• Imaging Science in Dentistry
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• v.54 no.1
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• pp.25-31
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• 2024

Purpose: The purpose of this study was to clarify the panoramic image differences of cleft alveolus patients with or without a cleft palate, with emphases on the visibility of the line formed by the junction between the nasal septum and nasal floor(the upper line) and the appearances of the maxillary lateral incisor. Materials and Methods: Panoramic radiographs of 238 patients with cleft alveolus were analyzed for the visibility of the upper line, including clear, obscure or invisible, and the appearances of the maxillary lateral incisor, regarding congenital absence, incomplete growth, delayed eruption and medial inclination. Differences in the distribution ratio of these visibility and appearances were verified between the patients with and without a cleft palate using the chi-square test. Results: There was a significant difference in the visibility distribution of the upper line between the patients with and without a cleft palate (p<0.05). In most of the patients with a cleft palate, the upper line was not observed. In the unilateral cleft alveolus patients, the medial inclination of the maxillary lateral incisor was more frequently observed in patients with a cleft palate than in patients without a cleft palate. Conclusion: Two differences were identified in panoramic appearances. The first was the disappearance (invisible appearance) of the upper line in patients with a cleft palate, and the second was a change in the medial inclination on the affected side maxillary lateral incisor in unilateral cleft alveolus patients with a cleft palate.

• Archives of Plastic Surgery
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• v.49 no.1
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• pp.43-49
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• 2022

Background Cleft lip and cleft palate are the most frequent congenital craniofacial deformities, with an incidence of approximately 1 per 700 people. Postoperative palatal fistula is one of the most significant long-term complications. This study investigated the incidence of postoperative palatal fistula and its predictive factors based on 25 years of experience at our hospital. Methods We retrospectively reviewed 636 consecutive palatal repairs performed between January 1996 and October 2020 by a single surgeon. Data from patients' medical records regarding cleft palate repair were analyzed. The preoperative extent of the cleft was evaluated using the Veau classification system, and the cleft palate repair technique was chosen according to the extent of the cleft. SPSS version 25.0 was used for all statistical analyses, and exploratory univariate associations were investigated using the t-test. Results Fistulas occurred in 20 of the 636 patients; thus, the incidence of palatal fistula was 3.1%. The most common fistula location was the hard palate (9/20, 45%), followed by the junction of the hard and soft palate (6/20, 30%) and the soft palate (5/20, 25%). The cleft palate repair technique significantly predicted the incidence of palatal fistula following cleft palate repair (P=0.042). Fistula incidence was significantly higher in patients who underwent surgery using the Furlow double-opposing Z-plasty technique (12.1%) than in cases where the Busan modification (3.0%) or two-flap technique (2.0%) was used. Conclusions The overall incidence of palatal fistulas was 3.1% in this study. Moreover, the technique of cleft palate repair predicted fistula incidence.

• Speech Sciences
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• v.9 no.4
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• pp.3-14
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• 2002

VPI occurs when the velum and lateral and posterior pharyngeal wall fail to separate the nasal cavity from the oral cavity during deglutition and speech. There are a number of congenital and acquired conditions which result in VPI. Congenital conditions include cleft palate, submucous cleft palate and congenital palatal insufficiency (CPI). Acquired conditions include carcinoma of the palate or pharynx and neurologic disorders. The speech characteristics of VPI is characterized by hypernasality, nasal air emission, decreased intraoral air pressure, increased nasal air flow, decreased intelligibility. VPI can be treated with various methods that include speech therapy, surgical procedures to reduce the velopharyngeal gap, speech aid prosthesis, and combination of surgery and prosthesis. This article describes four cases of VPI treated by speech aid prosthesis and speech therapy with satisfactory result.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.792-794
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• 2009

Purpose: Clotting factor X deficiency is one of the most uncommon coagulation disorders. The authors describe a case of cleft palate in a patient with a congenital clotting factor X deficiency. Methods: In pediatric patients with a cleft palate, the coagulation problem is more worrisome, because they are more sensitive to blood than adults, and because postoperative bleeding can cause blood ingestion with subsequent vomiting, aspiration, and airway obstruction. To prevent hemorrhagic complications in the described case, fresh frozen plasma (FFP) was administered every 24 hrs from the day before surgery to the second postoperative day. Results: Good hemostasis, normal healing, and no complications was shown postoperatively. Conclusion: The replacement of fresh frozen plasma was useful in the case of congenital clotting factor deficiency for bleeding prophylaxis in cleft palate operation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.81-86
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• 2000

Submucous cleft palate is a relatively uncommon congenital anomaly accompanying velopharyngeal incompetence(VPI). Double opposing Z-plasty has many advantages including prolongation of soft palate, normal midfacial growth, midline scar. We analyzed postoperative results comparing with those of preoperative evaluation by several variables(nasometer, endoscopy, satisfactory scale) in 14 patients treated with double opposing Z-plasty due to submcous cleft palate. Nasalance score in Ah sound, Ma phrase, and Pa phrase decreased 20.23%, 3.25%, and 23.26% in the average, respectively. As a result, hypernasality improved significantly. Closure rate in velum evaluated by endoscopy was increased from 0.44 to 0.76. In objective satisfactory scale checked by each patient's guardian at the postoperative period, much improved in 3, improved in 6, minimally improved in 1, and no difference in 1 was reported. (n=11 patients) Double opposing B-plasty is a good surgical modality in patients accompanying VPI with submucous cleft palate or incomplete cleft palate and will be used more usefully and widely.

• Archives of Craniofacial Surgery
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• v.15 no.2
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• pp.105-108
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• 2014

A 14-month-old child was diagnosed with a Veau Class II cleft palate. Von Langenbeck palatoplasty was performed for the right palate, and V-Y pushback palatoplasty was performed for the left palate. The child did not have a special problem during the surgery, and the authors were able to elongate the cleft by 10 mm. Contrary to preoperative concerns regarding the hybrid use of palatoplasties, the uvula and midline incisions remained balanced in the middle. The authors named this combination method "half-and-half palatoplasty" and plan to conduct a long-term follow up study as a potential solution that minimizes the complications of palatoplasty.

• Proceedings of The Korean Cleft Lip And Palate Association
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• 1998.06a
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• pp.26-26
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• 1998

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.205-211
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• 2001

Cleft palate is one of the most serious congenital anomalies in human that causes a sucking problem in newborn babies and morphologic deformity that usually leads to death in newborn mouse offspring due to an insufficient ability to suck milk. Therefore cleft palate had been researched with epidemiologic and molecular methods, and many etiologic factors were examined closely. Among of the research methods, biologic molecule researches have been more important method for cleft palate formation study. The $TGF-{\beta}$ had an important role in the cell migration, epithelial-mesenchymal transdifferentiation, extracellular matrix synthesis and deposition. But there was a little research which was study about correlation cleft palate induced by beta-aminonitroproprionitrile(BAPN) with $TGF-{\beta}$ expression. A purpose of this presented study was examed how $TGF-{\beta}$ expression in cleft palate mice. At gestation days 13, BAPN-monofumarate salts($(C_3H_6N_2)_2$ ${\cdot}$ $C_4H_4O_4$, Sigma Co.) was single oral administered to 4 pregnant rats according to 1g/kg body weight. And pregnant rats were sacrificed on day 20 post coitus(p.c.), The $TGF-{\beta}$ expression patterns of cleft formed fetus mice was followed that; 1.Osteoblast, mesenchymal cell and epithelial cell of cleft mice were low expression compare to control mice. 2.There was no $TGF-{\beta}$ difference expression pattern of osteocyte of cleft mice compare to control mice. 3. In western blot analysis, thickness of band of $TGF-{\beta}$ in cleft mice was thin and dilute compare to control mice.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.181-185
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• 2007

Purpose: Cleft lip and/or palate is the most common congenital facial anomaly whose incidence is about 1 in 500~1000 live births. As this anomaly may be associated with the serious chromosomal anomalies or the multiple organ abnormalities resulting in the fetal loss or perinatal maternal morbidity and mortality, careful prenatal counseling with early and accurate detection is important. Although conventional prenatal ultrasound(US) examination in midterm pregnancy has been applied for screening of cleft lip, there are definite limitations in the diagnosis of accompanying cleft palate or alveolar cleft. We applied high-resolution 3D US along the serial axial, coronal and sagittal plane so that we could diagnose the cleft palate and/or alveolar cleft in fetuses with cleft lip. Methods: From May 2005 to September 2005, 20 fetuses with cleft lip were examined with prenatal 3D US. Average maternal age was 28.8 years old(24-35 years old), and average gestational age was 24.8 weeks(17.6 to 34.2 weeks). Consecutive axial, coronal and sagittal multislice view were obtained via prenatal 3D US examination and diagnosis of cleft palate and/or alveolar cleft in cleft lip fetuses was followed. Results: With noninvasive and safe prenatal 3D US examination, 17 of 20 cleft lip fetuses were demonstrated to have cleft palate and/or alveolar cleft. Prenatal counseling according to the result was made. Conclusion: Existing prenatal US examination is suitable for screening the cleft lip fetuses but has limitation in identifying the related existence of cleft palate and/ or alveolar cleft. Authors verify the presence of cleft palate and/or alveolar cleft acquiring the successive multislice axial, coronal, and sagittal view with prenatal 3D US examination. Therefore, prenatal 3D US examination could be regarded as a noninvasive and secure screening modality in fetuses with cleft lip for confirming whether cleft palate and/or alveolar cleft is accompanied.

• Archives of Plastic Surgery
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• v.44 no.3
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• pp.217-222
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• 2017

Background The prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication. Methods In this case series, a 20-year retrospective analysis (1994-2014) identified patients from our records (medical records and screening day registries) with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty. Results Palatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%. Conclusions The prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility.