• Title/Summary/Keyword: Palate

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Prenatal Diagnosis of Accompanying Alveolar Cleft and Cleft Palate in Fetuses with Cleft Lip Using Prenatal 3D Sonographic Identification and Antenatal Counseling (구순열 태아에서 3D 산전 초음파를 이용한 치조열 및 구개열의 동반 유무 진단 및 산전상담)

  • Koh, Kyung Suck;Kim, Hoon;Choi, Jong Woo;Won, Hye Sung;Kim, Sun Kwon
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.181-185
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    • 2007
  • Purpose: Cleft lip and/or palate is the most common congenital facial anomaly whose incidence is about 1 in 500~1000 live births. As this anomaly may be associated with the serious chromosomal anomalies or the multiple organ abnormalities resulting in the fetal loss or perinatal maternal morbidity and mortality, careful prenatal counseling with early and accurate detection is important. Although conventional prenatal ultrasound(US) examination in midterm pregnancy has been applied for screening of cleft lip, there are definite limitations in the diagnosis of accompanying cleft palate or alveolar cleft. We applied high-resolution 3D US along the serial axial, coronal and sagittal plane so that we could diagnose the cleft palate and/or alveolar cleft in fetuses with cleft lip. Methods: From May 2005 to September 2005, 20 fetuses with cleft lip were examined with prenatal 3D US. Average maternal age was 28.8 years old(24-35 years old), and average gestational age was 24.8 weeks(17.6 to 34.2 weeks). Consecutive axial, coronal and sagittal multislice view were obtained via prenatal 3D US examination and diagnosis of cleft palate and/or alveolar cleft in cleft lip fetuses was followed. Results: With noninvasive and safe prenatal 3D US examination, 17 of 20 cleft lip fetuses were demonstrated to have cleft palate and/or alveolar cleft. Prenatal counseling according to the result was made. Conclusion: Existing prenatal US examination is suitable for screening the cleft lip fetuses but has limitation in identifying the related existence of cleft palate and/ or alveolar cleft. Authors verify the presence of cleft palate and/or alveolar cleft acquiring the successive multislice axial, coronal, and sagittal view with prenatal 3D US examination. Therefore, prenatal 3D US examination could be regarded as a noninvasive and secure screening modality in fetuses with cleft lip for confirming whether cleft palate and/or alveolar cleft is accompanied.

Palatal obturator restoration of a cleft palate patient with velopharyngeal insufficiency: a clinical report (구개인두 기능부전을 갖는 구개열 환자에서 폐쇄장치를 이용한 보철 치료 증례)

  • Heo, Yu-Ri;Kim, Jong-Wook;Lee, Gyeong-Je;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.353-360
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    • 2013
  • Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.

An epidemiologic study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Pusan National University Hospital (부산대학교병원 교정과에 내원한 구순구개열 환자들에 대한 역학조사)

  • Son Woo-Sung;Baek Jae-Ho;Lee Won-Chul
    • Korean Journal of Cleft Lip And Palate
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    • v.5 no.1
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    • pp.43-58
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    • 2002
  • A General survey on the cleft lip and/or palate patients in Pusan National University Hospital was done. The conclusions were as follow. 1. In gender ratio, male was higher than female. 2. In the cleft type, unilateral cleft lip and palate, cleft lip and alveolus, and bilateral cleft lip and palate in higher ratio order. Left unilateral cleft lip and palate was higher than right in ratio. 3. In first hospital visiting age for dental treatment, the group from 6 years old to 12 years old was most and in that the age group for attending elementary school (about 7-8 years old) showed especially higher ratio. The large majority of patient were born in 1980's and lived in Pusan metropolitan city, KyungSangNamDo. Especially, most of them lived in the neighboring Held of Pusan National University Hospital. 4. Class III skeletal pattern and Angle's Class III molar relationship was most prevalent. Angle's Class II molar relationship showed relative higher ratio because tooth loss and malposition. 5. Primary lip closure in 3 months, secondary lip closure in 6-7 years old, palatal closure in 12-16 months and bone graft in 8-10 years old were operated mostly. Rhinoplasty and scar revision were operated in too early age so the need of infantile orthopedics must be considered. 6. Maxillary expansion and protraction were operated mostly in 8-11 years old but operating in primary dentition must be considered. 7. Tooth alignment were started mostly in mixed dentition and consideration about prosthodontic treatment and retention will be need. 8. In tooth anomaly, tooth malformation and missing were most prevalent.

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A STUDY OF $TGF-{\beta}$ EXPRESSION DURING PALATOGENESIS IN RATS WITH CLEFT PALATE INDUCED BY BAPN (($TGF-{\beta}$ 발현이 BAPN으로 유도된 구개열 백서의 구개 형성에 미치는 영향에 대한 실험적 연구)

  • Tae, Ki-Chul;Lee, Dong-Kun;Kim, Jeng-Ghee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.205-211
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    • 2001
  • Cleft palate is one of the most serious congenital anomalies in human that causes a sucking problem in newborn babies and morphologic deformity that usually leads to death in newborn mouse offspring due to an insufficient ability to suck milk. Therefore cleft palate had been researched with epidemiologic and molecular methods, and many etiologic factors were examined closely. Among of the research methods, biologic molecule researches have been more important method for cleft palate formation study. The $TGF-{\beta}$ had an important role in the cell migration, epithelial-mesenchymal transdifferentiation, extracellular matrix synthesis and deposition. But there was a little research which was study about correlation cleft palate induced by beta-aminonitroproprionitrile(BAPN) with $TGF-{\beta}$ expression. A purpose of this presented study was examed how $TGF-{\beta}$ expression in cleft palate mice. At gestation days 13, BAPN-monofumarate salts($(C_3H_6N_2)_2$ ${\cdot}$ $C_4H_4O_4$, Sigma Co.) was single oral administered to 4 pregnant rats according to 1g/kg body weight. And pregnant rats were sacrificed on day 20 post coitus(p.c.), The $TGF-{\beta}$ expression patterns of cleft formed fetus mice was followed that; 1.Osteoblast, mesenchymal cell and epithelial cell of cleft mice were low expression compare to control mice. 2.There was no $TGF-{\beta}$ difference expression pattern of osteocyte of cleft mice compare to control mice. 3. In western blot analysis, thickness of band of $TGF-{\beta}$ in cleft mice was thin and dilute compare to control mice.

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Relapse after Treatment of Maxillary Hypoplasia with Cleft Lip and Palate by Rigid External Distraction System (Rigid External Distraction System을 이용한 구순구개열 상악열성장의 치료 후 회귀현상)

  • Do, Hyoung-Sik;Song, Young-Il;Jang, Hwan-Yong;Lee, Jin-Yong;Jang, Hyun-Seok;Rim, Jae-Suk;Kwon, Jong-Jin;Lee, Eui-Seok
    • Korean Journal of Cleft Lip And Palate
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    • v.16 no.1
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    • pp.9-18
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    • 2013
  • Distraction osteogenesis is useful treatment which the gradual separation of cut bone edges results in the generation of new bone. It is effective treatment for correcting maxillofacial deformities. Patients with cleft lip and palate usually have maxillary hypoplasia due to scarring of lip and palate. To correct these deformities, we chose to use a 2-jaw orthognathic surgery or distraction osteogenesis. But despite improvements in surgical techniques for maxillofacial deformities, postoperative stability still leaves the question of when relapse may occur. This case report describes the Relapse after treatment of maxillary hypoplasia with cleft lip and palate by Rigid External distraction system over a 2-year treatment and follow-up period. In addition, we reviewed related articles about the influence of the occlusal stability on postoperative stability in patients with cleft lip and palate correction with Distraction osteogenesis.

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Simultaneous Repair of Unilateral Cleft Lip and Hard Palate with Vomer Flap : a Case Report (편측성 구순구개열 환자에 있어 구순성형술과 동반한 서골피판법 치험례)

  • Park, Hyong-Wook;Song, In-Seok;Kim, Eu-Gene;Kim, Soo-Ho;Cheon, Kang-Yong;Seo, Byoung-Moo
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.2
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    • pp.61-68
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    • 2012
  • Cleft lip and palate is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation advancement flap method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, Millard's rotation advancement flap method has its advantage in designing the flap using the patient's anatomic landmarks. For performing this rotation advancement technique, skillful operation is needed to obtain esthetically satisfactory results. Vomer flap sometimes is used to repair anterior hard palate in complete cleft lip and palate patients. Vomerine tissue is readily available in the vicinity of the palatal defect and elevation of the vomerine flap is relatively simple procedure. In this article, we will introduce the comprehensive vomer flap technique conjunction with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with Millard's rotation advancement method and vomer flap.

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Growth modification treatment with facial mask in the cleft lip and palate patients (Facial mask를 이용한 구순구개열 아동의 악안면 성장조절)

  • Jean Young-Mi
    • Korean Journal of Cleft Lip And Palate
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    • v.4 no.2
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    • pp.9-18
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    • 2001
  • Cleft lip and palate is the most frequent congenital facial deformity of the orofacial area. Successful management of patients with cleft lip and palate requires a multidisciplinary approach from birth to adult stage. The early surgical intervention of lip and palate induces a significant incidence of maxillary growth restriction that produces secondary deformities of the jaws, and the severity of the skeletal discrepancies tends to increase with growth. The early growth modification treatment to utilize the patient's growth potential is necessary in the cleft lip and palate patients, and we must consider not only the existing skeletal discrepancies but the residual growth amount and the direction. However, once we have obtained good results with orthopedic treatment in mixed dentition stage, we must pay special attention to maintain the treatment results because of high relapse tendencies and the alterations of jaw relationships due to residual growth.

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A Study on the Change of the Palatal Length after Palatoplasty

  • Ryu Sun-Youl;Kim Sun-Kook;Kim Tae-Hee;Hwang Ung;Kook Min-Suk;Han Chang-Hun
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.1
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    • pp.25-34
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    • 2004
  • The present study was carried out to investigate the change of the palatal length after palatoplasty in congenital cleft palate. With the data from one hundred and twelve patients with cleft palate who had been treated at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital over a period of 10 years(April 1995 to April 2004). The epidemiological characteristics, the method of palate repair, the postoperative complications and the extent of palatal lengthening were investigated and analyzed statistically. Incomplete cleft palate occurs more frequently than complete cleft palate. Male were affected 2.1 times more than female in complete cleft palate, and female were affected 1.2 times more than male in incomplete cleft palate. Dorrance method and Wardill V-Y method were frequently used in repair of incomplete cleft palate. Wardill V-Y method, Furlow double opposing Z-plasty, two flap method, and Perko method were widely used in repair of complete cleft palate. The extent of palatal lengthening was greater in the incomplete cleft palate group(5.84 mm) than in the complete cleft palate group(4.71 mm), and in the Furlow double opposing Z-plasty group(5.70 mm) than in the push back palatoplasty group(5.33 mm). But no significant difference was noted. Palatal fistula and wound dehiscence were popular postoperative complications in cleft palate. These results indicate that the extent of palatal lengthening, which contributing to speech function, is a range of 3.5% to 24.0%(average 10.8%) after palatoplasty in cleft palate patients.

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