• Korean Journal of Cleft Lip And Palate
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• v.9 no.2
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• pp.93-100
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• 2006

Although the delayed type of rhinoplasty is currently acceptable in the correction of cleft lip and nasal deformity, Delaire tried to achieve the simultaneous nasolabial reconstruction and muscular rearrangement that affect the subsequent skeletal growth of the face. the anatomic muscular reconstruction can be achieved by making the anchorage of the nasolabial muscles of the cleft side to the nasal septum and muscles on the non-cleft side. Two cleft lip patients of 6 and 7 year-old without any previous operation history were treated with the functional cheilorhinoplasty. One patient with incomplete cleft lip underwent a cheiloplasty along with the rearrangement of orbicularis oris muscle. The other patient had a complete cleft lip and palate with accompanying nasal deformity, who underwent the functional cheilorhinoplasty with the reconstruction of anterior nasal base. All the operation was done under the general anesthesia and patients healed without any significant complications. In the incomplete case, the shapes of Cupid's bow was restored, and the length of columella was regained comparable to the non-affected side. In the complete cleft lip and palate case, the depressed nostril was reconstructed with acceptable symmetry by complete releasing of deformed alar cartilage undermined with a dissecting scissors. In summary, the functional repair of cleft lip and nose could be possible at the same time by using Delaire method. This method is effective to correct the primary nasolabial deformity, which results in the restoring favorable anatomy and its function.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.528-530
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• 2007

Purpose: Holoprosencephaly(HPE) is a rare developmental defect due to incomplete cleavages of the prosencephalon during the third week of fetal development. Chromosomal anomalies, genetic syndrome, teratogen, or genetic disorder of non-syndromic HPE are usually accepted as etiology. The consequences of prechordal mesoderm defect are varying degrees of deficit of midline facial development, especially the median nasal process(premaxilla), and incomplete morphogenesis of the forebrain. We experienced a case of lobar HPE with complete cleft lip and palate. Methods: A female newborn infant was born at $38^{+6}$ weeks' gestational age via NSVD. The infant's birth weight was 3.6 kg, height 52 cm, and head circumference 32.5 cm, showing microcephaly, flat nose, median complete cleft lip & palate, and hypotelorism, along with defects of midfacial development including losses of premaxilla, philtrum, nasal septum, and columella. Results: There were no specific findings noted from the head and neck X-ray and tests for endocrine and metabolic disorders, but clinical characteristics of midface and dysgenesis corpus callosum on brain MRI were seen, so that this case was diagnosed with HPE. Conclusion: HPE is divided into three categories of alobar, semilobar, and lobar prosencephaly according to the degree of cerebral hemisphere separation. Assesment of patient's brain abnormality and malformation is essential in determining the extent and benefit of surgical intervention. This case was included in the lobar type HPE which shows relatively good prognosis compared with other types and reconstruction of median complete cleft lip & palate and midfacial defects will be performed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.1
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• pp.55-62
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• 2007

Radical paring of the cleft edge during primary cleft lip operation or repeated secondary surgeries can result in tightness of the upper lip. In case, the degree of the resulting side-to-side tension is very severe, the possibility of a lip switch flap must be considered. When the lip tightness accompanies a loss of more than two-thirds of the Cupid's bow, an Abbe flap is an alternative. The disadvantages of Abbe flap are scar formation on the lower lip, design of incision line on the upper lip, disharmony of colors, and the dysfunction of the orbicularis muscle. These problems have been recognized in the literature and extreme discretion has been advised in its application. We experienced four cases of Abbe flap operation which were designed differently to correct the secondary unilateral or bilateral cleft-lip nasal deformities. The Abbe flap operations resulted in removal of the scars and tightness of the upper lip, reconstruction of the Cupid's bow, lengthening of the columella, and therefore secondary cleft-lip nasal deformity could be corrected. It is thought that carefully applied Abbe flap is an appropriate method to relieve horizontal tightness or flattening of the upper lip which occured after primary operation of cleft lip.