• Archives of Plastic Surgery
• /
• 제48권6호
• /
• pp.630-634
• /
• 2021

To date, there have been no reports of patients showing a Tessier number 7 cleft with unilateral complete cleft lip and palate. Furthermore, no studies have established the sequence, plan, or timing of surgical methods for treating patients presenting the above anomalies simultaneously. We report a case of a Tessier number 7 cleft with unilateral complete cleft lip and palate. Two months after birth, lip adhesion was performed on the unilateral complete cleft lip and total excision was performed on the skin tag. At 4 months of age, Tessier number 7 cleft was corrected. At 6 months of age, surgery involving two small triangular flaps was performed on the unilateral incomplete cleft lip after performing lip adhesion. At 13 months of age, two-flap palatoplasty with a vomer flap was performed on the complete cleft palate. At 6 years of age, open rhinoplasty was performed on the unilateral cleft lip nose deformity. At 9 years of age, bone grafting was performed for the alveolar cleft. At follow-up appointments up to 13 years of age, there were no major complications. Here, we present this patient, surgical procedures and timelines, and show our results demonstrating good postoperative outcomes.

• Archives of Plastic Surgery
• /
• 제36권2호
• /
• pp.174-182
• /
• 2009

Purpose: The Mulliken's method is a one of the very excellent technique to correction of the unilateral cleft lip. It could decrease the need of additional operation and second operation by the early simultaneous correction of unilateral cleft lip and nasal deformity, at a time. Numerous procedures were advocated for the correction of nasal deformity, but with general dissatisfaction of the results, it became obvious that no one procedure is the ideal one. The authors have been operating on unilateral cleft lip by Mulliken's method and long term follow - up of postoperative result was evaluated. Methods: The authors have done long term follow - up of result in the 75 cases unilateral cleft lip patient, during 1 ~ 7 years. That was repaired by simultaneous correction of cleft lip and nasal deformity by Mulliken's method at the period from June, 1997 to December, 2007. The patients were unilateral complete cleft lip 39 cases, unilateral incomplete cleft lip 36 cases. In the severe complete cleft lip cases, lip adhesion operation was done before definite operation. The mean age of unilateral cleft lip operation was 3.2 months. Five anthropometric parameters, which were upper lip, cutaneous lip and vermilion mucosa height, nasal tip protrusion, columella length were measured by Sliding Vernier Caliper. The anthropometric analysis was performed preoperative and postoperative at 6 months, 3, 5 and 7 years and the results were com pared with those of age - matched, normal children. T - tests were used to analyze the differences between the measurements. Results: Long - term postoperative results were evaluated by anthropometrically. Most patients showed adequate growth of upper lip height, vermilion mucosa height and columella length. But nasal tip protrusion was relatively short compare with normal value. Incomplete cleft lip group was nearly normal growth results than complete cleft lip group. Conclusion: In conclusion, we could make harmonious Cupid's bow, natural philtrum and lip, appropriate nasal shape by Mulliken's method. But nasal tip protrusion was under the normal values on complete and incomplete group. And incomplete group was more good results than complete group. We have experienced repair of cleft lip by Mulliken's method with 75 cases of unilateral cleft lip patients and conclude that it was very useful and good method.

• Archives of Plastic Surgery
• /
• 제33권1호
• /
• pp.75-79
• /
• 2006

The upper and lower lateral cartilages provide the key to the lower cartilaginous portion of the nose. Lifting the cartilages is essential procedure for correction of unilateral cleft lip nose deformity. After correction of cleft lip nose deformity, authors used acoustic rhinometry (AR) to compare the lower nasal cavity of cleft side with non-cleft side. AR is a well known new, non-invasive diagnostic technique in which nasal geometry is assessed by means of acoustic reflection. From June 1996 to January 2004, we performed acoustic rhinometric analysis after correction of unilateral cleft lip nose deformity. This study involved 40 children of age ranged from 3 months to 8 years. Subjects were divided into the group of incomplete unilateral cleft lip nose deformity(20 subjects), and the group of complete unilateral cleft lip nose deformity(20 subjects). Results show that lower nasal cavity volume between non-cleft side and cleft side has no difference, and better results were obtained when nasal molding prong was applied at cleft side nostril. The results between incomplete type and complete type have no significant difference. In conclusion, AR is an effective method to calibrate cross sectional area and nasal cavity volume of unilateral cleft lip nose deformity, and furthermore effective in comparing the volume of cleft side with non-cleft side after unilateral cleft lip nose deformity correction with lifting the lower lateral cartilages to the upper lateral cartilages.

• 대한구순구개열학회지
• /
• 제5권1호
• /
• pp.27-42
• /
• 2002

This study was designed to evaluate the morphology and the position of the mandible in the complete unilateral cleft lip and palate patients, Craniofacial skeletal morphology pattern was analyzed on the lateral cephalometric radiographs of the 50 subjects of complete unilateral cleft lip and palate, the 50 normal and 50 class III, Each group was divided into child and adult sub-groups, All the data were tested statistically. The results were as follows: I, In the comparison with the normal group, complete cleft group showed smaller angular, condylar length, clockwisely rotated mandible and larger NMe/SGo(p<0.01). 2, In the comparison with the class III group, the complete cleft group showed significantly smaller angular, condylar, ramal, body length of the mandible(p<0,01). 3. As for the position of the mandibular condyle to the cranial base, the class III group was the most anterior, the normal group was the most posterior and the complete cleft group was in the middle(p<0.05). 4. In the comparison with child group, the normal adult group showed smaller mandibular angle and mandibular plane angle, but not the other two groups. And the complete cleft group and the class III group showed the similar change. The normal and class III group showed increased XiCd/XiPog, but not the complete cleft group(p<0.01).

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권5호
• /
• pp.392-400
• /
• 2011

Purpose: Cleft lip and palate is one of the most frequent hereditary deformities of the maxillofacial region which can arise in facial and jaw abnormalities as well as malocclusion and speech problems. In particular, unilateral cleft lip and palate is characterized by midface deformity resulting in maxillary anterior nasal septal deviation and nasal deformity. The aim of this study is to analyze the facial deformity of untreated unilateral cleft lip patients for contribution to primary cheiloplasty. Methods: Thirty-three patients with unilateral cleft lip and palate were impressioned before operation and facial casts were made. The casts were classified into complete cleft lip and incomplete cleft lip groups and each group were classified into affected side and normal side. Anthropometric reference points and lines were setted up and analysis between points and lines were made. Results and Conclusion: The obtained results were as follows: 1. The intercanthal width had no significant difference between the incomplete and complete cleft lip groups. 2. Cleft width and alar base width were greater in the complete group, and nasal tip protrusion was greater in the incomplete group. 3. Involved alar width and nostril width were greater in the complete group and in both complete and incomplete groups, involved alar width and nostril width were greater than the non-involved side. 4. The lateral deviation of the subnasale was greater in the complete group in both involved and non-involved sides. 5. The nasal laterale was placed inferiorly in both cleft groups. 6. The subnasale was deviated to the non-involved side in both cleft groups. 7. The nose tip was deviated to the non-involved side in both cleft groups and had greater lateral deviation in the complete cleft group. 8. The midpoint of cupid's bow had no vertical difference between complete and incomplete groups, but had a greater lateral deviation in the complete group. 9. In the complete cleft group, correlation between differences in cleft width and nostril width and columella height difference were obtained.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제34권3호
• /
• pp.200-204
• /
• 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
• /
• 제2권1_2호
• /
• pp.1-4
• /
• 1999

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

• 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.

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