• 제목/요약/키워드: Secondary correction

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구순열 이차비기형의 교정; 아동과 성인에서의 이차 비성형술 (Correction of Secondary cleft lip-nasal deformity; secondary rhinoplasty in children and adults)

  • 송진아;명훈;황순정;서병무;이종호;정필호;김명진;최진영
    • 대한구순구개열학회지
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    • 제6권1호
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    • pp.17-25
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    • 2003
  • 본 교실에서 최근 4년 동안 행해진 수술의 경향을 분석한 결과를 정리해 보면 이차 비기형의 교정은 양측성의 경우 비교적 이른 시기인 4-5세에 시행되었고 편측성의 경우에는 치조성형술(alveoloplasty)의 시행을 먼저 고려한 후 10세에서 13세 경에 시행된 것을 알 수 있었다. 교정부위는 편측성의 경우 비대칭을 교정하는 수술이 중점적으로, 양측성의 경우 비주 연장술이 중점적으로 행해졌는데 아동과 성인에서 모두 비주와 비첨 수술이 거의 90%정도를 차지하였다. 그 외에 비중격 성형술, 비공 성형술 등이 10% 내외로 시행되었다. 비첨 성형술은 양측성 구순열의 경우 모두Millard's forked flap으로 시행되었고 편측성의 경우 간단하게 연골을 박리하고 Tajima suture를 시행한 경우가 아동에서 77%, 성인에서 30% 였다. 개방형 비성형술을 시행한 경우는 아동에서 40%, 성인에서 71%를 보였다. 자가 연골이식을 시행한 경우는 아동에서 23%, 성인에서 70%를 보였다. 비중격의 편향을 보이는 편측성 구순열 환자 모두에서 비중격 수술이 시행된 것은 아니었는데, 비익의 비대칭에는 적극적인 치료가 이루어진 반면 비중격의 비대칭에는 그렇지 못한 것을 알 수 있었다. 대부분의 수술이 심미적인 부분에 초점을 맞추고 있었으며 비중격 성형술의 시행에 있어 비강폐쇄의 객관적 평가가 이루어지지 않은 것이 개선해야 할 부분으로 사료되었다.

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Delaire 방법을 이용한 구순열의 교정 (Primary Cleft Lip Repair Using the "Delaire" Technique)

  • 김용하;이현태
    • 대한두개안면성형외과학회지
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    • 제12권2호
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    • pp.75-80
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    • 2011
  • Deformities related with cleft lip are not only limited to the cleft site but also extended to all around the nasolabial region. Facial development is composed of several complex processes as the formation, migration, coalescence and interaction of separate fields. When there is a cleft event, it means there are general problems of those processes. As a result facial elements should have displacement, deformation and functional hypotrophy. These also affect the mucocutaneous structures, which result in the typical deformities of cleft lip. Traditional surgical methods are not sufficient of the correction of functional impairments in the cleft lip. Accordingly, there are relatively high possibilities of occurring secondary deformities. The Delaire's method focuses on repair of functional impairment of the cleft. Consequently, it can maintain the initial good surgical result and avoid the unnecessary incision scar. And this method can minimize secondary nasal deformities which can reduce the risk of additional nasal correction. Therefore authors introduce this advantageous the Delaire technique cheliolplasty which it can be widely used for the cleft lip correction in Korea.

Surgical correction of cleft lip lower-lip deformity: a report of three cases

  • Ci Young, Kim;Sung-Ho, Ha;Jin-Young, Choi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권6호
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    • pp.390-396
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    • 2022
  • Cleft lip lower-lip deformity is a secondary deformity in patients who underwent primary cheiloplasty of the upper lip, characterized by an enlarged and anteriorly rotated lower lip. In these cases, soft-tissue imbalances remain even after skeletal correction with orthognathic surgery, and additional soft tissue treatment is required for lip harmony and esthetic facial balance in CLP (cleft lip palate) patients. This study describes three cases of transverse myomucosal excision of the lower lip for correction of cleft lip lower-lip deformity to restore facial esthetic balance. Each patient underwent orthognathic surgery, rhinoplasty, or upper lip revision cheiloplasty according to condition. Postoperatively, volume of the lower lip decreased and lip harmony was improved in all three patients. The surgeon should fully understand the anatomical structure around the lips and be able to evaluate overall harmony of the soft tissue. When a lower lip deformity is present, careful surgical planning and execution are important for each patient.

Open rhinoplasty in secondary cleft nose deformity with suture techniques

  • Lee, Chong Kun;Min, Byung Duk
    • 대한두개안면성형외과학회지
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    • 제23권5호
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    • pp.211-219
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    • 2022
  • Background: Correction of secondary cleft nose deformity is one of the most important portions in the management of cleft lip patients. Various techniques have been introduced to achieve adequate shape, balance, and symmetry of anatomical landmarks. None of these methods can claim to universally solve all aspects of the problems encountered in secondary cleft deformity surgery. Some authors overlook the aspect of functional rehabilitation with regard to nasal respiratory pathway problems, which is present in over 90% of the patients. This study aimed to evaluate the aesthetic and functional improvements of the authors' non-destructive technique. Methods: With over 15 years of experience, open rhinoplasty was performed, which included total remodeling of the deformed lower lateral cartilage using several suture fixation techniques without any graft or implantation with septo-turbinoplasty. A total of 150 questionnaires were sent by e-mail, but 55 completed questionnaires were returned. Surgical outcomes were evaluated using questionnaire responses, and outcomes were divided into five categories each for esthetic and functional analyses. Results: The satisfaction rate ranged from 75 % to 98%, which means "more or less," "very much," and "absolutely yes" in the esthetic and functional viewpoints. Conclusion: The results of this study strongly recommend performing the suture fixation technique and functional rehabilitation simultaneously for cleft lip/nose correction.

전류원 방식 푸시-풀 공진형 인버터로 구성된 단일단 고역률 형광등용 전자식 안정기 (Electronic Ballast using Current-Fed Push-Pull Resonant Inverter with Bypassing Capapcitor for Power Factor Correction)

  • 류태하
    • 전력전자학회:학술대회논문집
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    • 전력전자학회 2000년도 전력전자학술대회 논문집
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    • pp.489-492
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    • 2000
  • A novel low-cost simple and unity-power-factor electronic ballast is presented. The proposed electronic ballast employs a bypassing capacitor and load networks composed of ballast capacitors and small charge pump capacitors as power factor correction circuit combined with the secondary winding of the transformer in the self-excited current-fed push-pull resonant inverter(CF-PPRI) resulting in cost-effectiveness and higher efficiency. By analyzing the principles of power factor correction mathematically optimum design guidelines are presented. Since the lamps are used in power factor correction stage the input power is automatically adjusted according to the number of the lamps.

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Numerical study of flow of Oldroyd-3-Constant fluids in a straight duct with square cross-section

  • Zhang, Mingkan;Shen, Xinrong;Ma, Jianfeng;Zhang, Benzhao
    • Korea-Australia Rheology Journal
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    • 제19권2호
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    • pp.67-73
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    • 2007
  • A finite volume method (FVM) base on the SIMPLE algorithm as the pressure correction strategy and the traditional staggered mesh is used to investigate steady, fully developed flow of Oldroyd-3-constant fluids through a duct with square cross-section. Both effects of the two viscoelastic material parameters, We and ${\mu}$, on pattern and strength of the secondary flow are investigated. An amusing sixteen vortices pattern of the secondary flow, which has never been reported, is shown in the present work. The reason for the changes of the pattern and strength of the secondary flow is discussed carefully. We found that it is variation of second normal stress difference that causes the changes of the pattern and strength of the secondary flow.

Bardach씨 술식을 통한 이차성 구순열비변형의 교정 (Correction of the secondary nasal deformity using Bardach' s technique)

  • 김수관
    • 대한구순구개열학회지
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    • 제2권1_2호
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    • pp.23-28
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    • 1999
  • The author presents Bardach' s technique for the residual unilateral cleft lip nasal deformity, The key to a successful and stable correction of the nasal deformity is to lengthen the columella on the cleft side and to mobilize alar cartilage from its surrounding tissue, creating a symmetric shape and length, The major advantages of the technique are lengthening of the cleft columella and creation of a symmetric and well-projected nasal tip.

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일측성 이차 구순열 비변형에서 비공저와 비공턱 함몰의 수술적 교정 (Surgical correction of nostril base and nostril sill depression in unilateral secondary cleft lip nose deformity)

  • 이수향;이경진;황은아;최현곤;김순흠;신동혁;엄기일
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.637-641
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    • 2009
  • Purpose: Most unilateral secondary cleft lip nose deformities have depressed nostril base and sill on the cleft side. To obtain a symmetric nose, correction of the recession on nostril is critical. The authors have worked out effective methods to elevate the nostril of the cleft side according to the extent of the depression. Methods: A total of 115 unilateral secondary cleft lip nose deformity patients with nostril depression were evaluated. Data were acquired from patients' charts and photography with special reference to the height difference of the nostrils between the cleft side and the non - cleft side. Patients were divided into three groups based on the difference and operated with various techniques : (1) mild degree(< 1 mm) with graft, (2) moderate degree(1 ~ 3 mm) with C - flap or suspension suture of septal cartilage (3) severe degree(> 3 mm) with graft, C - flap and suspension suture. Follow - up period averaged 21.3 months. Results: Forty - six patients(40 percent) were in mild group, and forty - two(37 percent) were in moderate. In twenty - seven patients(23 percent), nostril recession was more than 3 mm. The elevated nostril base and sill were maintained without height alteration during follow - up. Conclusion: The symmetry of the nostril base, especially projection of nostril sill influences successful correction of unilateral cleft lip nose deformity. Our tolerable techniques can be applied to most deformities with nostril depression and can present a new guideline.

Hot Leg Temperature Uncertainty due to Thermal Stratification

  • Jang, Ho-Cheol;Ju, Kyong-In;Kim, Young-Bo;Sul, Young-Sil;Cheong, Jong-Sik
    • 한국원자력학회:학술대회논문집
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    • 한국원자력학회 1996년도 춘계학술발표회논문집(2)
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    • pp.29-35
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    • 1996
  • For the Reactor Coolant System(RCS) flow rate measurement by the secondary calorimetric heat balance method, the coolant temperature of the hot leg is needed. Several Resistance Temperature Detectors(RTD) are installed in the hot leg to measure the temperature, but the average value of RTDs does not correctly represent the energy-averaged(bulk) temperature because of the thermal stratification phenomenon. Therefore some correction is introduced to predict the bulk temperature, but the correction inevitably contains uncertainty because the stratification is not defined well quantitatively yet. Therefore a large uncertainty for the correction has been used for the conservative estimation. But unrealistically large uncertainty causes degradation of the measurement method and yields difficulty to meet the acceptance criterion in start-up flow measurement test. In this paper, an analytical estimation is made on the correction and the related uncertainty using the measured hot leg velocity profile of System 80 reactor flow model test and the measured temperatures of YGN 3&4 and PVNGS 1&2 start-up tests. The results reveal that the magnitude of the correction uncertainty is much smaller than that used in the previous design. Therefore, the confidence on the flow rate measurement method can be improved and the difficulty in start-up flow measurement test can be lessened if the smaller correction uncertainty obtained through this estimation is applied.

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안검하수 교정술 후 생긴 합병증 분석 (Analysis of Postoperative Complications in Blepharoptosis)

  • 오창현;박대환;김찬우;심정수;이용직
    • Archives of Plastic Surgery
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    • 제36권6호
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    • pp.743-749
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    • 2009
  • Purpose: Many researches about various surgical method for blepharoptosis have already been introduced. But researches for complications after blepharoptosis correction is relatively insufficient. So, this study was performed to recognize common complications that arised depending on the severity of blepharoptosis, levator function and surgical method. Methods: 250 patients who have underwent surgical treatment for blepharoptosis from 1987 to 2006 were employed in this study. Patients were categorized by severity of blepharoptosis, levator function and surgical method that has been used. Complications after blepharoptosis correction were analyzed. Result: Total of 64 patients had occurred complications, the specifics are as following; undercorrection 22, asymmetry 13, overcorrection 12, lagophthalmos 4, abnormal eyelid contour 4, exposure keratitis 3, ectropion 2, inclusion cyst 2, infection 1 and conjunctival prolapse 1. Among above patients, 3 patients had two kinds of complications. 21 patients was underwent secondary surgery due to complication. Conclusion: Evaluating the outcomes of the secondary surgery, the early correction was better than the late correction. The most of the complications were recovered through conservative and surgical treatments. The most of the complications (47 patients) were undercorrection, asymmetry, overcorrection and took 73.4% of the total complications. The more severe the blepharoptosis and the more poor the levator function, the rate of complications were higher. According to the operation methods, most complications were occurred in levator operation, frontalis transfer and OOM flap.