• 대한치과의사협회지
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• 제13권7호
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• pp.629-632
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• 1975

The clinical investigation and operation procedure were described on the gunshot wound which involved on soft, hard palate and nasal cavity. The patient, 19 years old, female, admitted in Han Yang Medical Center with clinical diagnosis of maxillofacial injuries on Nov. 1973. No Significant signs include of airway obstruction, Oro-nasal bleeding were revealed only exception of rupture and perforation on the soft, hard palate. For closure and reduction of destructed palatal wound, operation was done in out patient dental clinic under local anesthesia by means of Langenbeck method. And to control of post-operative inflammation and reactive swelling, administration of accurate antibiotics and physical therapy were performed for 5 days after operation. On the 10th day after administration, patient was discharged with satisfactory result of operation.

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 1997년도 종합학술대회
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• pp.31-31
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• 1997

• 대한소아치과학회지
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• 제31권4호
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• pp.721-728
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• 2004

비인강폐쇄란 연구개, 인두측벽 그리고 인두후벽간의 움직임이 서로 조화되어 구강과 비강을 나누어주는 괄약근 기전으로서 연하, 호흡, 발음 등의 생리적기능에 중요한 역할을 한다. 이 기능에 문제가 생긴 경우를 비인강폐쇄부전이라하며 그 원인으로는 (1) 연구개의 길이 및 움직임이상 (2) 비인두강의 해부학적 공간문제 (3) 인두 후벽과 측벽의 기능이상 등이 있다. 본 연구는 구개열 환자의 측면두부방사선계측사진을 통해 비인두강을 생리해부학적으로 분석하였으며, 산출된 말소리의 과비음정도를 Nasometer로 평가하였다. 이로부터 얻은 정상군과 구개열환자군의 결과를 각각 비교하였으며, 비인강폐쇄부전과의 연관성을 알아보기 위하여 Anatomic VPI와 Nasalance score의 값을 비교 분석하였다. 얻어진 결과는 다음과 같았다. 1. 측면두부방사선계측사진 결과, 연구개 길이, 연구개 두께 비인강 깊이, 비인강 면적, Adequate ratio에서 두 그룹간 유의 한 차이를 나타내었다. 2. Nasometer 결과, 모음/오/와 구강공명음문장, 구강장해음문장에서 두 그룹 간 유의한 차이를 나타내었다. 3. 구개열환자군에서 비인두강의 폐쇄부전 정도를 표현해주는 Anatomic VPI와 Nasalance score는 전반적으로 연관성이 없었다. 다만 모음/이/와 일부 구강자음으로 이루어진 문장에서 다소의 상관성을 나타내었다. 결론적으로, 측면두부방사선계측사진과 Nasometer 각각의 검사결과에서 두 그룹간 유의한 차이를 찾아볼 수 있었으나, 구개열환자군내에서 비인강폐쇄부전을 표현하는 Anatomic VPI와 Nasalance score는 모음/이/와 구강자음을 포함한 문장을 제외하고는 전반적으로 연관성이 없었다.후 불소도포시 레이저 에너지 밀도 증가에 따라 증가되는 경향을 보였다. 2. KOH 비처치군에서 법랑질 탈회깊이는 불소를 5분 도포후 레이저 $20J/cm^2$를 조사한 경우를 제외하고는 레이저와 불소를 병행하여 처치시 각각을 단독으로 처치시보다 탈회깊이가 작았다 (p<0.05). 3. Calcium fluoride의 양은 레이저의 조사에 의해 유의 있게 증가하지 않았다 (p>0.05). 4. Calcium fluoride 입자는 불소만 도포한 경우에 비해 레이저 조사후 불소도포시 입자크기가 증가되었으며, 불소도포후 레이저 조사시 입자크기의 증가와 함께 일부 융합된 양상을 보였다. 5. KOH 처치군에서 법랑질의 불소농도는 불소를 30분 도포후 레이저를 조사한 경우를 제외하고는 대조군의 불소농도와 유의한 차이가 없었다(p>0.05). 6. KOH 처치군에서 불소와 레이저를 병행한 경우, 불소만 도포한 경우보다 탈회된 법랑질의 깊이가 작았다 (p<0.05). 7. KOH 비처치군에서 탈회된 법랑질의 불소농도와 탈회깊이의 상관관계(Spearman correlation coefficient: -0.6281)는 KOH 처치군(Spearman correlation coefficient: -0.3792)에 비해 높은 음의 상관 관계를 보였고, 동일한 조건으로 불소도포 및 레이저 조사를 시행한 경우에 있어서 KOH 처리 여부에 따른 탈회법랑질 깊이의 유의차가 있는 경우 calcium fluoride의 형성량이 많았다. 이상의 실험결과로 미루어 보아 레이저 조사가 calcium fluoride의 형성량에 영향을 미치지 않았으나 레이저 조사의 영향으로 calcium fluoride의 용해가 감소하는 것으로 판단된다

• Archives of Plastic Surgery
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• 제42권4호
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• pp.419-423
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• 2015

Background Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). Methods Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. Results The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was $-4.1^{\circ}$ before surgery, and increased to $2.5^{\circ}$ after surgery. The mean nasolabial angle was $72.7^{\circ}$ before surgery, and increased to $88.7^{\circ}$ after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. Conclusions Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.

• 대한수의학회지
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• 제48권3호
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• pp.369-374
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• 2008

A neutered male, 8-year-old, Pekingese, weighing 4.3 kg with a history of anorexia, sneezing, nasal discharge, and epistaxis for one month was referred. Soft tissue swelling around the nasal bone and small defects of the hard palate with a tiny round dark red mass were found on physical examination. The laboratory tests represented mild leukocytosis. On skull radiographs, soft tissue swelling and osteolytic change of the incisor bone, nasal bone, and maxilla were found. On computed tomography scan images, there was soft tissue attenuating opacity with calcified spots in the bilateral nasal cavities and frontal sinuses. Loss of nasal turbinate pattern and nasal septum was found. And destruction of the insicor bone, nasal bone, maxilla, hard palate, perpendicular palatine bone, and cribriform plate were identified. Nasal malignant melanoma was confirmed by nasal biopsy.

• 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.

• 대한치과의사협회지
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• 제47권10호
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• pp.656-668
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• 2009

It is difficult to perform orthodontic treatment for cleft lip and palate patient. Although there are many orthodontic appliances to expand narrowed maxillary arch, results are rarely successful and the possibility of relapse is increased due to severe scars. Self-ligating bracket, recently used in orthodontic treatment, suggests solution of crowding by expansion of dental arches. Light and continuous force could apply for orthodontic movement due to characteristic low friction of self ligating bracket, which gives expansion force until dentition reaches its new equilibrium position and it can be expressed as spontaneous lateral expansion with heavy labial tension. This kind of expansion force is thought to be a possibility of expanding the constricted maxillary arch of cleft lip and palate patient. Repositioning of the maxilla by Le Fort I osteotomy in case of severe maxillary deficiency, increases the possibility of relapse because of limitation in anterior movement and adaptation of soft tissue. In these cases, distraction osteogenesis(DO) can be applied for stable result. We report a case of cleft lip and palate patient with narrowed maxillary arch and maxillary deficiency using self ligating bracket and DO.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.67-74
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• 2006

Palatoplasty using Furlow's double-opposing Z-plasty has been performed from June, 1995 to September, 1999 at Seoul National University Children's Hospital. The goal of this study is to determine the optimal timing of repair and cleft severity affecting velopharyngeal function. This is the retrospective study of patients operated by the second author. The mean age of patients was 10.53 months. The patients could be divided into three groups-isolated cleft palate(n=70), unilateral cleft lip and palate(n=88), and bilateral cleft lip and palate(n=42). To evaluate the velopharyngeal function, we used two parameters, speech evaluation and cineofluorography using DSR(digital subtraction radiography). Also, to determine the relevance between cleft severity and speech development, we measured the distance between maxillary tuberosities and cleft margins. Among 200 patients, about 96% had no or minimal hypernasality and 87% had no or mild nasal emission. The cleft width and length of soft palate seemed not to be related with the speech development. Palatoplasty at the age under 12 months resulted in less 'nasal emission' and better 'articulation' of the parameters that were assessed at the age of 7 years. It can be concluded Furlow palatoplasty shows satisfactory results and also it seems that it is better to perform the operation before the age of 12 months.

• 대한구순구개열학회지
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• 제15권2호
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• pp.89-96
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• 2012

Le Fort 1 osteotomy or maxillary advancement with distraction osteogenesis (DO) is main treatment strategy for cleft palate patients with maxillary hypoplasia. Maxillary DO allows greater maxillary advancement within physiological limit than Le Fort 1 osteotomy. Moreover, it is better for velopharyngeal function. However, there is a greater tendency for an increase in nasal sound when maxilla is advanced excessively. Therefore, the advancement of anterior maxillary segment using DO has been utilized. It offers advantages such as an increase in the length of the palate, a prevention of the change in palatopharyngeal depth, and a preservation of the velopharyngeal function. Moreover, it will obliterate the necessity of bone graft, and it prevents the occurrence of oronasal or oroantral fistula. Finally, it stimulates the regeneration of the soft and hard tissue of alveolus, and subsequently makes possible to place implant.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권5호
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• pp.483-488
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• 2006

Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, various muscles of palate & pharynx function as sphincter and occlude the oropharynx from the nasopharynx during the production of oral consonant sounds. Inadequate velopharyngeal function caused by neurologic disorder - cerebral apoplexy, regressive diseases - disseminated sclerosis, Parkinson's disease, congenital deformity - cleft palate, cerebral palsy and etc. may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. In our study, we constructed speech aids prosthesis - Speech bulb in the incomplete cleft palate VPI patient with hypernasality and assessed velopharyngeal function with nasometer which can evaluate the speech characteristics objectively.