통합 검색 | Korea Science

구순구개열 환자의 이비인후과적 관리 (Otolaryngologic Management related with Cleft Lip & Palate)

최홍식
- 대한구순구개열학회지
- /
- 제10권1호
- /
- pp.33-38
- /
- 2007
Team approach for the management of cleft lip & palate patients is very important. Plastic surgeon, oral-maxillofacial surgeon, orthodontist, otolaryngologist, and speech therapist should be included in the team. Main role of the ENT surgeon may be variable and is up to the team characteristics. Main topics of ENT surgeons' interesting fields are evaluation and management of hearing impairment due to SOM, voice disorder, and velopharyngeal incompetency due to submucous cleft palate & still remained VPI after curative palatoplasty. Basic review of anatomy & physiology related with otolaryngologic aspect of velopharyngeal system was done. Diseases related with hyponasality as well as hypernasality were discussed. Diagnostic and therapeutic methods were discussed. Proper management of hearing impairment and speech disorders are important.
PDF

삼각피판법을 이용한 편측 불완전 구순열 환자의 구순 교정 수술-증례 보고 (Repair of the Cleft Lip using Triangular Cheiloplasty-A Case Report)

송인석;홍종락;정필훈;서병무
- 대한구순구개열학회지
- /
- 제10권2호
- /
- pp.67-74
- /
- 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.
PDF

일측구순열비변형에서 물갈퀴일측지Z성형술을 이용한 외비공과 비주의 재건: 사진계측학적 연구 (Web Uni-Limb Z-Plasty for Correction of Alar Web Deformity in Unilateral Cleft Lip Nasal Deformities: Photogrammetric Analysis)

한기환;김대진;박무식;김준형;손대구
- Archives of Plastic Surgery
- /
- 제38권6호
- /
- pp.740-746
- /
- 2011
Purpose: In the treatment of the unilateral cleft lip nasal deformities, the correction of the low-nostril height and short-columella are very difficult problems. We report the treatment outcomes of web uni-limb Z-plasty used for correction of unilateral cleft lip nasal deformities by using photographic analysis. Methods: A total of 36 patients with unilateral cleft lip nasal deformities were enrolled in this study, who underwent web uni-limb Z-plasty and were followed up for at least 6 months. First, a triangular flap was made on the medial side of alar-columella web. The nostril apex of cleft side was corrected to a higher point compared to noncleft side by 2 mm. The flap was transposed into the defect of the vestibule. To reduce the bulging of the flap, horizontal cinching sutures were added. Postoperative outcomes were evaluated by using photographic analysis. 2 indices and 1 angle were measured on their photographs taken before and after the surgery. Symmetry was also evaluated by means of the noncleft side to cleft side index. For anthropologic assessment, observers described postoperative outcomes, using Ordinary Scale Method. Results: The postoperative values obtained in photographic analysis improved compared to preoperative ones. More improving anthropologic assessment was shown in post-than pre-operative. Conclusion: Although, further long term follow up is needed, we found this technique to be an effective procedure to the symmetry of nostril apex level and the lengthening of columella in the unilateral cleft lip nasal deformities.
PDF KSCI

구개열 환자의 치조열 골이식의 평가 (Evaluation of an Alveolar Bone Graft for Cleft Patients)

노량석;김종배;진병로;권대근;이상한
- Maxillofacial Plastic and Reconstructive Surgery
- /
- 제33권4호
- /
- pp.314-318
- /
- 2011
Purpose: The purpose of this study is to evaluate the results of alveolar bone grafting in patients with various types of cleft lip and to compare the success rates according to the lateral incisors and canines. Methods: The postoperative radiographs of 20 patient with a cleft lip and alveolar process alone (CLAP), complete unilateral cleft lip and palate (UCLP) and complete bilateral cleft lip and palate (BCLP) were retrospectively analyzed. The alveolar bone height was classified according to ${\AA}$byholm (1981) and Bergland (1986) and we evaluated the dentition at the time of surgery and the existence of a lateral incisor and impacted canines. Results: 16 (80%) of the 20 patients were assigned to Type I & II and they were considered successful. In the UCLP group, the success rate was significantly better than that of the UCLP and BCLP groups. The success rate was significantly better than when the cleft was grafted with the existence of a lateral incisor and before the eruption of the canines. Conclusion: The severity of the deformity influenced the success rate. The timing of the operation was a critical variable that affected the outcome in patients with cleft lip and palate.
PDF KSCI