• Title/Summary/Keyword: Cleft lip palate

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Effect of Preoperative Nasal Retainer on Nasal Growth in Patients with Bilateral Incomplete Cleft Lip: A 3-Year Follow-Up Study

  • Kim, Young Chul;Jeong, Woo Shik;Oh, Tae Suk;Choi, Jong Woo;Koh, Kyung S.
    • Archives of Plastic Surgery
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    • v.44 no.5
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    • pp.400-406
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    • 2017
  • Background The purpose of this study was to evaluate changes in nasal growth after the implementation of a preoperative nasal retainer in patients with bilateral incomplete cleft lip. Methods Twenty-six infants with bilateral incomplete cleft lip and cleft palate were included in the study. A preoperative nasal retainer was applied in 5 patients from the time of birth to 2.6-3.5 months before primary cheiloplasty. Twenty-one patients who were treated without a preoperative nasal retainer were placed in the control group. Standard frontal, basal, and lateral view photographs were taken 3 weeks before cheiloplasty, immediately after cheiloplasty, and at the 1- and 3-year postoperative follow-up visits. The columella and nasal growth ratio and nasolabial angle were indirectly measured using photographic anthropometry. Results The ratio of columella length to nasal tip protrusion significantly increased after the implementation of a preoperative nasal retainer compared to the control group for up to 3 years postoperatively (P<0.01 for all time points). The ratios of nasal width to facial width, nasal width to intercanthal distance, columellar width to nasal width, and the nasolabial angle, for the two groups were not significantly different at any time point. Conclusions Implementation of a preoperative nasal retainer provided significant advantages for achieving columellar elongation for up to 3 years postoperatively. It is a simple, reasonable option for correcting nostril shape, preventing deformities, and guiding development of facial structures.

Analysis of Procedures for Correction of Microform Cleft Lip through Strategic Approaches (전략적 접근을 통한 미세형 구순열의 수술에서 실제 사용된 술기의 분석)

  • Song, Kyeong Ho;Bae, Yong Chan;Bae, Seong Hwan
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.16-23
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    • 2013
  • Background: Even though degrees of deformation of microform cleft lip are not high, it has to be corrected with various procedures upon conditions and areas since it has various expressions. Many studies have focused on the classifications and procedures, but there are only a few studies on how much these procedures are performed in the actual field. This study aims to analyze the utilization of various procedures upon major correction points. Methods: A total of 52 patients who had been corrected by one surgeon from 1995 to 2011 were enrolled as subjects. Based on the medical records, it was checked whether the incision was made or not along with the correction procedures for alar base and philtral column, Cupid's bow, and vermillion free margin. Results: In case of an incision, full incision (42 times) was conducted most frequently. For alar base and philtral column, muscle re-approximation (25 times) was performed most frequently. However, recently, it was shown that excision on only the affected area and correction with dermis were more likely to be used. For Cupid's bow and vermilion free margin, elliptical excision on the only affected area followed by re-approximation was performed most frequently for 46 times (Cupid's bow) and 44 times (vermilion free margin), respectively. Conclusion: For the correction of microform cleft lip, less invasive procedures are preferred. However, in the actual field, if needed, aggressive procedures consisting of incisions have been conducted to correction. These trends are somewhat changed to utilization of a simple procedure, such as excision on the modified area, followed by a re-approximation rather than complicated procedures using the muscle.

The Relationship between the Growth of Cranial Base and the Position of Maxilla, Mandible in Complete Unilateral Cleft Lip and Palate Patients (완전 편측성 순구개열자의 두개저 성장과 상,하악골 위치의 상관 관계에 관한 연구)

  • Baek, Jae-Ho;Son, Woo Sung
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.399-411
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    • 2000
  • This study was designed to evaluate the correlations between the morphology and growth of cranial base and the position of nasomaxillary complex and mandible in complete unilateral cleft lip and palate patients. Craniofacial skeletal morphology Pattern was analyzed on the lateral cephalometric radiographs of the 100 subjects of complete unilateral cleft lip and palate group and the 100 normal grower group and each group was divided three sub-groups by age-range like spheno-ethmoidal synchodrosis growing group, spheno-occipital synchondrosis growing group and finished synchondrosis growth group. These data were statistically analyzed to examine significant difference between both groups and between each sub-groups. The results of this study were as follows: 1. In complete unilateral cleft group, the length, thickness of clivus, and the rate of increase in length of clivus showed smaller amount by adolescence. The anterior length of cranial base and the rotation pattern of clivus with age showed no significant difference between two group. 2. In complete unilateral cleft group, nasomaxillary complex were located more posteriorly. This difference between two groups is larger by adolescent group than adult. Vertical position showed no significant difference between two groups. There was significant correlation between the cranial base of cleft group and the horizontal measurements(p<0.01). PtmS showed no significant increment in cleft group. This showed the deficiency of growth in posterior part of maxilla. 3. In mandible, there was no significant difference between normal group and complete unilateral cleft group but articular angle showed significantly smaller in cleft group than in normal one. And the measurements of nasomaxillary complex position, cranial base and the position of mandible had significant correlation(p<0.01).

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Spectral & Aerodynamic Analysis of Cries in Infants with Cleft Lip and Palate. (구순구개열 환아의 crying에 대한 음향학적 및 공기역학적 분석)

  • Kim Eun-Ju;Ko Seung-O;Shin Hyo-Keun;Kim Hyun-Ki
    • Korean Journal of Cleft Lip And Palate
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    • v.5 no.2
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    • pp.95-108
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    • 2002
  • 언어 발달의 조기 단계를 이해하기 위한 일환으로 crying은 언어전 발달의 기초 단계로서 여러 학문적 분야에서 많은 연구가 있어왔다. 그러나 구순구개열(CLP))환아의 경우는cry-producing/control mechnism에 variation이 많은 이유로 이 분야의 연구는 거의 없는 실정이다. 이에 본 연구에서는 다음과 같은 의문점을 가지고 CLP환아의 cry feature에 대한분석을 하였다. 첫째, 정상아와 CLP환아의 cry에 전형적인 차이가 있는가? 둘째, CLP환아의 술전, 술후 cry feature에 변화가 있는가? 셋째, cry분석이 CLP환아의 이후 speech disorder에 대한 언어전 평가로서의 가치가 있는가? 넷째, 특정 parameter가 언어전 평가에 적절한 도구로 작용할 수 있는가? 생후 15개월 이내의 CLP 환아 3명과 유사한 나이대의 정상아 8명의 cry에 대한 공기역학 및 음향음성학적 분석을 통해 CLP 환아와 정상아, CLP환아의 술전, 술후 cry특성을 비교 분석하였다. 결과는 다음과 같다. 1 공기역학적 분석 1) airflow는 CLP 환아의 경우 정상아보다 약간 높았고 술 후 약간 증가하였다. 2)폐활량을 나타내는volume에서는 정상아보다 술전 CLP환자의 경우 보상적으로 더 큰 수치를 보였고 술후 약간 증가하였다. 3)강도를 나타내는 parameter(SPL)에서는 정상아 보다 술전 CLP환자의 계측치가 약간 작았으나 술 후 증가하는 양상을 보였다. 2. 음향음성학적 분석 1)기저 주파수 분석시 정상아에 비해 술 전 CLP환자의 경우 계측치가 약간 낮았으나 술 후 증가하여 정상군의 계측치에 근접하였다. 2)강도를 나타내는energy 측정시 정상아에 비해 술 전 CLP계측치가 보상성으로 약간 큰수치를 나타내었고 술 후 약간 더 증가하였다. 3) Shimmer에서는CUI환자의 술후계측치가술전에 비해 현저히 감소하여 정상군의 수치에 근접하였다.

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An unusual exophytic pleomorphic adenoma on the upper lip skin without mucosa involvement: a case report

  • Sae Hwi Ki;Do Hyuk Chung;Jin Myung Yoon
    • Archives of Craniofacial Surgery
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    • v.25 no.4
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    • pp.201-204
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    • 2024
  • Pleomorphic adenoma is a benign tumor that can occur in the salivary glands, most commonly in the parotid gland. While it primarily occurs in the major salivary glands, it can sometimes be found in the minor salivary glands. Within the minor salivary glands, it most often originates in the hard palate and soft palate, and less frequently in the upper lips. Due to its location in the minor salivary glands, most pleomorphic adenoma involve and protrude on the mucosa. A 61-year-old man presented with 1.5 cm exophytic mass on the skin of his upper lip. This mass was exophytic on the skin and did not involve or protrude into the inner lip mucosa. The mass was entirely excised, and a subsequent permanent biopsy diagnosed it as a pleomorphic adenoma. In such situations, it can be challenging to suspect pleomorphic adenoma during a physical examination, leading to potential diagnostic confusion. It might also be mistaken for an inclusion cyst or another type of mass, making it tempting to treat without verifying the pathological results.

Anatomical repair of a bilateral Tessier No. 3 cleft by midfacial advancement

  • Oh, Ji-hyeon;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.9.1-9.4
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    • 2018
  • Background: Bilateral Tessier number 3 clefts are extremely rare, and their surgical treatments have not been well established. Case presentation: The authors describe the case of a patient with a right Tessier number 3, 11 facial cleft with microphthalmia, a left Tessier number 3 facial cleft with anophthalmia, and cleft palate. We repaired simultaneously the bilateral soft tissue clefts by premaxillary repositioning, cleft lip repair, facial cleft repair by nasal lengthening, midfacial advancement, and an upper eyelid transposition flap with repositioning both the medial canthi. Postoperatively, the patient showed an esthetically acceptable face without unnatural scars. Conclusions: We achieved good results functionally and esthetically by midfacial advancement with facial muscle reposition instead of traditional interdigitating Z-plasties. The surgical modality of our anatomical repair and 3 months follow-up results are presented.

Open rhinoplasty in cleft nasal repair (구순열 환자에서의 개방형 비성형술)

  • Lee, Jong-Ho;Jeon, Se-Il;Myung, Hoon;Lim, Koo-Young;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pil-Hoon;Kim, Myung-Jin;Nam, Il-Woo;Kim, Jong-Won;Min, Byong-Il
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.1
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    • pp.17-22
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    • 2000
  • While in endonasal rhinoplasty transection and resection of nasal structures is primarily used for correction of nasal deformities, open rhinoplasty is performed using stures and repositioning of nasal structures in the repair of severe nasal deformities. We reviewd our experiences in the repair of cleft nasal deformities from 1991 to 1999 year in our institute, and compared the results of open rhinoplasty with endonasal rhinoplasty. In overall 164 cases of rhinoplasty in cleft nasal repair, open rhinoplasty was done in 13 cases. Male patients were 10, female 3(age between 6 to 34 years old). In this article, our experience, together with review of literatures of open rhinoplasty in the cleft nasal deformities are reported.

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CLINICAL STUDY OF ORTHOGNATHIC SURGERY ON CLEFT LIP AND PALATE PATIENTS (순악구개열환자에서의 외과적 악교정술의 검토(증례보고))

  • Song, Jae-Chul;Lee, Geon-Ho;Jang, Hyun-Joong;Kim, Chin-Soo;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.4
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    • pp.317-321
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    • 1993
  • Two patients with maxillary developmental deficiency who have previously undergone cheiloplasty and palatoplasty were operated on by simultaneous two jaw surgery and maxillary advancement surgery respectively. And the following results were obtained. 1. After the operation, maxilla shifted superiorly, and then inferiorly without noticible posterior relapse. 2. Postoperative mandibular relapse to the anterior direction was evident in both cases. 3. It is highly suggested that definitive measures to enhance postoperative stability in orthognathic surgery on the cleft lip and palate patients be developed.

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Split orthodontic airway plate: An innovation to the utilization method of conventional orthodontic airway plate for neonates with Robin sequence

  • Choo, HyeRan;Kim, Seong-Hun;Ahn, Hyo-Won;Poets, Christian F.;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.52 no.4
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    • pp.308-312
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    • 2022
  • Since the emergence of neonatal infant orthodontics for treatments of cleft lip and palate with or without Robin sequence (RS) in Europe in the 1950s, advancements in design and scope of its application have been remarkable. As the first institution to adopt orthodontic airway plate (OAP) treatment in the United States in 2019, we saw a need for innovation of the original design to streamline the most labor-intensive and time-consuming aspects of OAP utilization. A solution is introduced using a systematic split expansion mechanism to re-size the OAP periodically to accommodate the neonate's maxillary growth. To date, seven RS patients have received this modified treatment protocol at our institution. Each patient completed full treatment using only one OAP. This innovative utilization method is aptly named the split orthodontic airway plate (S-OAP). Details of the S-OAP and its modifications from conventional OAP are reported.