• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권3호
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• pp.200-204
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• 2012

In the repair of unilateral complete cleft lip, the most popular method is the rotation-advancement by Millard. Despite advantages of Millard repair, a few pitfalls exist. Above all, some of the scars, at the height of the cleft side philtral ridge, cross the Langer's line. Further, in the repair of complete cleft lip, small triangular lateral lip flap is often added in the base of an advancement flap to level the Cupid's bow. Moreover, preservation of the advancement flap has some negative effects on a primary nasal repair. As a result, the shape of philtrum is somewhat unnatural. Therefore, I applied the extended Mohler repair in the six cases of complete wide cleft lip to get a more esthetic scar. As a result, more natural, straight philtral ridge was obtained, without adding small triangular flap in the base of the advancement flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권2호
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• pp.154-157
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• 2011

The primary purpose of cleft lip surgery should be the aesthetic and functional recovery of the facial components. Triangular flap repair is one of the most common techniques used in cleft lip surgery. In this case report, thirty patients with unilateral cleft lip had been treated using the Tennison-Randall method. The results were favorable and there have been no permanent complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권4호
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• pp.348-355
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• 2006

우리는 3예의 편측성 불완전 구순열 환아에서 Bardach 삼각피판법을 사용하여 구순열을 수복하였다. Millard법에 비해 비주기저부와 비익기저부에 부가적인 절개를 가하지 않으므로 술후 반흔을 줄일 수 있었다. 또한 Tennison-Randall법에 비해 간단하면서도 정교한 계측에 의한 작도가 가능하였다. 한편 삼각피판법의 단점으로 지적되고 있는 인중 부위의 술후 반흔은 3예 모두 불완전 구순열이었기 때문에 삼각피판의 길이가 짧아 심미적으로 허용할 만하였다. Bardach 삼각피판법은 편측성 불완전 구순열의 수복에 추천할 만한 술식임을 경험하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권2호
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• pp.133-139
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• 2012

모든 환자들은 구순접합술을 시행 받았고 구순 및 구개열 유아들은 악정형장치인 Latham을 사용하였다. 수술의 기술적 변화들은 앞서 설명하였다. Columella 부위의 높은 rotation과 releasing incision은 내측 입술 부위를 충분히 길게 해주고, advancement flap이 phitral column 상방으로 최소로 침범되게 하여 균형적인 입술을 만들 수 있다. 또한 구륜근을 외번시켜 philtral ridge를 형성하고, 작은 unilimb Z-plasty을 구순측 Cupid's bow handle 높이에 맞게 시행 후, vermilion-cutaneous junction에서부터 상방으로 cutaneous closure 시행한다. 변위된 alar cartilage는 nostril rim incision을 통해 동측 upper lateral cartilage에 매달며, Alar base는 anterior-caudal septum의 위치, sill의 설정 그리고 외측 vestibular web 제거를 포함하여 3차원적으로 설계하여 치료해야 한다. 이번에 소개한 Mulliken의 치료법이 환자들과 외과의사들에게 많은 도움이 되기를 바란다.

• 대한구순구개열학회지
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• 제11권2호
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• pp.77-82
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• 2008

The harmonious lip length, residual scar and Cupid's bow width and peak with a normal side are the aims of a unilateral cleft lip repair. Also, long term amelioration without necessary of revisional surgeries may be the ideal conditions. No one method can satisfy the wide varieties of cleft lip deformities. Recently with rearrangement of paraoral muscle and some modifications, a straight line repair technique has been concerned again. Straight scar line, simplicity, and short learning curve are the advantages of the straight line technique. Here two cases of the simple straight line technique were presented and discussed for its usefulness and reliability with short reviews of previous reports.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권1호
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• pp.55-62
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• 2007

구순열의 일차 수술 또는 이차 수술 후에 발생하는 상순의 지나친 긴장은 상하순 간의 부조화, 상악열성장, 골격성 III급 부정교합 등 안모추형을 초래한다. 상순의 긴장이 매우 심한 경우에는 하순의 여유 있는 조직을 이용하여 상순을 수정하는 Abbe 피판을 고려할 수 있다. 상순의 긴장이 큐피드궁의 2/3 이상의 조직 손실을 동반할 경우 Abbe 피판의 적응증이 된다. Abbe 피판은 상순과 하순의 반흔, 색상의 부조화, 그리고 상순의 불완전한 운동을 초래하는 단점을 가진다. 그러므로 Abbe 피판은 신중하게 사용되어야 한다. 우리는 편측성 구순열 1예와 양측성 구순열 3예에서 상순의 과도한 긴장과 큐피드궁의 조직 결핍 그리고 비변형이 심한 이차성 구순열비변형을 교정하기 위해 세 가지 형태의 Abbe 피판을 이용한 이차 교정술을 경험하였다. Abbe 피판수술을 시행한 결과 상순의 반흔과 긴장이 해소되고 큐피드궁이 재건되고 비주의 길이가 증가되어 이차 구순열비변형을 교정할 수 있었다. Abbe 피판은 신중을 기해 적용한다면 구순열 수술 후에 발생되는 상순의 수평적 긴장감이나 편평함을 해결하는 데 유용한 술식임을 알 수 있었다.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.97-101
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• 2011

Purpose: Nasal bone fracture is the most common type of facial bone fracture. The standard 6-view photography was not adequate to support the evaluation of nasal deformity and the results of closed reduction. The authors have standardized a bird's eye view photography to more effectively evaluate this nasal deformity. Methods: We reviewed the medical records and radiologic studies of 63 nasal bone fracture patients. We had taken clinical photography including bird's eye view that was standardized as nasal tip was aligned to Cupid's bow of upper lip and light was focused on the nasion of all 63 patients. Results: Nasal deviations and reductions were more noticeable on the newly standardized bird's eye view. This clinical photography was very useful to explain the results of reduction. Conclusion: It was concluded that this photography can be more reliable for evaluation of severity of nasal deformity and the result of closed reduction.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.155-160
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• 2005

The aim of this study is to establish anatomical dimension of the lip in young population in Korean, using specially designed soft ware with photographic image. We measure 13 anatomical dimensions of lips in 2,229 young people. (917 male, 1312 female, Aged from 18-33 years. Average age 19.7). Statistical analysis of these measurements of large population could offer useful information in facial plastic surgery. The mean measurements are as follows 1. Lengths (male/female) Widths of philtrum: $1.11{\pm}0.19cm/1.02{\pm}0.21cm$ Heights of philtrum: $1.6{\pm}0.24cm/1.47{\pm}0.21cm$ Heights of cupid bow: $0.88{\pm}0.16cm/0.83{\pm}0.16cm$ Height of upper vermilion: $0.74{\pm}0.16cm/0.70{\pm}0.15cm$ Height of lower vermilion: $1.08{\pm}0.17cm/1.02{\pm}0.15cm$ Height of upper lip(Rt.): $1.24{\pm}0.2cm/1.23{\pm}0.2cm$ Height of upper lip(Lt.): $1.24{\pm}0.2cm/1.17{\pm}0.19cm$ Half horizontal length of lip: $2.2{\pm}0.26cm/2.11{\pm}0.2cm$ Horizontal length of lip: $4.41{\pm}0.4cm/4.25{\pm}0.36cm$ Height of lower face: $7.1{\pm}0.58cm/6.52{\pm}0.6cm$ 2. Angles Nasolabial angle: $97.77{\pm}11.97^{\circ}/95.5{\pm}11.34^{\circ}$ Mentolabial angle: $133.88{\pm}14.65^{\circ}/129.27{\pm}13.67^{\circ}$ Angle of Cupid's bow: $111.65{\pm}13.99^{\circ}/116.75{\pm}16.2^{\circ}$ Previous reported photogrammetric measurements was difficult to implement to surgical practice. Because these were printed photographies of the same size. Therefore, in this study, we can measure a lot of objects and items more conveniently and correctly by using proportional program on computer after taking a digital photograph. Consequently, proportional measurements with photogrammetry of lip could be useful and corrective substitute for anthropometrical measuring. These data could be useful reference for preoperative consultation, surgical planning and learning anatomical measurement of lips and adjacent structures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권3호
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• pp.178-183
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• 2013

Cleft lip arises from congenital underdevelopment with various degrees and patterns. Mulliken named a unilateral incomplete cleft lip with no severe cleft as a lesser-form cleft lip and categorized it into three subgroups. Anatomically categorized subgroups are minor-form, microform, and mini-microform cleft by the extent of vermilion-cutaneous dysjuntion. The vermillion cutaneous notch is more than 3 mm from the regular Cupid's bow peak for minor-form, less than 3 mm for microform, and almost no gap with discontinuity on the vermillion cutaneous border for mini-microform. The treatments are rotational advancement flap for minor-form, double unillimb Z-plasty for microform, and vertical lenticular excision for mini-microform, respectively. This article aims to present the literature review about the incomplete lesser form cleft lip classified by Mulliken and to report our experiences.

• Clinical and Experimental Pediatrics
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• 제57권6호
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• pp.292-296
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• 2014

The deletion of the distal long arm of chromosome 1 is associated with a characteristic facial appearance and a pattern of associated malformations. Characteristic manifestations include a round face with prominent 'cupid's bow' and downturned corners of the mouth, thin vermilion borders of lips, a long upper lip with a smooth philtrum, a short and broad nose, epicanthal folds, apparently low-set ears, micrognathia, microcephaly, abnormal hands and feet, variable cardiac or genital anomalies, moderate to severe mental retardation, and growth retardation. Using fluorescent in situ hybridization (FISH) analysis to map precisely the deletion, we present a case of chromosome 1q44 deletion with craniofacial characteristics, multiple congenital anomalies, and growth and psychomotor retardation. In comparison with other reported cases of 1q43-44 deletion, the subject does not show hydrocephalus, seizure, syn- or polydactyly of hands, and a urogenital anomaly. However, an arachnoid cyst, pinpoint dimple on the midline of the forehead, a right-sided supernumerary nipple and auricular pit, polydactyly of the right foot, adducted thumb, and flexion restriction of the proximal interphalangeal joint with a simian line in both hands were observed additionally.