• 대한구순구개열학회지
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• 제10권1호
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• pp.23-32
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• 2007

The classic triad of diagnostic signs of submucosal cleft palate which may be present are: 1) bifid uvula 2) short palate with no muscle in the midline and 3) hard palate with a submucous notching defect in the posterior midline. The treatment of submucous cleft palate are V-Y push back palatorrhaphy, and superior based pharyngoplasty implant in the posterior pharynx. The best speech results were in those children operated upon in the younger age group (especially at or before 2 years of age), thus pointing up the importance of early diagnosis.

• 대한음성학회:학술대회논문집
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• 대한음성학회 1996년도 2월 학술대회지
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• pp.23-40
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• 1996

The communicative disorders in cleft palate patients have relationship with the acoustic and He physiological phenomena. Particularily hypernasality is a parameter of cleft palate speech that has been studied by many clinicians and speech pathologists. The degree of hypernasality has been assessed by the listener,s judgement, but perceptual assessements have poor scientific reliability, so objective instruments have been needed to test hypernasality with diagnostics accuracy. This study was analyzed the nasalance score using a Nasometer for cleft palate patients. The simple vowels /a/, /i/, /e/ and the approximants /j/, /w/ were tested for the degree of hypernasality after operation. The phrases containing long and short duration times were used in this study to asses hypeernasality. Fiberopic views shows the open velopharyngeal port that resulted in hypernasality of cleft palate patients. The authors assert the important of the management of cleft palate patients.

• 대한구순구개열학회지
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• 제11권2호
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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.

• 대한치과교정학회지
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• 제18권2호
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• pp.329-342
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• 1988

In methods of finding causes for cleft palate, many cases have been studied by investigators using teratogenic agents. Among them, a synthetic agent known as triamcinolone acetonide (TA) was widely used. When this drug was injected into mice during palatogenesis, it induced lowered body weight and a deformed mandible. But many cases have been studied on growth changes, only of the developmental stages of the palate. Therefore, the objective of this study was to evaluate craniofacial growth in experimentally induced cleft palate mice after finishing palatogenesis namely just before birth. Normal, alcohol treated, and TA treated DDY mice were obtained at 18-days of gestation and heads were prepared for serial sectioning in the sagittal plane. The midsagittal sections were photographically enlarged (${\times}40$) and measurements made to asses the amount of growth. The obtained results were as follows. 1. The incidence of cleft palate was 41.2% when TA was injected. 2. The body weight of the cleft palate group was lower than the control group. 3. In the cleft palate group, mandibular length (H-M) was lighter than the control group. 4. In the cleft palate group, degree of staining was not distinct compared to the control group by the double staining method. 5. In the cleft palate group, anteroposterior posture of the tongue tip to facial plane (C-M) was more posterior than the control group. 6. The cause of posterior posture of the tongue tip to facial plane (C-M) in the cleft palate group, was not short and retracted tongue but the mandibular length was increased. 7. The anteroposterior relationship of hyoid cartilage to cranial base was the same in all groups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권6호
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• pp.681-683
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• 2007

Kabuki(Niikawa-Kuroki) syndrome was first reported by Niikawa et al(1981). The faces of the patients are similar to the make-up of traditional Japanese Kabuki actors: long palpebral fissures, an ectropium of the lateral third of the eyelids, and arching eyebrows with sparse lateral halves. Craniofacial findings include a depressed nasal tip, short nasal septum, large and prominent ears, and micrognathia. Other main features area mild to moderate mental deficiency, short stature, skeletal and dermatoglyphic abnormalities, including prominent finger tip pads. Oral anomalies are common in KS(over 60%) and include abnormal dentition, widely spaced teeth, cleft palate or lip, high vault of palate, hypodontia, conical incisors, screw driver-shaped incisors and ectopic upper 6-year molars. The increased occurrence of cleft lip and palate or the development of a high vault of palate has been described by a number of authors. This condition is believed to be common in Japan, but has been reported from other parts of the world. The objective of this presentation is to report a case of this syndrome in six-year-old girl, with characteristic findings.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.102-106
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• 2011

Purpose: It is accepted universally that correction of the cleft lip nasal deformity requires multiple stages of surgery. Following primary lip repair in infancy or early childhood, secondary surgery to improve the deformity of the lip and nose is frequently necessary. A suitable surgical procedure to correct the accompanying deformity, such as cleft palate and alveolus, must be carried out at an appropriate age. In developing countries, it is common for patients with cleft lip nasal deformity to present severe secondary deformities in adolescence, because of poor follow-up and inappropriate surgery. Methods: The first patient was a 12 year old Mongolian boy. He presented prominent lip scar, short lip, wide columella, asymmetric nostril, palatal fistula, cleft alveolus, and velopharyngeal incompetence. He underwent cheilorhinoplasty, transpositional flap, alveoloplasty by iliac bone graft, and sphincter pharyngoplasty. On follow-up, a bilateral maxillary hypoplasia and a class III malocclusion developed. He underwent LeFort I osteotomy and maxillary advancement at the age of 16 years. The second patient was an 18 year old Eastern Russian girl. She presented with a deviated nose, right alar base depression, short lip, protrusion on vermilion, large palatal fistula, and severe VPI due to short palate. She underwent the combined procedure of cheilorhinoplasty, corrective rhinoplasty, tongue flap for palatal fistula, and superiorly based pharyngeal flap. And the tongue flap was detached at postoperative 3 weeks. Results: The overall results have been extremely pleasing and satisfactory to patients. There were no postoperative complications. Conclusion: We discovered the one stage operation for radical correction was sufficient procedure to provide excellent clinical outcomes in patients with severe cleft lip nose deformity.

• Journal of Yeungnam Medical Science
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• 제18권1호
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• pp.112-122
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• 2001

구순 구개열을 가지는 성인 남자 17명의 두 부계측방사선 사진을 McNamara씨 분석법을 중심으로 하여 정상 대조군과 비교하여 다음과 같은 결론을 얻었다. 구순 구개열 환자에서 Na. perpendicular to point A. SNA angle이 통계적으로 유의하게 작게 나와 두개저에 대해 상악이 후방에 위치하였다(p<0.01). Effective maxillary length, Maxillomandibular differential, Wit's appraisal 등이 구순 구개열 환자와 대조군에서 통계적으로 유의하였으나 Effective mandibular length, Mandibular plane angle, Facial axis angle, Lower anterior facial height 등은 유의하지 않았다. 이는 하악의 경사도, 성장방향 등은 정상이나 상악의 절대적인 길이가 작으며 이로 인하여 상하악간의 부조화가 생긴 것으로 사료된다. 구순 구개열 환자에서 pogonion to Na. perpendicular가 95% 신뢰구간에서 통계적으로 유의하게 작게 나와 하악이 두개저에 대해 상대적으로 후방에 위치하였다. 교정치료에도 불구하고 point A에 대해 상악 전치가 상대적으로 후방에 위치하였다.

• Archives of Plastic Surgery
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• 제40권2호
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• pp.97-103
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• 2013

Background Velopharyngeal insufficiency (VPI) may persist after primary repair of the cleft palate, and surgical correction is necessary in many cases. The purpose of this study is to evaluate the effect of double opposing Z-plasty (DOZ) in cleft palate patients suffering from VPI after primary two-flap palatoplasty. Methods Between March 1999 and August 2005, we identified 82 patients who underwent two-flap palatoplasty for cleft palate repair. After excluding the patients with congenital syndrome and mental retardation, 13 patients were included in the final study group. The average age of the patients who underwent DOZ at was 5 years and 1 month. Resonance, nasal emission, and articulation were evaluated by a speech pathologist. The velopharyngeal gaps were measured before and after surgery. Results Six patients attained normal speech capabilities after DOZ. The hypernasality grade was significantly improved after surgery in all of the patients (P=0.0015). Whereas nasal emission disappeared in 8 patients (61.5%), it was diminished but still persisted in the remaining 5 patients. Articulation was improved in all of the cases. In two cases, the velopharyngeal gap was measured using a ruler. The gap decreased from 11.5 to 7 mm in one case, and from 12.5 to 8 mm in the second case. Conclusions The use of DOZ as a surgical option to correct VPI has many advantages compared with other procedures. These include short surgery time, few troublesome complications, and no harmful effects on the dynamic physiological functioning of the pharynx. This study shows that DOZ can be another option for surgical treatment of patients with VPI after two-flap palatoplasty.

• 대한치과보철학회지
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• 제57권4호
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• pp.475-482
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• 2019

본 증례는 서울대학교 치과병원 치과보철과로 내원한 76세 남성 환자의 총의치 기능을 겸하는 연구개 폐색 장치의 제작에 관한 증례이다. 상환은 편도암으로 인해 연구개 및 편도 부위 절제 후 발음이 잘 되지 않고 음식물이 코로 넘어간다는 주소로 내원하였다. 제작과정에서 CT를 3차원으로 재구성하여 연구개 결손부위의 형태를 관찰하고, 비성도 검사와 비내시경 검사를 통해 발음 및 연하의 개선여부를 확인하였다. 환자는 발음과 저작 및 연하에 있어서 만족할만한 결과를 보여 본 증례를 보고하는 바이다.

• 대한두개안면성형외과학회지
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• 제19권1호
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• pp.48-50
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• 2018

Bony anomaly caused by lip tie is not many reported yet. There was a case of upper lip tie wrapping into the anterior premaxilla. We represent a case of severe upper lip tie of limited lip motion, upper lips curling inside, and alveolar hypoplasia. Male patient was born on June 3, 2016. He had a deep philtral sulcus, low vermilion border and deep cupid's bow of upper lip due to tension of short, stout and very tight frenulum. His upper lip motion was severely restricted in particular lip eversion. There was anterior alveolar hypoplasia with deep sulcus in anterior maxilla. Resection of frenulum cord with Z-plasty was performed at anterior premaxilla and upper lip sulcus. Frenulum was tightly attached to gingiva through gum and into hard palate. Width of frenulum cord was about 1 cm, and length was about 3 cm. He gained upper lip contour including cupid's bow and normal vermilion border after the surgery. This case is severe upper lip tie showing the premaxillary hypoplasia, abnormal lip motion and contour for child. Although there is mild limitation of feeding with upper lip tie child, early detection and treatment are needed to correct bony growth.