• Korean Journal of Cleft Lip And Palate
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• v.10 no.2
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• pp.97-108
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• 2007

For many years a wide variety of surgical techniques for closure of cleft lip has been used. Still many surgeons prefer the Millard's rotation-advancement lip repair because the surgical scar is masked in the philtral crest and the nostril floor, and it improves the relationship of the alar base of the cleft side, producing harmonious symmetry of the nostril and the nostril sill. In addition, it uses and preserves the lip anatomy, returning lip tissue into its normal position, minimizing the amount of tissue that is discarded, and reconstructing the orbicular oris muscle. One of the major disadvantages of this procedure is the lack of accurate measurements. The object of this study is to help in the cleft lip surgery with investing its features and design.

• 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.

• Archives of Plastic Surgery
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• v.44 no.3
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• pp.202-209
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• 2017

Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ${\geq}17$ years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

• The korean journal of orthodontics
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• v.14 no.1
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• pp.7-13
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• 1984

A roentgeno cephalometric comparative study was undertaken to reveal significant differences of craniofacial morphology and growth between unilateral cleft lip and palate and normal individuals. The material for this study consisted 32 subjects with repaired unilateral cleft lip and palate (27 male, 5 female) and 44 normal subjects (22 male, 22 female). The analysis was performed by Coben's method and the measurements were compared by Student's t-test. The following conclusions were obtained. 1. In the UCLP subjects there is definite decrease in midfacial growth, so they showed concave profile. 2. The ramus inclination angle and AR-GO of UCLP subjects are larger than normal subjects. 3. The craniofacial height of UCLP subjects is smaller than normal subjects, especially in midface. 4. The lower part of craniofacial height of UCLP subjects is larger than normal subjects.

• The Journal of the Korean dental association
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• v.55 no.12
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• pp.870-882
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• 2017

Maxillary growth is hindered by the restricting pressure from the scar tissue formed after lip closure and palate closure surgeries of the cleft. Therefore, the anteroposterior skeletal relationship of both jaws exacerbates as patient grows. Conventional facemask treatment is valuable for dentoalveolar compensatory treatment and for very mild maxillary hypoplasia. To achieve further maxillary protraction, bone-anchored facemask or bone-anchored maxillary protraction can be attempted. For moderate maxillary hypoplasia, surgical orthodontic treatment after growth completion can be an efficient treatment reducing uncontrollable problems. For moderate to severe maxillary hypoplasia, distraction osteogenesis (DO) can be used alone or with later surgical orthodontic treatment. To compensate the severe relapse after DO, overcorrection and bone plate placement after DO are recommended. In case of hypernasality, maxillary anterior segmental distraction osteogenesis can be chosen to prevent exacerbation of the hypernasality.

• The Journal of the Korean dental association
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• v.53 no.7
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• pp.450-456
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• 2015

Even the adult cleft lip and palate patient who has not had timely treatment during the growth period, can be treated with orthodontic treatment without the necessity of orthognathic surgery if only the patient is treated under correct diagnosis and fitting appliances. Initially, maxillary arch form is established by constructing trifocal circles. Posterior region can be expanded and derotated laterally with pentahelix and anterior teeth are aligned with Tiggle brackets and "ㄷ"-shaped spring. Thereafter, anterior and posterior regions are consolidated. Mandibular intercanine width should be adjusted to maxillary intercanine width which was unavoidably reduced. Mandibular anterior tooth extraction will be helpful to attain proper mandibular intercanine width and better anterior dental showing.

• The Journal of the Korean dental association
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• v.13 no.2
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• pp.169-173
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• 1975

The author had treated 35 caseds of cleft lips and cleft palate patients including 26 male patients and 8 female patients. There were 29 cases of unilateral cleft lip patients and 4 cases of bilateral cleft lip patients, 5 cases with together cleft lips and cleft palates among 35 cases were observed. I had accomplished that "Plastic Cheiloplasty", surgical plastic closure of cleft lips and cleft palates had been performed by using Millard's, Hagedorn's, Meyer's and LeMesurier's method.

• The korean journal of orthodontics
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• v.25 no.4
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• pp.447-451
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• 1995

The purpose of this study was to investigate the effects of cleft on mesiodistal dimensions of permanent teeth in unilateral cleft lip and palate patients. Mesiodistal dimensions of permanent teeth were measured to the nearest 0.01mm on plaster models of 50 subjects with unilateral complete cleft lip and palate, 10 siblings and 50 Controls. The results were as follows : 1. Tooth size discrepancy in the cleft group was significant in all regions except maxillary cuspid, mandibular cuspid and mandibular first premolar. 2. Some of the mesiodistal dimensions of the teeth on the cleft side were significantly smaller than those of their antimeres on the non-cleft side in the cleft group. 3. A comparison of mesiodistal dimensions of the teeth for the right and left sides of the control group showed no statisically significant differences excepts maxillary lateral incisor. 4. Asymmetries of mesiodistal dimensions of the teeth in the sibling group was not found except maxillary first molar.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.2
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• pp.131-135
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• 2003

Severe maxilla1y deficiency can be caused by cleft lip and palate(CLP), other craniofacial deformities, atrophy in the edentulous maxilla, and trauma. Patients with maxillary deficiency present a difficult treatment challenge. Traditionally, this skeletal deformity has been treated by Le Fort osteotomy, skeletal repositioning, and fixation with mini-plates and screws. The drawbacks of this method include a limited amount of anterior maxillary advancement often requiring simultaneous mandibular setback, the inability to create new bone, and minimal soft tissue adaptation to the new position, all of which increase the potential of relapse in case of large advancement. The alternative method of maxillary distraction osteogenesis offers promising results for successfully treatment of these patients while potentially minimizing the risk of relapse.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.2
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• pp.57-64
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• 2009

전방으로 심하게 돌출된 전상악골로 인하여 구순성형술 및 비성형술의 결과가 악화 될 수 있다. 따라서 변위된 전상악골의 이상적인 위치로 재위치 시키려는 다양한 노력이 시도되어 왔다. 에디오피아와 같은 개발도상국에서는 어른이 되어서도 수술을 받지 못하는 구순구개열 환자가 많이 있다. 성인이 될 때까지 수술받지 못한 양측성 완전 구순구개열 환자에서는 근육, 골, 피부, 점막의 연속성이 없어서 전상악골이 심하게 전방으로 혹은 하방, 좌우측으로 변위된 경우가 대부분이다. 이 경우 구순성형술이 거의 불가능하며, 시도된다 할지라도 돌출된 전상악골 때문에 양쪽 구륜근을 봉합하여 주기가 대단히 어렵다. 따라서 이상적인 결과를 얻기 위해서는 구순성형술 전 혹은 동시에 전상악골의 재위치 술식이 필수적이다. 저자는 한국국제협력단에서 국제협력의사로 선발되어 에디오피아에서 30 개월간 근무하였다. 그 동안 다양한 양측성 완전 구순구개열 환자에서 전상악골의 재위치 술식을 경험하였다. 저자가 경험한 전상악골의 재위치 술식(전상악골의 재위치와 골이식술 동시 시행, 전상악골의 재위치와 구개열 성형술 동시시행)에 대하여 문헌고찰과 함께 보고하고자 한다.