• Title/Summary/Keyword: Cleft lip palate

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The nasoalveolar molding technique versus DynaCleft nasal elevator application in infants with unilateral cleft lip and palate

  • Abdallah Bahaa;Nada El-Bagoury;Noura Khaled;Sameera Mohamed;Ahmed Bahaa;Ahmed Mohamed Ibrahim;Khaled Mohamad Taha;Mohsena Ahmad Abdarrazik
    • Archives of Craniofacial Surgery
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    • v.25 no.3
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    • pp.123-132
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    • 2024
  • Background: The introduction of presurgical nasoalveolar molding represented a significant departure from traditional molding methods. Developed by Grayson and colleagues in 1993, this technique combines an intraoral molding device with a nasal molding stent. This study aimed to compare the Grayson nasoalveolar molding appliance versus DynaCleft appliance as two methods of presurgical nasoalveolar molding. Methods: A single-blinded, randomized, parallel-arm clinical trial was conducted. Sixteen infants with complete unilateral cleft lip and palate were enrolled and divided into two groups of eight. Group 1 was treated with a modified Grayson nasoalveolar molding appliance that included a nasal stent, while group 2 was treated with DynaCleft elastic adhesive tape and an external nasal elevator. Standardized digital photographs of each infant were taken at baseline and post-treatment using a professional camera. Nine extraoral anthropometric measurements were obtained from each image using image measurement software. Results: The modified Grayson nasoalveolar appliance demonstrated a more significant improvement compared to DynaCleft in terms of alar length projection (on both sides), columella angle, and nasal tip projection. Symmetry ratios also showed enhancement, with significant improvements observed in nasal width, nasal basal width, and alar length projection (p< 0.05). Conclusion: Both the modified Grayson nasoalveolar appliance and DynaCleft appear to be effective presurgical infant orthopedics treatment options, demonstrating improvements in nasolabial aesthetics. The modified Grayson appliance, equipped with a nasal stent, improved nasal symmetry more effectively than DynaCleft, resulting in a straighter columella and a more medially positioned nasal tip.

Primary Cleft Lip Repair Using the "Delaire" Technique (Delaire 방법을 이용한 구순열의 교정)

  • Kim, Yong-Ha;Lee, Hyun-Tae
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.75-80
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    • 2011
  • Deformities related with cleft lip are not only limited to the cleft site but also extended to all around the nasolabial region. Facial development is composed of several complex processes as the formation, migration, coalescence and interaction of separate fields. When there is a cleft event, it means there are general problems of those processes. As a result facial elements should have displacement, deformation and functional hypotrophy. These also affect the mucocutaneous structures, which result in the typical deformities of cleft lip. Traditional surgical methods are not sufficient of the correction of functional impairments in the cleft lip. Accordingly, there are relatively high possibilities of occurring secondary deformities. The Delaire's method focuses on repair of functional impairment of the cleft. Consequently, it can maintain the initial good surgical result and avoid the unnecessary incision scar. And this method can minimize secondary nasal deformities which can reduce the risk of additional nasal correction. Therefore authors introduce this advantageous the Delaire technique cheliolplasty which it can be widely used for the cleft lip correction in Korea.

Understanding of Cleft Lip Managment by Review of Treatment History (역사적 고찰을 통한 구순열 치료의 이해)

  • Kim, Hui-Young;Myoung, Hoon;Lee, Jong-Ho;Lee, Suk-Keun;Choi, Jin-Young;Kim, Soung-Min
    • Korean Journal of Cleft Lip And Palate
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    • v.16 no.1
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    • pp.37-49
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    • 2013
  • Cleft lip is a common congenital facial deformity which might cause speech, hearing, appearance, and psychological disorder. For the purpose of appropriate management for the cleft lip patients according to their individual situations, reviews of the historical evolution for the cleft lip treatment were summarized. More than 15 English written articles with 4 related historical books were reviewed, and the chronology of the cleft lip management from ancient to recent twenty first century, via middle ages and Renaissance, were summarized. Multifactorial causes of cleft lip, before the modern understanding of embryological background of it, most management of cleft lip has been explained under the basis of religions and/or superstitions. As the anatomic and embryologic knowledges were known and revealed, various misconceptions were corrected continously, and the simple closure of the lip defect was also evoluted to the applications of plastic concept. Recently, cosmetic outcomes with functional results, such as speech, hearing, psychological status, have been considered importantly, under the multidiciplinary care system. For the better understanding of cleft lip management as a routine esthtetic and funtional reconstructive procedure, the various historical treatment trends were reviewed and summarized as time goes on. This review presentation will discuss the appropriate management for cleft lip patients.

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Distraction osteogenesis in patients with complete cleft lip and palate (완전 구순구개열을 가진 환자에서의 골신장술)

  • Yi, J.K.;Park, C.H.;Na, J.I.;Jeong, J.S.;Koo, H.M.;Eom, M.Y.;Song, M.S.
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.2
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    • pp.63-70
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    • 2005
  • Patients with cleft lip and palate usually show up maxillary hypoplasia. In these cases, a large amount of maxillary advancement is often needed to correct the severe deformity, but local soft-tissue scars around the maxilla restrict maxillary advancement and increase the relapse rate. Maxillary distraction osteogenesis is an effective method for facial and occlusal improvement in these patients. By gradually lengthening both the bones and the soft tissues, distracted midface can greatly increase postoperative stability and decrease the relapse rate. However, the maxillary extraoral appliances of the early days used were esthetically unappealing as well as difficult for the patient to manage. Recently, more inconspicuous intraoral distraction appliances have been developed and used with success. We acquired favorable result in two patients(bilateral 1 patient and unilateral 1 patient) with severe maxillary hypoplasia secondary to complete cleft lip and palate were treated with midface distraction using internal distractor (Zurich Pediatric Maxillary Distractor, KLS Martin, Tuttlingen, Germany). So, we report our experience with literatures.

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Cleft Lip and Palate Repair Using a Surgical Microscope

  • Kato, Motoi;Watanabe, Azusa;Watanabe, Shoji;Utsunomiya, Hiroki;Yokoyama, Takayuki;Ogishima, Shinya
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.490-495
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    • 2017
  • Background Cleft lip and palate repair requires a deep and small surgical field and is usually performed by surgeons wearing surgical loupes. Surgeons with loupes can obtain a wider surgical view, although headlights are required for the deepest procedures. Surgical microscopes offer comfort and a clear and magnification-adjustable surgical site that can be shared with the whole team, including observers, and easily recorded to further the education of junior surgeons. Magnification adjustments are convenient for precise procedures such as muscle dissection of the soft palate. Methods We performed a comparative investigation of 18 cleft operations that utilized either surgical loupes or microscopy. Paper-based questionnaires were completed by staff nurses to evaluate what went well and what could be improved in each procedure. The operating time, complication rate, and scores of the questionnaire responses were statistically analyzed. Results The operating time when microscopy was used was not significantly longer than when surgical loupes were utilized. The surgical field was clearly shared with surgical assistants, nurses, anesthesiologists, and students via microscope-linked monitors. Passing surgical equipment was easier when sharing the surgical view, and preoperative microscope preparation did not interfere with the duties of the staff nurses. Conclusions Surgical microscopy was demonstrated to be useful during cleft operations.