• Title/Summary/Keyword: Cleft lip & palate

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Retinoic Acid Induces Abnormal Palate During Embryogenesis in Rat

  • Shin, Jeong-Oh;Park, Hyoung-Woo;Bok, Jin-Woong;Kim, Myoung-Hee
    • Biomedical Science Letters
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    • v.16 no.1
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    • pp.1-9
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    • 2010
  • In order to understand the effects of all-trans-RA on palate development, RA was injected into the abdominal cavity of pregnant mice and then the embryos were taken in the following days and analyzed morphologically as well as molecular biologically. When RA was administered at the stage of E11 or E15, the overall craniofacial development was retarded. The length from jaw to eye was shortened, compared to that of normal group. When the E11 embryos were exposed to RA, cleft lip was also found along with the cleft palate. In vitro palate culture experiment also revealed that RA caused cleft palate. When RT-PCR was performed, early stage administration of RA at E11 inhibited the upregulation of Hoxa7 expression at E15 through E17. Whereas in control group, high level of Hoxa7 expression was detected in the palate of E15 to E17. In the case of Bax, the expression was decreased from E16, while remaining constant in control group. When TUNEL analysis was performed following the RA treatment at E15, TUNEL positive cells were detected in the mesenchymal cells as well as epithelial cells of palatal shelves of E16 and in E17 embryos. Whereas in normal control, TUNEL positive cells were observed mostly at the epithelium around the nasal cavity and oral cavity where rugae is made. These results altogether indicate that exposure to RA during palate development causes facial deformity including cleft palate and cleft lip by modulating the expression of homeotic genes such as Hoxa7 as well as an apoptosis-related gene, Bax, and thus malregulating the apoptosis.

Correction of The Unilateral Cleft Lip Using Triangular Flap Technique - Report of cases - (삼각 피판법을 이용한 편측성 구순열의 교정 -증례보고-)

  • Lee, Ju-Hwan;Lee, In-Woo;Seo, Byoung-Moo
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.1
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    • pp.41-46
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    • 2009
  • Historically, various techniques to correct the deformity of lip and nose in functional and esthetic ways were developed and applied in dealing the patients with cleft lip. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation-advancement method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, triangular flap technique has its advantage in designing the flap using the patient's anatomic landmarks. It enables less skillful operator to perform this technique relatively easily and produce reasonable results. In this report we present 8 cases of unilateral complete cleft lip and 3 casesof unilateral incomplete cleft lip. They all underwent primary cheiloplasty based on triangular flap technique, and functional, esthetic outcomes were favorable.

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Effect of Presurgical Nasoalveolar Molding in Unilateral Cleft Lip and Palate Infants (편측성 구순구개열 신생아에 대한 술전비치조정형장치의 효과)

  • Kim, Jin-Sun;Kim, Young-Jin;Nam, Soon-Hyeun;Kim, Hyun-Jung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.3
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    • pp.209-215
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    • 2013
  • Cleft lip and palate, the most common craniofacial anomalies, are severe congenital defects that have an incidence of 0.28 to 3.74 per 1000 live births. Although there has been great improvement in the field of cleft surgery, surgical approach cannot be the single solution to resolve the various problems encountered in patients with cleft lip and palate. The concept of presurgical infant orthopedics (PSIO) for gradual closure of the cleft gap and simplified surgical performance was first introduced by McNeil in 1950. Recently, there are many attempts not only to approximate the alveolar segments but also to reshape the nasal cartilage. Three infants with unilateral cleft lip and palate were referred from the department of Plastic Surgery for presurgical nasoalveolar molding (PNAM). Maxillary appliances using resin with orthodontic wire were fabricated. Then these appliance was applied until patients underwent lip surgery. In all cases, the patients could wear the appliance all day since they were able to eat even with the appliance on, This resulted in significant improvements in the nasal symmetry were found. Our appliance, namely K-NAM, extends the wearing time within the limited period and as a result it is expected to maximize the treatment effects. Used properly, this appliance would play a major role in enhancing nasal symmetry with satisfactory results.

Prenatal Sonographic Diagnosis of Cleft Lip (구순열의 초음파 진단)

  • Seo, Mi-Hyun;Kim, Soung-Min;Oh, Jin-Sil;Myoung, Hoon;Lee, Jong-Ho;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.14 no.1_2
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    • pp.29-36
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    • 2011
  • The frequency of fetal malformations accounts for around 3-5% and evaluation of the health of the fetus and screening for fetal malformations has become an important part of prenatal care. Improvements in prenatal diagnosis have allowed identification of malformation in fetuses during first and second trimesters of pregnancy. Prenatal ultrasonography has become routine part of antenatal examination. For development of imaging, the accuracy of diagnosis is getting higher and earlier diagnosis of congenital malformation, such as cleft lip and palate, can provide to parent counseling, and opportunity to prepare the further treatment. For the better understanding of congenital cleft lip diagnosis to the oral and maxillofacial surgeons, as healthcare providers, we reviewed around 19 english-written articles and summarized some knowledges of ultrasound findings in the prenatal cleft lip fetus.

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Distraction Osteogenesis for Maxillary Hypoplasia in a Cleft Patient (구순구개열환자에서 골신장술을 통한 상악골 열성장의 치험례)

  • Kim Jong-Ryoul;Byun June-Ho;Jang Won-Seok;Jung Tae-Young;Son Woo-Sung
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.27-34
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    • 2003
  • Patients with maxillary hypoplasia secondary to cleft lip and palate present numerous challenging problems for the oral and maxillofacial surgeon, These patients present with maxillary hypoplasia in multiclimensions, and often have thin or structually weak bone. This deformity has been traditionally corrected by Le Fort I osteotomy and acute skeletal advancement with wide surgical exposure. The long-term results of cleft patients with maxillary deficiency treated with this traditional approach has been sometimes disappointing, and an increased relapse tendency has been reported, Distraction osteogenesis for these cleft patients offers successful results while potentially minimizing the risk of relapse. Advancing the maxilla via distraction forces requires only a minor surgical procedure that maintains vascularity and neurosensory integrity. Moreover, the response of the facial soft tissues during maxillary distraction has proven to be more favorable than with a conventional LeFort I osteotomy. The purpose of this report is to present the use of maxillary distraction osteogenesis by rigid external distraction (RED) system for the treatment of patient with maxillary deficiency secondary to cleft lip and palate.

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Cone-beam computed tomography assessment of mandibular asymmetry in unilateral cleft lip and palate patients (편측성 구순 구개열 환자의 하악 비대칭에 대한 cone-beam computed tomography를 이용한 평가)

  • Veli, Ilknur;Uysal, Tancan;Ucar, Faruk Izzet;Eruz, Murat;Ozer, Torun
    • The korean journal of orthodontics
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    • v.41 no.6
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    • pp.431-439
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    • 2011
  • Objective: To determine whether there is any difference between the cleft and non-cleft sides of the mandible in unilateral cleft lip and palate (UCLP) patients, or the right and left sides in control patients; and to determine if there is any difference between the mandibular asymmetry of UCLP patients and that of control patients. Methods: We examined cone-beam computed tomography (CBCT) scans of 15 patients with UCLP and 15 age- and gender-matched control patients. We evaluated 8 linear, 3 surface, and 3 volumetric measurements and compared the cleft/non-cleft sides of UCLP patients and the right/left sides of controls. Results: There were no statistically significant gender differences in any linear, surface, or volumetric measurement. The single significant side-to-side difference in UCLP patients was a longer coronoid unit on the cleft side than on the non-cleft side ($p$ = 0.046). Body volume was significantly lower in the UCLP group than in the control group ($p$ = 0.008). Conclusions: In general, UCLP patients have symmetrical mandibles, although the coronoid unit length is significantly longer on the cleft side than on the non-cleft side. UCLP patients and controls differed only in body volume.

The Diagnosis and Management of Velopharyngeal Insufficiency (연구개인두 폐쇄 부전 환자의 진단과 치료)

  • Lee, Yong-Kwon;Choi, Jae-Pyong;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.11 no.1
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    • pp.13-22
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    • 2008
  • Velopharyngeal insufficiency(VPI), characterized by hypernasal resonance and nasal air emission, is a speech disorder that can significantly compromise speech intelligibility. Cleft palate, previously repaired cleft palate and submucous cleft palate are associated with VPI. Less commonly, patients may acquire it after adenoidectomy with or without tonsillectomy or as a result of neuromuscular dysfunction. Comprehensive evaluation by a VPI team includes medical assessment focusing on airway obstructive symptoms, perceptual speech analysis, MRI and instrumental assessment. Options for intervention include speech therapy, intraoral prosthetic devices and surgery. Surgical methods can be categorized as palatal, palatopharyngeal or pharyngeal procedures. Each surgical approach has its strengths and limitations. Oro-maxillofacial surgeons are increasingly involved in the referral, evaluation, and treatment of velopharyngeal function. Therefore, understanding of physiology, anatomic structures, evaluation and treatment protocols in VPI is very important. This article presents protocol for evaluation of velopharyngeal function with a focus on indications for surgical interventions.

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