• Korean Journal of Cleft Lip And Palate
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• v.10 no.1
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• pp.39-56
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• 2007

The bilateral cleft lip, a more severe form of clefting than unilateral cleft lip, involves separation of the lip along philtral lines, isolating the central segment (prolabium). Bilateral cleft lip may be either symmetrical or asymmetrical, in which case the cleft lip is split more on one side than on the other. The cleft affects the obvious facial form as an anatomic deformity and has functional consequences, affecting the child's ability to eat, speak, hear, and breathe. Although there would seem to be quite a variance in reported figures, ratios of cleft lip with or without cleft palate have gone as high as 1:500 and as low as 1:1000. It is known that less than 10% of cleft lips are bilateral. Although bilateral cleft lip is less common than unilateral cleft lip, the deformity is more severe, and the reconstructive technique is more complex. Surgery is the only treatment necessary for patients with bilateral cleft lip. Accompanying the evolution of surgical repair is the increasingly important role of orthodontic support with early presurgical alveolar and nasal molding. Repositioning the maxillary and alveolar segments into a more anatomic position allows the surgeon to repair the lip and associated nasal deformity under more optimal conditions. The purpose of this article is to review the related anatomy, presurgical management, and surgical management of bilateral cleft lip.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.397-400
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• 2019

Frontonasal dysplasia is an uncommon congenital anomaly with diverse clinical phenotypes and highly variable clinical characteristics, including hypertelorism, a broad nasal root, median facial cleft, a missing or underdeveloped nasal tip, and a widow's peak hairline. Frontonasal dysplasia is mostly inherited and caused by the ALX genes (ALX1, ALX3, and ALX4). We report a rare case of a frontonasal dysplasia patient with mild hypertelorism, a broad nasal root, an underdeveloped nasal tip, an accessory nasal tag, and a widow's peak. We used soft tissue re-draping to achieve aesthetic improvements.

• Archives of Craniofacial Surgery
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• v.18 no.4
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• pp.287-291
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• 2017

Preauricular sinus is a congenital malformation that is very commonly encountered among the general population and it has especially high prevalence among Asians when compared to other ethnic groups. It can often go unnoticed or easily overlooked by the patient or even by doctors because most of them are asymptomatic and is most of the time only a tiny pit that can be trivial in terms of aesthetics. We report a very rare and unique case that has no precedence what so ever; hence no reported case in the literature: an ectopic preauricular sinus in a facial cleft and microsomia patient.

• The korean journal of orthodontics
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• v.20 no.1
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• pp.197-207
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• 1990

This comparative study was undertaken to investigate the position of the hyoid bone in unilateral cleft lip and palate individuals. The materials for this study consisted of 35 subjects with surgically repaired unilateral cleft lip and palate (25 males, 10 females) and 40 subjects with normal facial morphology (20 males, 20 females). Cephalometric measurements of unilateral cleft and palate individuals were compared with those of non-cleft individuals. The conclusions of this study were obtained as follows: 1. To the anterior cranial base, the hyoid bone in unilateral cleft lip and palate individuals was located downward as compared with non-cleft individuals. 2. To the mandible, the hyoid bone in unilateral cleft lip and palate individuals was located backward as compared with non-cleft individuals. 3. The distance between the dorsum of the tongue and the inferior border of the hard palate in unilateral cleft lip and palate individuals was longer than that in non-cleft individuals. 4. Unilateral cleft lip and palate individuals showed no significant difference in the distance between the hyoid bone and the dorum of the tongue as compared with non-cleft individuals.

• Korean Journal of Cleft Lip And Palate
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• v.13 no.2
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• pp.77-84
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• 2010

Vomer flap is used to repair anterior hard palate in complete cleft lip and palate patients. As the midline structure located in between the two cleft segments of hard palate, the vomer flap is very useful because of its vicinity to cleft site and their ease of execution when it is done with primary cheiloplasty simultaneously. In addition, the quality of tissue is very similar to that of the nasal mucosa with good vascularity. In cases of simultaneous repair of cleft lip with anterior palate using vomer flap, the hard palate can be repaired at the same time with primary cheiloplasty which is earlier period than other techniques. With simultaneous close of cleft lip and cleft hard palate by vomer flap, subsequent palatoplasty does not require wide dissection, and consequently chance of oronasal fistula formation will be minimized. Additionally, surgical time will be reduced and, the harmful effects on mid-facial growth will be diminished. In this article, we will introduce the comprehensive vomer flap technique with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.13-20
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• 2006

The articulation disorders associated with velopharyngeal insufficiency (VPI) in cleft palate patients are interested to clinicians particularly. The purpose of this study was to investigate mainly the oropharyngeal air pressure and overall air flow in cleft palate patients. The pressure-measuring catheter was positioned at the midportion of the oropharyngeal cavity with a facial mask. Test words were composed of 9 meaningless polysyllabic words and 17 meaningful words. Aerophone II and Nasometer II were used to measure peak air pressure, mean air pressure, maximum flow rate, volume, phonatory flow rate, nasalance. The data shows that airflow of the cleft palate patient group were higher than those of the control group. Intraoral air pressure of the cleft palate patient group was lower than those of the control group. The first vowel formant and first Bandwidths of the cleft palate patient group were higher than those of the control group.

• Archives of Craniofacial Surgery
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• v.16 no.2
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• pp.49-52
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• 2015

The alveolar cleft has not received as much attention as labial or palatal clefts, and the management of this cleft remains controversial. The management of alveolar cleft is varied, according to the timing of operation, surgical approach, and the choice of graft material. Gingivoperiosteoplasty does not yet have a clear concensus among surgeons. Primary bone graft is associated with maxillary retrusion, and because of this, secondary bone graft is the most widely adopted. However, a number of surgeons employ presurgical palatal appliance prior to primary alveolar bone graft and have found ways to minimize flap dissection, which is reported to decrease the rate of facial growth attenuation and crossbite. In this article, the authors wish to review the literature regarding various advantages and disadvantages of these approaches.

• Korean Journal of Cleft Lip And Palate
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• v.11 no.2
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• pp.59-63
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• 2008

Craniofacial Centre at Children's Hospital Boston is a worldwide leader in the care of children and adolescents with craniofacial anomalies especially with cleft lip and/or cleft palate, which provides a team approach to the evaluation, diagnosis and treatment of children and adults with congenital (present at birth) or acquired facial deformities. This is staffed by an experienced team of clinicians, such as in oral and maxillofacial surgery, plastic surgery, neurosurgery, dentistry, audiology, speech and language pathology, genetics, psychiatry, otolaryngology, and social work, all with specialized training in the care of children with craniofacial anomalies. Here, there is a short introduction of history, attending surgeons, works, and sequential treatment for cleft lip/palate patients about this institution.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.407-413
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• 1999

Maxillary duplication is a kind of proliferative neurocristopathy and considered to arise from bifurcation of neural crest elements soon after migration into mandibular arch. Sometimes this malformation is accompanied with oblique facial cleft. Usually this type of maxillofacial malformation requires multiple surgical intervention and the results are far from ideal. It became more troublesome if it had not been properly corrected on time, because secondary deformities could be developed from growth and development of abnormal tissues. This is a case of a 25-year-old-female patient who showed severe facial asymmetry thought to secondary deformity of maxillary duplication and masticatory disturbance due to multiple supernumerary teeth on posterior part right maxilla. We successully treated these deformities through four times of surgery of bone resection, orthodontic treatment, zygomatic and orbital reconstruction, orthognathic surgery and scar revision... ect. So we reported this rare case with review of literatures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.406-415
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• 2010

Purpose: The secondary correction of cleft lip nasal deformity still presents a difficult surgical problems. The present study was aimed to investigate the usefulness of Bardach's technique for secondary correction of cleft lip nasal deformity. Materials and Methods: The subjects were eight patients with unilateral and bilateral cleft lip nasal deformity, who had secondary correction by using Bardach's rhinoplasty technique. Age range was from 2 to 21 years and mean age was 10.6 years. There were 3 boys and 5 girls. Six patients had bilateral and two patients had unilateral cleft lip. Facial photographs were taken before and twenty days after the operation. By using Adobe photoshop, the columella height and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. Results: The degree of improvement of the columella length and the nostril width after Bardach's technique was $70.39{\pm}50.14%$ and $-22.93{\pm}0.15%$ respectively. Bardach's technique resulted in projecting the nasal tip, lengthening the columella, medially advancing the alar bases, restructuring the lower lateral cartilages, and changing orientation of the nostrils from horizontal to oblique. The profile view shows projection of the nasal tip, lengthening of the columella, and the change in the nasolabial angle. The scars remained at the philtrum were matter little in compared with improvement of the nasal appearance. Conclusion: These results indicate that Bardach's technique is an useful surgical technique for secondary correction of cleft lip nasal deformity.