• Korean Journal of Cleft Lip And Palate
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• v.6 no.1
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• pp.27-34
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• 2003

Patients with maxillary hypoplasia secondary to cleft lip and palate present numerous challenging problems for the oral and maxillofacial surgeon, These patients present with maxillary hypoplasia in multiclimensions, and often have thin or structually weak bone. This deformity has been traditionally corrected by Le Fort I osteotomy and acute skeletal advancement with wide surgical exposure. The long-term results of cleft patients with maxillary deficiency treated with this traditional approach has been sometimes disappointing, and an increased relapse tendency has been reported, Distraction osteogenesis for these cleft patients offers successful results while potentially minimizing the risk of relapse. Advancing the maxilla via distraction forces requires only a minor surgical procedure that maintains vascularity and neurosensory integrity. Moreover, the response of the facial soft tissues during maxillary distraction has proven to be more favorable than with a conventional LeFort I osteotomy. The purpose of this report is to present the use of maxillary distraction osteogenesis by rigid external distraction (RED) system for the treatment of patient with maxillary deficiency secondary to cleft lip and palate.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.3
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• pp.141-151
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• 2019

Objectives: The outcomes of the treatment of unilateral cleft lip can vary considerably due to variations in repair techniques. The aim of this study was to evaluate and compare treatment outcomes of surgical repair of unilateral cleft lip using either the Tennison-Randall or Millard technique based on (qualitative) parent/subject and professional assessments. Materials and Methods: This was a prospective, randomized, controlled study conducted at Lagos University Teaching Hospital between January 2013 and July 2014. A total of 56 subjects with unilateral cleft lip presenting for primary surgery who satisfied the inclusion criteria were recruited for the study. Subjects were randomly allocated to surgical groups A or B through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard rotation advancement technique. Surgical outcome was assessed using qualitative evaluation by the guardian/subject and independent assessors based on a modified form of the criteria described by Christofides and colleagues. Results: Of the 56 subjects enrolled in this study, 32 were male, with a male to female ratio of 1.3:1. Fifteen of the guardians/subjects in the Tennison-Randall group were most bothered about the lower part of the residual lip scar, while 12 guardians/subjects in the in the Millard group were most bothered about the upper part of the scar. More noses were judged to be flattened in the Millard group than in the Tennison-Randall group. Assessors observed a striking disparity in scar transgression of the philtral ridges between the two groups. Conclusion: Essentially, there were no major difference in the overall results between Millard rotation-advancement and Tennison-Randall repairs. Both Millard and Tennison-Randall's techniques require significant improvements to improve the appearance of the scar on the upper part and lower part of the lip, respectively.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.1
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• pp.3-11
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• 2018

Objectives: The unilateral cleft lip (UCL) repair technique has evolved extensively over the past century into its modern form and has been identified as an important determinant of treatment outcome. The aim of this study was to evaluate and compare treatment outcomes following repair of UCL using either the Tennison-Randall (triangular) technique or the Millard rotation-advancement technique. Materials and Methods: This was a prospective randomized controlled study conducted at the Lagos University Teaching Hospital between January 2013 and July 2014. A total of 48 subjects with UCL presenting for primary surgery and who satisfied the inclusion criteria were recruited for the study. The subjects were randomly allocated into two surgical groups through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard rotation-advancement technique. Surgical outcome was assessed quantitatively according to anthropometric measurements, using a method described by Cutting and Dayan (2003). Results: Our 48 enrolled subjects were evenly divided into the two surgery groups (n=24 for both group A and group B). Twenty-seven subjects were male (56.3%) and 21 were female (43.8%), making a sex ratio of 1.3:1. The Millard group showed a greater increase in postoperative horizontal length and vertical lip height and a greater reduction in nasal width and total nasal width. Meanwhile, the Tennison-Randall group showed better reduction of Cupid's-bow width and better philtral height. Conclusion: We did not find any significant differences in the surgical outcomes from the two techniques. The expertise of the surgeon and individual patient preferences are the main factors to consider when selecting the technique for unilateral cleft repair.

• Imaging Science in Dentistry
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• v.42 no.4
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• pp.225-229
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• 2012

Purpose: This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. Materials and Methods: The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either "non-cleft side" or "cleft side". The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. Results: The pixel area showed a significant difference between the "non-cleft side" and "cleft side" in group 0 ($404.27{\pm}103.72/117.73{\pm}92.25$; p=0.00), group 1 ($434.29{\pm}86.70/388.31{\pm}109.51$; p=0.01), and group 4 ($430.98{\pm}98.11/366.71{\pm}154.59$; p=0.02). No significant differences were found in group 2 ($423.57{\pm}98.12/383.47{\pm}135.88$; p=0.06) or group 3 ($433.02{\pm}116.07/384.16{\pm}146.55$; p=0.19). Conclusion: Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

• Proceedings of The Korean Cleft Lip And Palate Association
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• 1997.06a
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• pp.46-46
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• 1997

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2002.05a
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• pp.26-26
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• 2002

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2002.05a
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• pp.37-38
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• 2002

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2002.05a
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• pp.35-35
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• 2002

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.81-86
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• 2005

Cleft palate patients with congenital anomalies have an increased risk of airway problems following palatoplasty. Factors that were related included presence of associated congenital anomalies, duration of surgery, age at time of surgery, history of previous airway problem, and excessive pressure exerted on the base of the tongue by Dingman retractor. This report described a complication of post-operative Pneumonia after palatoplasty (Furlow technique), which resulted in a life-threatening acute airway obstruction in an infant with cleft palate. Patient has a history of previous mild airway problems. In addition to this problem, we speculate that Furlow technique involves more extensive surgical dissection than other techniques may increase risk for upper airway obstruction. Awareness of this risk permits identifying those patients prior to surgery so that they can be monitored and managed properly, minimizing the likelihood of major complications or possibility of death.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.87-94
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• 2005

Patients with unilateral cleft lip and palate (UCLP) generally demonstrate the asymmetries in the lip, nose and the naso-maxillary complex. And their skeletal asymmetries are known to be derived from the displacement of nasal septum, anterior nasal spine (ANS) and the pre-maxilla toward the non-affected side during the developmental and growth period. Due to the interruption of the important facial muscles, which are critical for the symmetric growth of premaxilla, functional matrix system fails to develop and results in the displacement of the ANS toward the non-affected side and nasal asymmetry. Therefore the rhinoplasty for CLP patients is required to have inter-skeletal and muscular rearrangement in the naso-maxillary complex in order to let them recover from esthetic and physiologic imbalances. And functional cheilorhinoplasty (FCR) has been a representative treatment of choice for this concept of treatment modality. The outcome and prognosis of primary or repair FCR have been known to be definitely affected by timing of the operation as well as adequate reconstruction of naso-labial muscles. However, sometimes FCR has an ineffective treatment results for patients after the facial growth period, and the limited rhinoplasty around the nose often fails to bring satisfying results. In order to circumvent this limitation, we performed ANS osteotomy for patients with unilateral CLP showing asymmetric nose, as an alternative way for corrective rhinoplasty. We could observe that the nose was rearranged along the facial mid-line by this osteotomy design and asymmetries were evidently improved postoperatively. Here we present this osteotomy method in CLP patients.