The cleft in the left showed a much higher prevalence than in the rirht, while bilateral cleft showed a lower prevalence than unilateral cleft. 4. The orthodontic treatment rate of Korean male adults among cleft lip and/or palate Patients was $35\%$, and it was in the order of cleft lip and Palate, cleft lip, and cleft Palate, being $67\%,\;29\%\;and\;29\%$ respectively. The orthodontic treatment rate in patients with the more severe cleft lip and palate was higher than in patients solely having cleft lip or cleft palate.

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An epidemiologic study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Pusan National University Hospital (부산대학교병원 교정과에 내원한 구순구개열 환자들에 대한 역학조사)

  • Son Woo-Sung;Baek Jae-Ho;Lee Won-Chul
    • Korean Journal of Cleft Lip And Palate
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    • v.5 no.1
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    • pp.43-58
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    • 2002
  • A General survey on the cleft lip and/or palate patients in Pusan National University Hospital was done. The conclusions were as follow. 1. In gender ratio, male was higher than female. 2. In the cleft type, unilateral cleft lip and palate, cleft lip and alveolus, and bilateral cleft lip and palate in higher ratio order. Left unilateral cleft lip and palate was higher than right in ratio. 3. In first hospital visiting age for dental treatment, the group from 6 years old to 12 years old was most and in that the age group for attending elementary school (about 7-8 years old) showed especially higher ratio. The large majority of patient were born in 1980's and lived in Pusan metropolitan city, KyungSangNamDo. Especially, most of them lived in the neighboring Held of Pusan National University Hospital. 4. Class III skeletal pattern and Angle's Class III molar relationship was most prevalent. Angle's Class II molar relationship showed relative higher ratio because tooth loss and malposition. 5. Primary lip closure in 3 months, secondary lip closure in 6-7 years old, palatal closure in 12-16 months and bone graft in 8-10 years old were operated mostly. Rhinoplasty and scar revision were operated in too early age so the need of infantile orthopedics must be considered. 6. Maxillary expansion and protraction were operated mostly in 8-11 years old but operating in primary dentition must be considered. 7. Tooth alignment were started mostly in mixed dentition and consideration about prosthodontic treatment and retention will be need. 8. In tooth anomaly, tooth malformation and missing were most prevalent.

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