• 대한구순구개열학회지
• /
• 제10권1호
• /
• pp.39-56
• /
• 2007

The bilateral cleft lip, a more severe form of clefting than unilateral cleft lip, involves separation of the lip along philtral lines, isolating the central segment (prolabium). Bilateral cleft lip may be either symmetrical or asymmetrical, in which case the cleft lip is split more on one side than on the other. The cleft affects the obvious facial form as an anatomic deformity and has functional consequences, affecting the child's ability to eat, speak, hear, and breathe. Although there would seem to be quite a variance in reported figures, ratios of cleft lip with or without cleft palate have gone as high as 1:500 and as low as 1:1000. It is known that less than 10% of cleft lips are bilateral. Although bilateral cleft lip is less common than unilateral cleft lip, the deformity is more severe, and the reconstructive technique is more complex. Surgery is the only treatment necessary for patients with bilateral cleft lip. Accompanying the evolution of surgical repair is the increasingly important role of orthodontic support with early presurgical alveolar and nasal molding. Repositioning the maxillary and alveolar segments into a more anatomic position allows the surgeon to repair the lip and associated nasal deformity under more optimal conditions. The purpose of this article is to review the related anatomy, presurgical management, and surgical management of bilateral cleft lip.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권4호
• /
• pp.223-227
• /
• 2023

A midline or median cleft lip is rare, and a midline cleft associated with a unilateral cleft and a proboscis-like structure is rarer still. We present a case managed at our center in which a 5-year-old male had a median cleft of the upper lip with an associated 'proboscis' and a microform unilateral cleft lip.

• 대한구순구개열학회지
• /
• 제7권1호
• /
• pp.1-16
• /
• 2004

본 연구에서는 구순접합술의 효과를 알아보기 위하여, 일측성 완전구순열을 가진 5명의 환아에서 Millard의 high haU-underminded adhesion과 Seibert 의 lip adhesion을 이용한 구순접합술후 Millard 변법을 이용한구순성형술을 시행하였다. 구순접합술은 상악치조분절 간의 관계를 개선해 주고 구순성형술을 쉽게해주며 최종적인 구순성형술 후 더욱 좋은 결과를 나타냈다. High kalf-underminded adhesion과 Seibert의 lip adhesion은 둘 다 넓은 구순열을 하는데 유용한 방법이며, 특히 Seibert의 lip ahesion은 강한 접합력을 얻을 수 있고 변위된 비중격의 개선 효과가 있으며 보다 심미적인 상순의 연속성을 얻게 해 주었다. 이상의 결과에서 넓은 완전구순열 환아에서 구순성형술에 앞서 구순접합술을 시행하면 상악치조분절 간의 관계를 개선시키고 구순성형술 후 최종적인 결과를 향상시킴을 알 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제35권3호
• /
• pp.178-183
• /
• 2013

Cleft lip arises from congenital underdevelopment with various degrees and patterns. Mulliken named a unilateral incomplete cleft lip with no severe cleft as a lesser-form cleft lip and categorized it into three subgroups. Anatomically categorized subgroups are minor-form, microform, and mini-microform cleft by the extent of vermilion-cutaneous dysjuntion. The vermillion cutaneous notch is more than 3 mm from the regular Cupid's bow peak for minor-form, less than 3 mm for microform, and almost no gap with discontinuity on the vermillion cutaneous border for mini-microform. The treatments are rotational advancement flap for minor-form, double unillimb Z-plasty for microform, and vertical lenticular excision for mini-microform, respectively. This article aims to present the literature review about the incomplete lesser form cleft lip classified by Mulliken and to report our experiences.

• Archives of Plastic Surgery
• /
• 제36권6호
• /
• pp.702-706
• /
• 2009

Purpose: Analysis of lower nose and upper lip asymmetry in patients with unilateral cleft lip nose deformity has been proceeded through direct measurement and photo analysis. But there are limitation in presenting real image because of its 2 dimensional trait. The authors analyzed such an asymmetry using 3D VECTRA system (Canfield, NJ, USA) in quantitative way. Methods: In 25 Patients with unilateral cleft lip nose deformity(male 12, female 13, age ranging from 4 to 19), patients with right side deformity were 10 and left were 15. Analysis of asymmetry was proceeded through 3D VECTRA system. After taking 3 dimensional photo, alar area, upper lip area, nostril perimeter, nostril area, Cupid's bow length, nostril height and nostril width were measured. Correlation coefficient and inter data quotients were calculated. Results: In nostril perimeter, maximal difference of cleft side and non - cleft side was 39.3%, asymmetric quotient Qasy = Qcl/Qncl(Qcl, value of cleft side; Qncl, value of non - cleft side) was ranged from 0.84 to 1.85 and in seven cases the length of cleft side was smaller. In nostril area, maximal difference was 69.6% and in 13 cases cleft side was smaller. In lower nasal area, maximal difference was 37.2% asymmetric quotient Qasy = Qcl/Qncl was ranged from 0.47 to 2.03 and in 20 cases cleft side was smaller. The correlation coefficients of nostril perimeter and area were 0.8345. Conclusion: Using 3D VECTRA system, the authors can measure nostril perimeter and lower nasal area that could not been measured with previous methods. Asymmetry of midface was analyzed through area comparison in quantitative way. Futhermore, post operative change can be measured in quantitative method.

• 대한구순구개열학회지
• /
• 제2권1_2호
• /
• pp.1-4
• /
• 1999

• 대한구순구개열학회지
• /
• 제3권1호
• /
• pp.37-41
• /
• 2000

• 대한구순구개열학회:학술대회논문집
• /
• 대한구순구개열학회 2002년도 연수회
• /
• pp.35-39
• /
• 2002

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

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제18권4호
• /
• pp.529-545
• /
• 1996

In order to find the distribution, causes and treatments of cleft lip and/or palate, I analyzed 113 patients of cleft lip and/or palate who were treated in the Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Iksan, Chunbuk, KOREA from September 1984 to August 1995. The obtained results were as follows. 1. In total 113 patients of cleft lip and/or palate, male patients were 63 cases (56%) and female patients were 50 cases (44%). 2. In distribution of cleft lip and/or palate, cleft lip patients were 30 cases (27%), cleft palate patient were 23 cases (20%) and cleft lip and palate patients were 60 cases (53%). 3. Unilateral cleft lip patients (78 cases: 87%) were larger than bilateral cleft lip. In unilateral cleft lip patients, lip side cleft lip patients (45 cases: 50%) were larger than right side cleft lip patients (33 cases: 37%). 4. Possible causes of cleft lip and/or palate were related with familial tendency, drug intoxication, malnutrition, old maternal age, stress and hypoxia during 4-8 weeks of pregnancy period. 5. The favorite treated method of cleft lip was Millard rotation-advancement method. Probably the most popular operated period was 3 months. 6. The useful operating technique of cleft palate was Wardill V-Y flap method. The most popular period has been 18 to 24 months. 7. In 11 patients with velopharyngeal insufficiency, hypernasality decreased by superior based pharyngeal flap pharyngoplasty. 8. Cleft alveolus was treated with autogenous and allogeneic bone graft. The most appropriate operation period was 9 to 11 years.