• Title/Summary/Keyword: Cleft Lip

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A CEPHALOMETRIC STUDY ON THE POSITION OF THE HYOID BONE IN CLEFT LIP AND PALATE INDIVIDUALS (순구개열자의 설골 위치에 관한 두부방사선 계측학적 연구)

  • Cho, Il Je;Rhee, Byung Tae
    • The korean journal of orthodontics
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    • v.20 no.1
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    • pp.197-207
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    • 1990
  • This comparative study was undertaken to investigate the position of the hyoid bone in unilateral cleft lip and palate individuals. The materials for this study consisted of 35 subjects with surgically repaired unilateral cleft lip and palate (25 males, 10 females) and 40 subjects with normal facial morphology (20 males, 20 females). Cephalometric measurements of unilateral cleft and palate individuals were compared with those of non-cleft individuals. The conclusions of this study were obtained as follows: 1. To the anterior cranial base, the hyoid bone in unilateral cleft lip and palate individuals was located downward as compared with non-cleft individuals. 2. To the mandible, the hyoid bone in unilateral cleft lip and palate individuals was located backward as compared with non-cleft individuals. 3. The distance between the dorsum of the tongue and the inferior border of the hard palate in unilateral cleft lip and palate individuals was longer than that in non-cleft individuals. 4. Unilateral cleft lip and palate individuals showed no significant difference in the distance between the hyoid bone and the dorum of the tongue as compared with non-cleft individuals.

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Epidemiology of cleft lip and palate charity mission surgery at Bandung Cleft Lip and Palate Center, Indonesia: a 14-year institutional review

  • Ali Sundoro;Dany Hilmanto;Hardisiswo Soedjana;Ronny Lesmana;Selvy Harianti
    • Archives of Craniofacial Surgery
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    • v.25 no.2
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    • pp.62-70
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    • 2024
  • Background: The management of cleft lip and palate aims at improving the patient's aesthetic and functional outcomes. Delaying primary repair can disrupt the patient's functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. Methods: This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. Results: In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). Conclusion: Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.

Gene Targeting Mouse Genetic Models for Cleft Lip and Palate (구순구개열 발생의 분자유전학 연구를 위한 유전자 표적/적중 생쥐모델의 이용)

  • Baek, Jin-A
    • Korean Journal of Cleft Lip And Palate
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    • v.11 no.2
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    • pp.65-70
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    • 2008
  • Cleft lip and/or palate are common birth defects in humans and the causes including multiple genetic and environmental factors are complex. Combinations of genetic, biochemical, and embryological approaches in the laboratory mice are used to investigate the molecular mechanisms underlying normal craniofacial development and the congenital craniofacial malformations including cleft lip and/or palate. Both forward and reverse genetic approaches are used. The forward genetic approach involves identification of causative genes and molecular pathways disrupted by uncharacterized mutations that cause craniofacial malformations including cleft lip and/or cleft palate. The reverse genetic approach involves generation and analyses of mice carrying null or conditional mutations using the Cre-loxP mediated gene targeting techniques.

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Revisited Straight Line Technique for Unilateral Cleft Lip (구순구개열 환자에 있어 직선봉합법의 역할)

  • Seo, Byoung-Moo
    • Korean Journal of Cleft Lip And Palate
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    • v.11 no.1
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    • pp.31-36
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    • 2008
  • The variations of cleft lip deformities imposed the difficulty to the surgical correction for them. Straight line technique for cleft lip surgery has been ignored quite long since other techniques were developed. Initially the straight line technique was introduced and widely accepted because it is simple and easy to perform during the period of no adequate anesthetics. But it was abandoned for its several shortcomings such as tighten lip, vermilion notching, anatomical distortion, and wound contractures. Recently, some groups advocated the usefulness of straight line technique which has a significant modification from its original form. Additionally the variable degree of cleft lip deformity allows simple straight line closure for those patients. Here a case of simple straight line technique was presented and discussed for its reliability and plausible results as well.

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A STUDY ON THE MAXILLARY DENTAL ARCH AND PALATE OF UNILATERAL CLEFT LIP AND PALATE INDIVIDUALS (편측성(片側性) 순(脣), 구개열자(口蓋裂者)의 상과치열궁(上顆齒列弓) 및 구개(口蓋)에 관(關)한 연구(?究))

  • Son, Woo Sung;Yang, Won Sik
    • The korean journal of orthodontics
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    • v.14 no.1
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    • pp.115-125
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    • 1984
  • A comparative study was undertaken to investigate the collapse of maxillary dental arch and palate in unilateral cleft lip and palate individuals. The material for this study consisted of 39 subjects with repaired unilateral cleft lip and palate (30 males, 9 females). The measurements of unilateral cleft lip and palate individuals were compared with the measurements of normal individuals (30 males, 30 females). All the subjects were in the mixed dentition stage and the mean age was almost the same. The following conclusions were obtained. 1. A large number of the maxillary dental arch of the unilateral cleft lip and palate individuals showed ${\Omega}$-shape, and the arch length was shorter than that of normal individuals. The intermolar width did not show significant difference between cleft group and group, but the intercanine width was mcuh smaller than that of normal individuals. 2. The palate of the unilateral cleft lip and palate subjects showed shorter and shallower form than that of normal subjects. 3. The palatal area of the unilateral cleft lip and palate subjects was smaller than that of normal subjects, and the cleft side area was much smaller than the opposing side area. 4. There was no significant sexual difference in measurements of maxillary dental arch and palate of the unilateral cleft lip and palate subjects.

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Correction of Upper Lip Depression Using Conchal Cartilage Graft in Unilateral Cleft Lip Deformity (일측구순열변형에서 이갑개연골이식술을 이용한 상구순 함몰의 교정)

  • Han, Ki-Hwan;Yun, Sang-Ho;Yeo, Hyun-Jung;Kim, Jun-Hyung;Son, Dae-Gu
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.383-390
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    • 2011
  • Purpose: To correct the upper lip depression after the correction of unilateral cleft lip, autologous grafts such as bone, dermal, fascial grafts and fat injections or alloplastic implants are used. Transplanted bones, dermis and fascia have a tendency to be absorbed and have donor morbidity. Fat injections are absorbed inconsistently and alloplastic implants have problems such as foreign body reactions, protrusions and infections. Authors corrected the upper lip depression using conchal cartilage graft in unilateral cleft lip deformity and the results was analysed with photos. Methods: 26-unilateral cleft lip and 2-microform cleft lip cases, totally 28 cases were performed. Their mean age was 21.89 years. The male and female cases were 12 and 16, respectively. Under anesthesia (general: 18 cases and local: 10 cases), cavum conchae (n=8), cymba conchae (n=16) and whole conchae (n=4) were harvested. Transversely cut the margin of the obtained cartilage, we cut out the most bent portion and put a partial-thickness incision on concave surface in cases of excessive convexity. Then, we performed the onlay graft of the conchal cartilage via scar revision site in unilateral cleft lip and via the reconstruction site of the cupid bow in microform cleft lip. The augmentation of the upper lip was evaluated with photos. Adapting the baseline connecting between the both cheilions as a horizontal standard line, we measured the highest point among the tangents between the upper lip and nose (point a), the lowest point (point c), the middle point between a and c (point b) and the vertical line from the alare (point d) to the horizontal standard line. To assess the postoperative symmetry, we compared cleft side upper lip contour index (%) A,B,C,D=(a,b,c,d)-ch ${\times}$ 100/(ch-ch) and non-cleft side upper lip contour index (%) A',B',C',D'= (a',b',c',d')-ch ${\times}$ 100 / (ch-ch).h) Results: After the surgery, no complication was found except in one case which double layers graft performed in the cleft lip deformity, the lateral portion was protruded. The upper lip contour index, the difference of A and A' were-0.83%, and thus the mild depression was persisted. Difference of B and B', C and C', D and D' were 0.83%, 1.07%, 0.90%. There were statistically significant difference, and thus the depression of upper lip were improved generally. Conclusion: Authors performed the onlay graft of the conchal cartilage in unilateral cleft lip deformity and found that the depression of the upper lip was well corrected except the uppermost part when photogrammetrically analyzed.

Prenatal Diagnosis of Accompanying Alveolar Cleft and Cleft Palate in Fetuses with Cleft Lip Using Prenatal 3D Sonographic Identification and Antenatal Counseling (구순열 태아에서 3D 산전 초음파를 이용한 치조열 및 구개열의 동반 유무 진단 및 산전상담)

  • Koh, Kyung Suck;Kim, Hoon;Choi, Jong Woo;Won, Hye Sung;Kim, Sun Kwon
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.181-185
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    • 2007
  • Purpose: Cleft lip and/or palate is the most common congenital facial anomaly whose incidence is about 1 in 500~1000 live births. As this anomaly may be associated with the serious chromosomal anomalies or the multiple organ abnormalities resulting in the fetal loss or perinatal maternal morbidity and mortality, careful prenatal counseling with early and accurate detection is important. Although conventional prenatal ultrasound(US) examination in midterm pregnancy has been applied for screening of cleft lip, there are definite limitations in the diagnosis of accompanying cleft palate or alveolar cleft. We applied high-resolution 3D US along the serial axial, coronal and sagittal plane so that we could diagnose the cleft palate and/or alveolar cleft in fetuses with cleft lip. Methods: From May 2005 to September 2005, 20 fetuses with cleft lip were examined with prenatal 3D US. Average maternal age was 28.8 years old(24-35 years old), and average gestational age was 24.8 weeks(17.6 to 34.2 weeks). Consecutive axial, coronal and sagittal multislice view were obtained via prenatal 3D US examination and diagnosis of cleft palate and/or alveolar cleft in cleft lip fetuses was followed. Results: With noninvasive and safe prenatal 3D US examination, 17 of 20 cleft lip fetuses were demonstrated to have cleft palate and/or alveolar cleft. Prenatal counseling according to the result was made. Conclusion: Existing prenatal US examination is suitable for screening the cleft lip fetuses but has limitation in identifying the related existence of cleft palate and/ or alveolar cleft. Authors verify the presence of cleft palate and/or alveolar cleft acquiring the successive multislice axial, coronal, and sagittal view with prenatal 3D US examination. Therefore, prenatal 3D US examination could be regarded as a noninvasive and secure screening modality in fetuses with cleft lip for confirming whether cleft palate and/or alveolar cleft is accompanied.

THE USE OF CLASSIFICATION IN PRIMARY AND SECONDARY CLEFT LIP AND NOSE DEFORMITIES IN MEDICAL RECORDS (구순구개열 환자의 의무기록시 분류법의 도입)

  • ChoiI, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.198-204
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    • 1999
  • The treatment of cleft lip and palate patients requires multidisciplinary coorperation, and the involved clinicians rely on the completeness and accuracy of the patient's medical records in developing comprehensive treatment plans. There are so many classifications in cleft lip and palate but each classification has advantages and disadvantages. Furthermore there are few classification or assessment in secondary cleft lip and palate deformities. A modification of Kenahan's Y classification in primary cleft lip and palate and new classification in secondary cleft lip and palate deformities are proposed as a simple and reproducible method. These reproducible classification may be used to facilitate not only storing and analyzing of medical informations in computer but also the planning of secondary repairs

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A comprehensive review of surgical techniques in unilateral cleft lip repair

  • Tae-Suk Oh;Young Chul Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.3
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    • pp.91-104
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    • 2023
  • Unilateral cleft lip is a common congenital anomaly that affects the appearance and function of the upper lip and nose. Surgical repair of cleft lip aims to restore the normal anatomy and functionality of the affected structures. In recent years, several advances have been made in the field of cleft lip repair, including new surgical techniques and approaches. This comprehensive review discusses the surgical management of patients with unilateral cleft lip and palate and provides step-by-step instructions for the surgical procedures.