• 대한전기학회:학술대회논문집
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• 대한전기학회 2005년도 심포지엄 논문집 정보 및 제어부문
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• pp.45-47
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• 2005

Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity. Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed on quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three greatly experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis.

• 대한전기학회논문지:시스템및제어부문D
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• 제54권8호
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• pp.517-520
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• 2005

Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed at quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권5호
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• pp.230-236
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• 2014

Esthetic reconstruction of cleft lip nose deformity is a challenging task in surgical management of patients with orofacial cleft. The author reconstructed cleft lip nose deformity effectively using autogenous auricular cartilage and a relatively new graft material of porcine dermal collagen, $Permacol^{TM}$. After correction of the deformed lower third of the nose with patient's auricular cartilage, we applied $Permacol^{TM}$ to augment the entire nasal dorsum. Three patients were treated and followed for up to five years. All patients improved in nose aesthetics without any inflammatory or immunogenic reaction. The author suggests that the use of $Permacol^{TM}$ for nasal profile augmentation in the treatment of cleft lip nose deformity is an alternative surgical strategy with minimal surgical invasiveness. The author report long-term experience with combined use of auricular cartilage and $Permacol^{TM}$ in nasal reconstruction for cleft lip nose deformity.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.75-79
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• 2006

The upper and lower lateral cartilages provide the key to the lower cartilaginous portion of the nose. Lifting the cartilages is essential procedure for correction of unilateral cleft lip nose deformity. After correction of cleft lip nose deformity, authors used acoustic rhinometry (AR) to compare the lower nasal cavity of cleft side with non-cleft side. AR is a well known new, non-invasive diagnostic technique in which nasal geometry is assessed by means of acoustic reflection. From June 1996 to January 2004, we performed acoustic rhinometric analysis after correction of unilateral cleft lip nose deformity. This study involved 40 children of age ranged from 3 months to 8 years. Subjects were divided into the group of incomplete unilateral cleft lip nose deformity(20 subjects), and the group of complete unilateral cleft lip nose deformity(20 subjects). Results show that lower nasal cavity volume between non-cleft side and cleft side has no difference, and better results were obtained when nasal molding prong was applied at cleft side nostril. The results between incomplete type and complete type have no significant difference. In conclusion, AR is an effective method to calibrate cross sectional area and nasal cavity volume of unilateral cleft lip nose deformity, and furthermore effective in comparing the volume of cleft side with non-cleft side after unilateral cleft lip nose deformity correction with lifting the lower lateral cartilages to the upper lateral cartilages.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.702-706
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• 2009

Purpose: Analysis of lower nose and upper lip asymmetry in patients with unilateral cleft lip nose deformity has been proceeded through direct measurement and photo analysis. But there are limitation in presenting real image because of its 2 dimensional trait. The authors analyzed such an asymmetry using 3D VECTRA system (Canfield, NJ, USA) in quantitative way. Methods: In 25 Patients with unilateral cleft lip nose deformity(male 12, female 13, age ranging from 4 to 19), patients with right side deformity were 10 and left were 15. Analysis of asymmetry was proceeded through 3D VECTRA system. After taking 3 dimensional photo, alar area, upper lip area, nostril perimeter, nostril area, Cupid's bow length, nostril height and nostril width were measured. Correlation coefficient and inter data quotients were calculated. Results: In nostril perimeter, maximal difference of cleft side and non - cleft side was 39.3%, asymmetric quotient Qasy = Qcl/Qncl(Qcl, value of cleft side; Qncl, value of non - cleft side) was ranged from 0.84 to 1.85 and in seven cases the length of cleft side was smaller. In nostril area, maximal difference was 69.6% and in 13 cases cleft side was smaller. In lower nasal area, maximal difference was 37.2% asymmetric quotient Qasy = Qcl/Qncl was ranged from 0.47 to 2.03 and in 20 cases cleft side was smaller. The correlation coefficients of nostril perimeter and area were 0.8345. Conclusion: Using 3D VECTRA system, the authors can measure nostril perimeter and lower nasal area that could not been measured with previous methods. Asymmetry of midface was analyzed through area comparison in quantitative way. Futhermore, post operative change can be measured in quantitative method.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2004년도 학술대회 논문집 정보 및 제어부문
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• pp.3-5
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• 2004

Cleft lip is one of the most common congenital deformities in craniofacial region. Despite the many reports on the outcome of various surgical techniques from individual medical centers, the evaluation of the outcome is based on the subjective observation because of lack of the objective evaluation system. Therefore, a new technique of objective and scientific evaluation for the nasal deformity of secondary cleft lip and nose deformity is critical to improve the management of the cleft patients including the decision of optimal age of operation and surgical technique as veil as evaluation of the outcome. In this study, a new method was proposed to evaluate the nasal deformity using nostril angle, distance, and area of patient images. The images were also evaluated by three expert plastic surgeons, and put into scale of 5 percentile. Measurement results were compared between the each category and the surgeon's evaluation, and coefficients of each category were statistically tested. As a result, The normalized overlap area of right and left nostrils and distance ratio between two centers of nostrils showed high coefficient with evaluations of plastic surgeons.

• 대한구순구개열학회지
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• 제2권1_2호
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• pp.23-28
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• 1999

The author presents Bardach' s technique for the residual unilateral cleft lip nasal deformity, The key to a successful and stable correction of the nasal deformity is to lengthen the columella on the cleft side and to mobilize alar cartilage from its surrounding tissue, creating a symmetric shape and length, The major advantages of the technique are lengthening of the cleft columella and creation of a symmetric and well-projected nasal tip.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.637-641
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• 2009

Purpose: Most unilateral secondary cleft lip nose deformities have depressed nostril base and sill on the cleft side. To obtain a symmetric nose, correction of the recession on nostril is critical. The authors have worked out effective methods to elevate the nostril of the cleft side according to the extent of the depression. Methods: A total of 115 unilateral secondary cleft lip nose deformity patients with nostril depression were evaluated. Data were acquired from patients' charts and photography with special reference to the height difference of the nostrils between the cleft side and the non - cleft side. Patients were divided into three groups based on the difference and operated with various techniques : (1) mild degree(< 1 mm) with graft, (2) moderate degree(1 ~ 3 mm) with C - flap or suspension suture of septal cartilage (3) severe degree(> 3 mm) with graft, C - flap and suspension suture. Follow - up period averaged 21.3 months. Results: Forty - six patients(40 percent) were in mild group, and forty - two(37 percent) were in moderate. In twenty - seven patients(23 percent), nostril recession was more than 3 mm. The elevated nostril base and sill were maintained without height alteration during follow - up. Conclusion: The symmetry of the nostril base, especially projection of nostril sill influences successful correction of unilateral cleft lip nose deformity. Our tolerable techniques can be applied to most deformities with nostril depression and can present a new guideline.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.102-106
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• 2011

Purpose: It is accepted universally that correction of the cleft lip nasal deformity requires multiple stages of surgery. Following primary lip repair in infancy or early childhood, secondary surgery to improve the deformity of the lip and nose is frequently necessary. A suitable surgical procedure to correct the accompanying deformity, such as cleft palate and alveolus, must be carried out at an appropriate age. In developing countries, it is common for patients with cleft lip nasal deformity to present severe secondary deformities in adolescence, because of poor follow-up and inappropriate surgery. Methods: The first patient was a 12 year old Mongolian boy. He presented prominent lip scar, short lip, wide columella, asymmetric nostril, palatal fistula, cleft alveolus, and velopharyngeal incompetence. He underwent cheilorhinoplasty, transpositional flap, alveoloplasty by iliac bone graft, and sphincter pharyngoplasty. On follow-up, a bilateral maxillary hypoplasia and a class III malocclusion developed. He underwent LeFort I osteotomy and maxillary advancement at the age of 16 years. The second patient was an 18 year old Eastern Russian girl. She presented with a deviated nose, right alar base depression, short lip, protrusion on vermilion, large palatal fistula, and severe VPI due to short palate. She underwent the combined procedure of cheilorhinoplasty, corrective rhinoplasty, tongue flap for palatal fistula, and superiorly based pharyngeal flap. And the tongue flap was detached at postoperative 3 weeks. Results: The overall results have been extremely pleasing and satisfactory to patients. There were no postoperative complications. Conclusion: We discovered the one stage operation for radical correction was sufficient procedure to provide excellent clinical outcomes in patients with severe cleft lip nose deformity.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2006년도 심포지엄 논문집 정보 및 제어부문
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• pp.45-47
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• 2006

Cleft palate is a congenital deformity condition with separation of the two sides of the lip resulting in nose deformity. Evaluation of surgical corrections and outcome assessments for nose deformity due to the cleft lip depends mainly on doctor's subjective judgment. An objective method for evaluation of the condition and surgical outcome of nose deformity due to the cleft palate is needed. This study aimed at objective assessment of a cleft palate nose deformity condition by analyzing the following parameters obtained from photographic images of a cleft palate patients: (1) angle difference between two nostril axes. (2) center of the nostril and distance between two centers. (3) overlapped area of two nostrils, and (4) the overlapped area ratio of the two nostrils. A regression equation of doctor's grades was obtained using the eight parameters. Three plastic surgeons gave us the grades for the each photographic image by 10 increments with maximum grade of 100. The average reproducibility of the grades given by the three plastic surgeons and the three laymen using the developed program was $10.8{\pm}4.6%$ and $7.4{\pm}1.8%$, respectively. Kappa values representing the degree of consensus of the plastic surgeons and the three laymen were 0.43 and 0.83. respectively. Correlation coefficient of the grades evaluated by the surgeons and obtained by the neural network was 0.798. In conclusion. the developed neural network model provided us better reproducibility and much better consensus than doctor's subjective evaluation in addition to objectiveness and easy application.