• 대한구순구개열학회지
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• 제15권2호
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• pp.69-82
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• 2012

Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.53-60
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• 2009

Maxillary deficiency, anterior cross bite, constriction of maxillary arch, malaligned teeth are frequently observed in patients with cleft lip and palate. Surgery and orthodontics, combined intervention are needed to correct maxillary deficiency. Distraction osteogenesis that currently used has many advantages like less relapse tendency, more advancement of maxilla, capable in growing patients. In case 1, 18 years old girl with BCLP had severe midfacial deficiency and multiple missing of teeth. LeFort I osteotomy, followed by maxillary distraction osteogenesis utilizing rigid external distraction device(RED) system, was performed. After a 6-day latency period, distraction proceeded at a rate of 1mm per day (at 1st week, 1.5mm/day). Total advancement was 19mm. The RED device left in place for the additional 4 weeks for consolidation. After the RED device was removed, face mask was applied with elastic traction for 5 weeks. After achieving acceptable facial appearance and occlusion, orthodontic appliance was removed. The results after 4 years follow-up was sustained pretty well without aggravation of velopharyngeal function. In case 2, 22 years old man with UCLP had severe midfacial deficiency and palatally erupted upper 2nd premolars due to arch length discrepancy, but the anterior segment of maxillary did not show constriction and crowding. patient had no arch width discrepancy, crowding was concentrated on premolar region. Segmental LeFort I osteotomy was performed. After a 6 - day latency period, using internal distraction device, distraction proceeded at a 0.5mm per day(at 1st week, 0.75 - 1 mm/day). Total advancement was 15mm. After internal distraction device was removed, face mask was applied with elastic traction for 4 weeks. After surgical-orthodontic treatment, facial appearance and occlusion was improved pretty good, and after 46 months follow-up the result was retained well.

• 구강회복응용과학지
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• 제24권1호
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• pp.19-27
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• 2008

이 연구의 목적은 한국어를 사용하는 성인에서 성별에 따른 비음도의 차이가 있는지 알아보고, 후천적 구개부 결손환자의 보철치료를 위한 기초자료로 사용을 위해 정상 비음도를 획득하는 것이다. 음성언어 표본으로 선정된 단순모음, 이중모음, 반복자음, 그리고 비음의 비율이 높은 문장, 비음의 비율이 중간인 문장, 비음의 비율이 낮은 문장에 대해 비음도의 평균과 표준편차를 구하고 남녀간의 차이가 있는지를 t-test와 Mann-Whitney test를 이용하여 분석하였다. 피실험자들은 서울 경기 지역에 거주하는 남자 15명과 여자 15명으로 구성되었고 이들 중 남자 피실험자들의 나이는 24세에서 38세까지 분포하였고 평균나이는 26.3세였다. 여자 피실험자들의 나이는 19세부터 33세까지 분포하였고 평균나이는 24.4세였다. 비음측정기 Nasometer II 가 실험에 사용되었다. 연구의 결과로 /이/ 모음을 포함하는 일부 반복 자음을 제외하고는 모음, 반복자음, 문장을 이용한 음성언어표본에서 남녀 간 비음도의 유의성 있는 차이가 발견되지 않았다. 비음측정기는 음성언어표본이 달라짐에 따라 비음도의 유의한 차이를 나타내었다.

• 대한구순구개열학회지
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• 제12권1호
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• pp.1-6
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• 2009

Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.