• Proceedings of the KIEE Conference
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• 2005.05a
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• pp.45-47
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• 2005

Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity. Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed on quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three greatly experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.54 no.8
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• pp.517-520
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• 2005

Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed at quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.5
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• pp.230-236
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• 2014

Esthetic reconstruction of cleft lip nose deformity is a challenging task in surgical management of patients with orofacial cleft. The author reconstructed cleft lip nose deformity effectively using autogenous auricular cartilage and a relatively new graft material of porcine dermal collagen, $Permacol^{TM}$. After correction of the deformed lower third of the nose with patient's auricular cartilage, we applied $Permacol^{TM}$ to augment the entire nasal dorsum. Three patients were treated and followed for up to five years. All patients improved in nose aesthetics without any inflammatory or immunogenic reaction. The author suggests that the use of $Permacol^{TM}$ for nasal profile augmentation in the treatment of cleft lip nose deformity is an alternative surgical strategy with minimal surgical invasiveness. The author report long-term experience with combined use of auricular cartilage and $Permacol^{TM}$ in nasal reconstruction for cleft lip nose deformity.

• Archives of Plastic Surgery
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• v.33 no.1
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• pp.75-79
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• 2006

The upper and lower lateral cartilages provide the key to the lower cartilaginous portion of the nose. Lifting the cartilages is essential procedure for correction of unilateral cleft lip nose deformity. After correction of cleft lip nose deformity, authors used acoustic rhinometry (AR) to compare the lower nasal cavity of cleft side with non-cleft side. AR is a well known new, non-invasive diagnostic technique in which nasal geometry is assessed by means of acoustic reflection. From June 1996 to January 2004, we performed acoustic rhinometric analysis after correction of unilateral cleft lip nose deformity. This study involved 40 children of age ranged from 3 months to 8 years. Subjects were divided into the group of incomplete unilateral cleft lip nose deformity(20 subjects), and the group of complete unilateral cleft lip nose deformity(20 subjects). Results show that lower nasal cavity volume between non-cleft side and cleft side has no difference, and better results were obtained when nasal molding prong was applied at cleft side nostril. The results between incomplete type and complete type have no significant difference. In conclusion, AR is an effective method to calibrate cross sectional area and nasal cavity volume of unilateral cleft lip nose deformity, and furthermore effective in comparing the volume of cleft side with non-cleft side after unilateral cleft lip nose deformity correction with lifting the lower lateral cartilages to the upper lateral cartilages.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.81-87
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• 2007

Purpose: Correction of saddle nose remains problematic both in the technique of reconstruction and in the choice of implant material for nasal augmentation. A large variety of graft materials have been used for the reconstruction of the saddle nose deformity. The purpose of this study is to determinate an algorithm for deciding alternative graft materials used in correction of saddle nose deformity. Methods: Six patients with saddle nose who were corrected using by auricular cartilage and costal cartilage at Chosun university hospital were analyzed. Results: After a mean interval of 12 months, all patients were satisfied with the esthetic and functional result. Conclusion: Auricular cartilage is an excellent graft material for esthetic and functional reconstruction of mild to moderate saddle nose deformity.

• Proceedings of the KIEE Conference
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• 2006.04a
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• pp.45-47
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• 2006

Cleft palate is a congenital deformity condition with separation of the two sides of the lip resulting in nose deformity. Evaluation of surgical corrections and outcome assessments for nose deformity due to the cleft lip depends mainly on doctor's subjective judgment. An objective method for evaluation of the condition and surgical outcome of nose deformity due to the cleft palate is needed. This study aimed at objective assessment of a cleft palate nose deformity condition by analyzing the following parameters obtained from photographic images of a cleft palate patients: (1) angle difference between two nostril axes. (2) center of the nostril and distance between two centers. (3) overlapped area of two nostrils, and (4) the overlapped area ratio of the two nostrils. A regression equation of doctor's grades was obtained using the eight parameters. Three plastic surgeons gave us the grades for the each photographic image by 10 increments with maximum grade of 100. The average reproducibility of the grades given by the three plastic surgeons and the three laymen using the developed program was $10.8{\pm}4.6%$ and $7.4{\pm}1.8%$, respectively. Kappa values representing the degree of consensus of the plastic surgeons and the three laymen were 0.43 and 0.83. respectively. Correlation coefficient of the grades evaluated by the surgeons and obtained by the neural network was 0.798. In conclusion. the developed neural network model provided us better reproducibility and much better consensus than doctor's subjective evaluation in addition to objectiveness and easy application.

• Proceedings of the KIEE Conference
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• 2004.11c
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• pp.3-5
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• 2004

Cleft lip is one of the most common congenital deformities in craniofacial region. Despite the many reports on the outcome of various surgical techniques from individual medical centers, the evaluation of the outcome is based on the subjective observation because of lack of the objective evaluation system. Therefore, a new technique of objective and scientific evaluation for the nasal deformity of secondary cleft lip and nose deformity is critical to improve the management of the cleft patients including the decision of optimal age of operation and surgical technique as veil as evaluation of the outcome. In this study, a new method was proposed to evaluate the nasal deformity using nostril angle, distance, and area of patient images. The images were also evaluated by three expert plastic surgeons, and put into scale of 5 percentile. Measurement results were compared between the each category and the surgeon's evaluation, and coefficients of each category were statistically tested. As a result, The normalized overlap area of right and left nostrils and distance ratio between two centers of nostrils showed high coefficient with evaluations of plastic surgeons.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.702-706
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• 2009

Purpose: Analysis of lower nose and upper lip asymmetry in patients with unilateral cleft lip nose deformity has been proceeded through direct measurement and photo analysis. But there are limitation in presenting real image because of its 2 dimensional trait. The authors analyzed such an asymmetry using 3D VECTRA system (Canfield, NJ, USA) in quantitative way. Methods: In 25 Patients with unilateral cleft lip nose deformity(male 12, female 13, age ranging from 4 to 19), patients with right side deformity were 10 and left were 15. Analysis of asymmetry was proceeded through 3D VECTRA system. After taking 3 dimensional photo, alar area, upper lip area, nostril perimeter, nostril area, Cupid's bow length, nostril height and nostril width were measured. Correlation coefficient and inter data quotients were calculated. Results: In nostril perimeter, maximal difference of cleft side and non - cleft side was 39.3%, asymmetric quotient Qasy = Qcl/Qncl(Qcl, value of cleft side; Qncl, value of non - cleft side) was ranged from 0.84 to 1.85 and in seven cases the length of cleft side was smaller. In nostril area, maximal difference was 69.6% and in 13 cases cleft side was smaller. In lower nasal area, maximal difference was 37.2% asymmetric quotient Qasy = Qcl/Qncl was ranged from 0.47 to 2.03 and in 20 cases cleft side was smaller. The correlation coefficients of nostril perimeter and area were 0.8345. Conclusion: Using 3D VECTRA system, the authors can measure nostril perimeter and lower nasal area that could not been measured with previous methods. Asymmetry of midface was analyzed through area comparison in quantitative way. Futhermore, post operative change can be measured in quantitative method.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.574-580
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• 2008

Purpose: Philtral deformity is a stigma of secondary cleft lip nose. It occurs from the false arrangement of orbicularis oris muscle and the scar of previous operation. Various methods have been used to correct this deformity. We successfully corrected philtral deformity using overlapping of orbicularis oris muscle flap. Methods: From November 2000 to August 2007, we performed 39 cases of correction of philtral deformity in secondary cleft lip nose with overlapping of orbicularis oris muscle flap. Their age ranged from 5 to 53 years old. Existing scar tissue of previous operation was deepithelialized and preserved as scar flap. Lateral orbicularis oris muscle flap was elevated, advanced and overlapped upon medial muscle flap after dissection of orbicularis oris muscle of both sides. Reconstruction of philtral column was made from overlapping area by fixation of end part of lateral muscle flap to the point between philtral dimple and column. The degree of muscle flap advancement was decided by correction state of lateral muscle bulging. Correction of nostril floor depression or whistle deformity was also performed with preserved scar flap, if necessary. Results: Realignments of orbicularis oris muscle were possible in the majority of the patients and final results of philtral reconstruction were satisfactory mostly. Correction of nostril floor depression and whistle deformity was also achieved. Additional correction was performed later to 4 patients in whom insufficient reconstruction was noted. No significant complication was observed. Conclusion: More natural and symmetric philtrum was acquired with overlapping of orbicularis oris muscle flap. To the authors' knowledge, it is an easy and effective method for correction of philtral deformity through anatomical rearrangement of distorted orbicularis oris muscle with relatively simple procedure.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.458-464
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• 2006

Purpose: Saddle nose deformity results from lack of support to the nasal dorsum. The integrity of both the cartilaginous or bony portion of the nose is compromised. Cantilever bone graft is the mainstay for correction of saddle nose deformity, but the problems of bone graft are stiffness of the nasal tip and resorption. Thus the authors propose a costochondral cantilever graft, with the bony and cartilaginous portion harvested as one block, using cartilaginous portion as support to the nasal tip. Methods: Between October of 1996 and July of 2005, 8 cases of saddle nose deformity were treated by the same surgeon. All patients had undergone costochondral cantilever graft. Postoperative evaluation included the depression of the nasal dorsum and tip. Comparisons of preoperative and postoperative photographs was done if possible. Results: The mean follow-up period was 5.9 years. The results were excellent aesthetically and there was no complication. Conclusion: The authors' method maximize the benefits of each bone and cartilage graft while minimizing their inherent limitations.