• 제목/요약/키워드: Double Opposing Z-Plasty

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과대비성을 동반한 점막하 구개열 환자에 대한 Double Opposing Z-plasty 3례 (Three Cases of Submucous Cleft Palate with Hypernasality Treated with Double Opposing Z-plasty)

  • 최홍식;이승수;김성국;김태만;김현준
    • 대한후두음성언어의학회지
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    • 제9권2호
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    • pp.168-172
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    • 1998
  • Several kinds of surgical methods have been used to treat the submucous cleft palate with hypernasality. The purpose of this study was to evaluate the double opposing Z-plasty which is one of the newly established surgical methods by Dr. Furlow in three cases of submucous cleft palate with hypernasality operated in this department. There were a number of advantage of double opposing Z-plasty. The surgery is adaptable for use in early patient. Midfacial growth retardation and complication were not seen in all cases. Hypernasality was improved subjectively. Using the nasometer, the nasalance score of the postoperative period was compared with that of before surgery, much improvement were noted in 'Ah', 'PaPa'. And fiberoptic endoscope was used to evaluate the velopharyngeal closure pattern. Velopharyngeal closure pattern with velum was improved dramatically, Double opposing Z-plasty seem to be a good procedure for the treatment of submucous cleft palate with hypernasality.

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과대비성을 동반한 점막하구개열 환자에 대한 Double Opposing Z-plasty를 통한 수술적 치료 결과 (Outcomes for Patients with Submucous Cleft Palate Accompanying Hypernasality Treated with Double Opposing Z-plasty)

  • 김현준;김진영;배정호;김광문;최홍식
    • 대한후두음성언어의학회지
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    • 제11권1호
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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.

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Double Opposing Z-Plasty 수술 후의 점막하 구개열 아동의 말소리 개선에 관한 연구 (Speech Outcomes of Submucous Cleft Palate Children With Double Opposing Z-Plasty Operation)

  • 최홍식;홍진희;김정홍;최성희;최재남;남지인
    • 대한후두음성언어의학회지
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    • 제13권2호
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    • pp.180-187
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    • 2002
  • Background and Objectives : The operation Double Opposing Z-Plasty, has been used for improving VPI function in the submucous cleft palate. However, few reports on the effects of the speech change were presented. The purpose of this study is to compare the difference of nasality and nasalance, parents satisfaction between before and after this operation and to consider how much improvement in speech. Materials and Methods : Ten submucous cleft palate children who underwent double opposing Z-plasty were analyzed. We retrospectively studied nasalance, auditory perception (nasality) with hypernasality, patients satisfaction, speech evaluation by using charts review, video tape, telephone interview. Results : In 8 patients of 10 submucous cleft palate, hypernasality reduced and speech intelligibility was higher and mean 0.35 point was increased in the velum length after operation. After operation, nasality was improved (2.0 point) and level of nasal emission decreased. Regarding satisfaction of this operation, scale was mean 2.8 (5 point-scale) : 8 parents were satisfied in the resonance, 3 parents were satisfied articulation. The reason of dissatisfaction was mostly compensatory articulation. Conclusion : To improve of speech in the submucous cleft palate, speech therapy afterthis operation as well as successful surgery should be considered.

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비인강폐쇄기능부전의 치료에 있어서 Furlow 이중 Z-성형술의 효과 (The Effectiveness of Furlow's Double Opposing Z-plasty for Treatment of Velopharyngeal Insufficiency)

  • 김수호;김유진;박형욱;천강용;황순정
    • 대한구순구개열학회지
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    • 제15권2호
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    • pp.97-108
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    • 2012
  • Velopharyngeal insufficiency (VPI) is improper closure of velopharynx during the phonation and swallowing due to various causes, especially appeared in cleft palate patients. The several surgical techniques and speech therapy can be considered in treatment of VPI. The surgical techniques such as Furlow's double opposing Z-plasty, pharyngeal flap, push-back palatoplasty, etc. have been widely used when the speech therapy is not so much effective. However, there is considerable variability in the methods for evaluation and in success criteria making difficult to compare among surgical techniques. This article reviewed the recent articles about comparing the surgical techniques in treatment of VPI. Although there is no significant difference in speech assessment by speech pathologist, Furlow's double opposing Z-plasty is a useful technique especially diminishing hypernasality and nasal emission.

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댄디워커증후군에 동반된 점막 밑 입천장갈림증 치험례 (Dandy-Walker Syndrome with Submucous Cleft Palate: A Case Report)

  • 강범식;나영천
    • 대한두개안면성형외과학회지
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    • 제13권1호
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    • pp.54-56
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    • 2012
  • Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

점막하 구개열이 동반된 선천성 비구개누공 (Congenital Palatal Fistula with Submucous Cleft Palate)

  • Kim, Sukwha;Min, Kyung Hee;Yun, Byung Min
    • Archives of Plastic Surgery
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    • 제36권3호
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    • pp.333-335
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    • 2009
  • Congenital palatal fistulas are rare, and few cases have been reported. Most reported cases present with a submucous cleft palate. In terms of etiology, whether the fistula is congenital or acquired has been debated. Moreover, there is not a generally accepted surgical procedure for repair of palatal fistulas. We present a case of a congenital palatal fistula with a submucous cleft palate that was successfully treated with a Furlow double - opposing Z - plasty. We discuss palatal fistulas with a review of the literature.

Three Cases of Submucous Cleft Palate with Hypernasality Treated with Double Opposing Z-plasty

  • 최홍식;이승수;김성국;김태만;김현준
    • 대한음성언어의학회:학술대회논문집
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    • 대한음성언어의학회 1998년도 제10회 학술대회 심포지움
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    • pp.189-189
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    • 1998
  • 점막하 구개열(submucous cleft palate)은 특징적인 임상적 해부학적 기형을 나타내는데 이분 구개수(bifid uvula), 근육의 분리(muscular diastasis), 경구개 후연의 절흔(frank notching of the posterior hard palate)등이다. 결국 이러한 기형을 교정하지 않으면 과비음과 공명장애로 인한 조음장애는 사회생활에 중요한 영향을 미치고, 사람의 인상에 나쁜 영향을 주게되어 개인의 인성 형성의 장애와 삶의 질의 저하를 초래하게 된다. (중략)

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