• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권5호
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• pp.415-421
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• 2001

본 연구는 편측성 완전구순열에서 Cronin의 삼각피판법과 Millard의 회전신전법에 의한 수복시 술후 결과를 비교 하고자 시행되었다. 13명의 편측성 완전구순열 환자를 대상으로 삼각피판법과 회전신전법에 의해 구순성형술을 시행하고, 술전${\cdot}$술후 사진을 토대로 구순부에서는 수직 길이, 반흔, 적순, 입술의 볼록함(lip pout), 큐피드궁의 다섯항목에 대하여, 비부에서는 비익, 비주, 비공저, 비첨, 비중격의 다섯 항보겡 대하여 각 항복 당 $0{\sim}10$점씩 총 100점으로 평가하고 술후 결과를 분석하여 다음과 같은 결과를 얻었다. 총폄점은 Cronin의 삼각피판법을 시행한 경우에 $74.77{\pm}0.86$점으로 Millard의 회전신전법을 시행한 경우의 $66.50{\pm}1.14$점에 비해 유의하게 높았다. 반흔비대는 Millard의 회전신전법을 시행한 경우에 28.6%의 발생율을 나타냈으나 Cronin의 삼각피판법을 시행한 경우에는 발생되지 않았다. 구순 기엥 대한 객관적 평가 결과 평균 길이 비는 Millard의 회전신전법을 시행한 경우에 $0.73{\pm}0.10$으로 Cronin의 삼각피판법을 시행한 경우 $0.80{\pm}0.96$보다 짧았으나 통계학적으로 유의한 차이는 없었다. 이상의 결과는 편측성 오나전구순열에서 Cronin의 삼각피판법이 Millard의 회전신전법보다 더 좋은 결과를 나타냄을 시사한다.

• Archives of Plastic Surgery
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• 제43권4호
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• pp.311-315
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• 2016

In Korea, lateral canthoplasty, along with medial epicanthoplasty, has become popular over the past years to widen the horizontal length of the palpebral fissure. However, the effect of the surgery differs greatly depending on the shape and structure of the eyes. If over-widened, complications such as eversion, scarring, and conjunctival exposure may occur. Thus, the author of this study suggests a more effective and safe method for lateral canthal lengthening that causes minimal complications. A total of 236 patients underwent lateral canthoplasty between July 2007 and December 2015. For each patient, a triangular flap 4-5 mm away from the lateral canthus was elevated and rotated 45 degrees laterally while the continuity of the lower eyelid gray line was maintained. A new lateral canthus was created by fixating the rotation flap to the lateral orbital rim with minimal skin trimming and tension-free sutures, preventing relapse and maintaining a triangular shape. In more than 95% of cases, effective and satisfactory extension was achieved. On average, a 3 mm extension of the lateral canthus was achieved. There were minor complications such as wound dehiscence, webbing, and scarring, which were easily corrected. The author not only extended the lateral canthus 3-4 mm laterally but also maintained the continuity of the gray line on the lower lid as a more natural-looking triangular shape, while minimizing complications such as webbing and conjunctival exposure.

• 대한구순구개열학회지
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• 제12권1호
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• pp.41-46
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• 2009

Historically, various techniques to correct the deformity of lip and nose in functional and esthetic ways were developed and applied in dealing the patients with cleft lip. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation-advancement method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, triangular flap technique has its advantage in designing the flap using the patient's anatomic landmarks. It enables less skillful operator to perform this technique relatively easily and produce reasonable results. In this report we present 8 cases of unilateral complete cleft lip and 3 casesof unilateral incomplete cleft lip. They all underwent primary cheiloplasty based on triangular flap technique, and functional, esthetic outcomes were favorable.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권3호
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• pp.200-204
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• 2012

In the repair of unilateral complete cleft lip, the most popular method is the rotation-advancement by Millard. Despite advantages of Millard repair, a few pitfalls exist. Above all, some of the scars, at the height of the cleft side philtral ridge, cross the Langer's line. Further, in the repair of complete cleft lip, small triangular lateral lip flap is often added in the base of an advancement flap to level the Cupid's bow. Moreover, preservation of the advancement flap has some negative effects on a primary nasal repair. As a result, the shape of philtrum is somewhat unnatural. Therefore, I applied the extended Mohler repair in the six cases of complete wide cleft lip to get a more esthetic scar. As a result, more natural, straight philtral ridge was obtained, without adding small triangular flap in the base of the advancement flap.

• 대한구순구개열학회지
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• 제15권2호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권2호
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• pp.154-157
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• 2011

The primary purpose of cleft lip surgery should be the aesthetic and functional recovery of the facial components. Triangular flap repair is one of the most common techniques used in cleft lip surgery. In this case report, thirty patients with unilateral cleft lip had been treated using the Tennison-Randall method. The results were favorable and there have been no permanent complications.

• 대한구순구개열학회지
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• 제12권2호
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• pp.65-72
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• 2009

Quadrilateral flap technique for primary cheiloplasty in patients with cleft lip was initially developed by Hagedorn in 1884. After Le Mesurier presented this procedure in 1940's, many surgeons adopted this technique for clinical advantage of reconstruction of Cupid's bow and lesser amount of tissue discarding than straight line technique. However, owing to its drawbacks such as sacrifice of Cupid's bow and prominent scar on philtral ridge, other techniques like Tennison's triangular flap and Millard's rotation-advancement flap have gradually taken its place. Nevertheless, some clinicians like Dr. Wang has modified this quadrilateral flap technique for better clinical outcomes. In this report we present 3 cases of unilateral complete cleft lip patients who underwent primary cheiloplasty with favorable outcomes based on Dr. Wang's modified quadrilateral flap technique.

• 한국해안·해양공학회논문집
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• 제33권5호
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• pp.203-216
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• 2021

진자형 파력발전장치(Oscillating Wave Surge Converter, OWSC)는 다양한 유형의 파랑 조건에서 효율적으로 작동해야하며 최적의 파랑에너지를 추출하도록 설계되어야 하기 때문에 OWSC의 거동과 관련된 복잡한 파랑-구조물 상호작용이 광범위한 조건에서 검토되어야 한다. OWSC의 개념 설계 및 개발단계에서 수치해석은 OWSC의 설계도구로써 좋은 대안이 될 수 있다. 본 연구에서는 기초적인 OWSC의 거동특성에 대한 검토를 목적으로 오픈소스 CFD를 이용하여 내습하는 파랑에 대한 역삼각형 플랩의 거동특성에 대한 수치해석을 수행하였다. 규칙파 내습시 주기의 변화에 따른 역삼각형 플랩 인근의 자유수면변위 및 회전각도(Flap Rotation angle)를 산정하여 구조물의 거동 특성에 대해 고찰하고, 그 결과를 수리실험과 비교·검토하여 해석성능의 타당성 및 OWSC의 관련 문제를 수치적으로 해석하기 위한 수치모델로서의 적용성능을 검증하였다. 수치해석결과는 파랑과 역삼각형 플랩의 상호작용에 의한 유체역학적 거동 특성을 양호하게 재현함을 확인하였다.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.263-266
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• 2020

Infantile hemangiomas have a growth phase and an involution phase. For this reason, serial observation has generally been recommended as the treatment for uncomplicated infantile hemangiomas. Recently, however, individualized approaches have been emphasized. Although cleft lip and infantile hemangioma are common congenital diseases, infantile hemangiomas on the cleft side (i.e., in the operative field of the cleft lip) are extremely rare, and no clear guidelines have been established for their treatment. We experienced a case in which a patient with a cleft lip had an infantile hemangioma on the cleft side. In accordance with general treatment guidelines, cleft repair was performed 3 months after birth. The Millard rotation-advancement technique, which involves the use of a lower small triangular flap, was used for the repair. No intraoperative complications, such as massive bleeding, or postoperative complications were noted. The patient has received regular follow-up for the past 18 years, and other than a reddish scar on the lower lip, he currently has no related issues. Therefore, this case demonstrates that cleft lip repair performed according to cleft lip treatment guidelines produces good outcomes, even in cases involving a hemangioma on the cleft side.