• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권1호
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• pp.3-11
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• 2018

Objectives: The unilateral cleft lip (UCL) repair technique has evolved extensively over the past century into its modern form and has been identified as an important determinant of treatment outcome. The aim of this study was to evaluate and compare treatment outcomes following repair of UCL using either the Tennison-Randall (triangular) technique or the Millard rotation-advancement technique. Materials and Methods: This was a prospective randomized controlled study conducted at the Lagos University Teaching Hospital between January 2013 and July 2014. A total of 48 subjects with UCL presenting for primary surgery and who satisfied the inclusion criteria were recruited for the study. The subjects were randomly allocated into two surgical groups through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard rotation-advancement technique. Surgical outcome was assessed quantitatively according to anthropometric measurements, using a method described by Cutting and Dayan (2003). Results: Our 48 enrolled subjects were evenly divided into the two surgery groups (n=24 for both group A and group B). Twenty-seven subjects were male (56.3%) and 21 were female (43.8%), making a sex ratio of 1.3:1. The Millard group showed a greater increase in postoperative horizontal length and vertical lip height and a greater reduction in nasal width and total nasal width. Meanwhile, the Tennison-Randall group showed better reduction of Cupid's-bow width and better philtral height. Conclusion: We did not find any significant differences in the surgical outcomes from the two techniques. The expertise of the surgeon and individual patient preferences are the main factors to consider when selecting the technique for unilateral cleft repair.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권4호
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• pp.295-309
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• 2006

The present study was aimed to evaluate the incidence, etiological factors, and management of cleft lip and palate. Two hundred and twenty patients with cleft lip and/or cleft palate who were treated at Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, during the period between January 1994 and December 2003 were reviewed. The ratios of cleft lip : cleft lip with cleft palate : and cleft palate were 0.4:1.1:1. Males were more common than females in cleft lip (1.3:1) and cleft lip and palate (2.5:1), while females were more common than males in cleft palate (1:1.3). In the cleft side, left clefts were more prevalent than right clefts (cleft lip 1.3:1, cleft lip and palate 1.6:1). Unilateral clefts were more common than bilateral clefts in cleft lip (79:21). Cleft lip and cleft palate were more common in those with blood type A (34.5%) than those with other types. There was no significant relationship between birth season and frequency of clefts. The clefts were common in the first-born (48.8%), and in mothers aged between 25 and 29 (51.7%). Medication (24.7%) and stress (16.7%) during the first trimester were noted. Positive familial history was noted in 13 cases (5.9%). Thirty-two cases (15%) were associated with other congenital anomalies, in which tonguetie (40.6%) and congenital heart disease (21.9%) were most common. Among 100 patients with cleft palate, 77 patients had middle ear disease (77%), which occurred predominently in the incomplete cleft palate. Seventy-six among the 77 patients received myringotomy and ventilation tube insertion, and the remaining one received antibiotic medication only. Cleft lips were treated primarily at 3 to 6 months, and cleft palates were at 1 to 2 years. Treatment regimens included modified Millard method mainly in the cleft lip, and Wardill V-Y, Dorrance method, and Furlow method in the cleft palate. The percentage of palatal lengthening as type of cleft palate was greater in the incomplete cleft palate group (11.2%) than in the complete cleft palate group (9.6%). The percentage of palatal lengthening as operating method was no difference between the Furlow method (10.9%) and the push back method (10.7%). As postoperative complications, hypertrophic scar was most frequent in the cleft lip, and oronasal fistula in the cleft palate. In summary, it was shown that medication and stress during the first trimester of pregnancy were frequently associated with cleft lip and cleft palate, adequate timing and selection of method of operation are important factors to obtain morphologically and functionally good results. Furthermore prevention and treatment of middle ear disease are important in cleft palate patients because of its high co-occurrence.

• 대한치과의사협회지
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• 제12권3호
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• pp.183-188
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• 1974

The authors had treated 68 case of cleft lip and cleft palate patients including 44 male patients and 24 female patients. There ware 55 cases of unilateral cleft lip patients and 13 cases of bilateral cleft lip patients, and 37 cases with together cleft lips and cleft palates among 68 cases were observed. We had accomplished that 'Plastic Cheiloplasty', surgical closures of cleft lips and cleft palates had been performed by using of Millard's, Hagedorn's, LeMesurier's and Veau's methods with Z-plasty.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.20.1-20.6
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• 2016

Background: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. Case presentation: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. Conclusions: The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권1호
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• pp.13-15
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• 2014

Epithelial cysts are benign epithelium-lined lesions that contain fluid or semisolid material. Most epithelial cysts in the oral cavity occur in the anterior part of the mouth floor. Cysts arising on the uvula in a cleft palate patient are rare. Intraoral examination in a 14-month-old boy with a complete cleft lip and palate revealed a cystic lesion on the right uvula. The lesion was excised and push-back palatorrhaphy with Z-plasty on the uvula was performed. Histopathological examination diagnosed an epithelial cyst. We report a case of an epithelial cyst of uvula in a patient with a unilateral complete cleft lip and palate.

• 대한치과교정학회지
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• 제19권1호
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• pp.153-167
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• 1989

This study was undertaken to analyze the growth of mandible in surgically repaired unilateral cleft lip and palate. The subjects consisted of 63 unilateral cleft lip and palate individuals, 60 class III malocclusions and 60 normal occlusions ranging from 6 to 15 years old. Each group was divided into two age groups. (6-10 Y and 11-15 Y) The results obtained from UCLP compared with other groups were as follows: 1. The anteroposterior position of the chin was similar to that of the normal occlusions. 2. The shape of the mandible was similar to that of the class III malocclusions. 3. In mandibular size, ramus height was the smallest among three groups, but body length and overall mandibular length were similar to those of the normal occlusions. 4. The lower border of the mandible was the steepest among three groups and strong vertical or clockwise growth tendency was indicated. 5. The position of condyle in relation to the cranial base showed little difference in three groups. 6. In older age group , vertical growth tendency of the mandible decreased more or less.

• 대한치과교정학회지
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• 제23권3호
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• pp.319-326
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• 1993

The purpose of this study was to evaluate the frequency of congenital missing teeth and supernumerary teeth in cleft patients. The subjects were divided into bilateral cleft lip and palate(BCLP), unilateral cleft lip and palate(UCLP) and cleft palate alone(CP alone) groups. 97 cleft patients(BCLP 15, UCLP 70, CP alone 12) between 6-20 years old were evaluated. Panorama film, Orthodontic chart and initial intraoral photogram were employed for this research. The obtained results were as follows. 1. The incidence of congenital missing teeth in total cleft samples was $57.7\%$, and the incidence of supernumerary teeth was $26.8\%$. Each incidence was higher than non-cleft. 2. The incidence of congenital missing teeth was the highest in BCLP and the lowest in CP alone. 3. The number of congenital missing teeth per perso was usually one, and the frequency was higher in the maxillary lateral incisors$(67.8\%)$, and maxillary second premolar$(14.9\%)$ than other teeth. 4. Most of tooth number anomalies in cleft patients were found in maxilla, especially adjacent region to the cleft site.

• 대한구순구개열학회지
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• 제4권2호
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• pp.1-8
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• 2001

The dissimilarities between South and North Korea have persisted in spite of the reconciliation campaign by both countries. The situation of the cleft lip & palate of North Korea was very unclear until now. The purpose of this study is to understand all the current facts of cleft lip & palate in North Korea so that we can find ways of helping North Korea in this field of medicine. The present data and analysis are extracted from North Korean textbooks. The results are as follow. 1. In North Korea, patients with CLP are treated by oral surgeons or maxillofacial surgeons. The detailed contents about the CLP are well described in the North Korean textbooks for the dental students. 2. The terminology of CLP in North Korea has changed from time to time, but the present terminology not being so different from South Korean counterpart. So there will be no particular problems in mutual communication. 3. The main classification for CLP in North Korea originated from Kernahan & Stark's classification as is with South Korea. 4. The incidence of CLP is 1 : 1,000-1,200 in North Korea, which is lower than that of South Korea. There is, however, some difference between the North and South Korean CLP in detailed statistics. 5. We found the North Korean physicians have shown much interest in pursuing the etiology and the prevention of CLP. 6. The timing of CLP operations varied a lot in North Korea. There was recommendation by few for the operation in much late age than in South Korea. 7. The classical operation techniques of cleft lip have changed. For unilateral cleft lip Tennison-Randall method was replaced by Millard I method: and for bilateral cleft lip LeMesurier method was replaced by Veau III and Tennison methods. But for cleft palate Pushback palatoplasty has been utilized consistently.

• 대한구순구개열학회지
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• 제13권2호
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• pp.63-76
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• 2010

After introduction of Delaire's basic philosophy, to consider the normal and pathologic anatomy, the role of some structures, such as nasal septum, musculature, and tongue, and some functions, such as dental occlusion or nasal respiration, which play important roles in maxillary and particularly premaxillary growth, on the Korean Journal of cleft lip and palate in 2009, Delaire's primary functional cheilorhinoplasty (FCR) in the unilateral and bilateral cleft lip patients was summarized and introduced according to already published literatures and lectures. This paper will be the second publishment of Delaire philosophy with Korean language.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.563-569
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• 2006

Purpose: In the correction of cleft lip, there have been various methods to minimize recurrence of the nasal deformity after primary nasal surgery. After cheiloplasty and primary nasal surgery, we tried to elongate the columella of the cleft side, to stretch the vestibular lining of cleft side, and to elevate the alar cartilage of the cleft side with a molding prong. Methods: We had fifteen cleft lip patients; 12 unilateral cases(6.3-8.2 months), and 3 bilateral cases(3 - 7.5 months). Immediately after primary repair of the cleft lip, the toboggan shaped molding prong was located to deep inside of vestibular web of the cleft side. It was persistently suspended by a silicone tube which was connected to the prong and the frontal scalp. The results were analyzed with $Photoshop^{(R)}$ photogrammetrically for 6 - 48 months with on average of 20.6 months. We measured the proportion index of columellar length-interalar distance for three times(preoperation, immediate postoperation, and postoperation) on the nasal base views. Results: In unilateral, the index had a significant increase statistically between preoperation(10.73) and immediate postoperation(23.96). It is supposed that columellar length was reconstructed to 105.80% of normal side. But, it was decreased to maintain 87.7% of normal side in postoperation(20.54). The results were similar in bilateral. The linear scars by suture penetrating nose skin were not discernable. Conclusion: In summary, placement of the molding prong could elongate the reconstructed columella with some relapse postoperatively.