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Long term results in the unilateral cleft lip repair by Mulliken's method (Mulliken 방법을 이용한 일측성 구순열의 장기 추적 결과)

  • Kim, Seok-Kwun;Moon, In-Sun;Lee, Chang-Ho;Heo, Jung;Kwon, Yong-Seok;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.174-182
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    • 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.

A chromosome 1q44 deletion in a 4-month-old girl; The first report in Korea

  • Cho, Joo Hyun;Song, Eun Song;Kim, Hee Na;Oh, Burm Seok;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.57 no.6
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    • pp.292-296
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    • 2014
  • The deletion of the distal long arm of chromosome 1 is associated with a characteristic facial appearance and a pattern of associated malformations. Characteristic manifestations include a round face with prominent 'cupid's bow' and downturned corners of the mouth, thin vermilion borders of lips, a long upper lip with a smooth philtrum, a short and broad nose, epicanthal folds, apparently low-set ears, micrognathia, microcephaly, abnormal hands and feet, variable cardiac or genital anomalies, moderate to severe mental retardation, and growth retardation. Using fluorescent in situ hybridization (FISH) analysis to map precisely the deletion, we present a case of chromosome 1q44 deletion with craniofacial characteristics, multiple congenital anomalies, and growth and psychomotor retardation. In comparison with other reported cases of 1q43-44 deletion, the subject does not show hydrocephalus, seizure, syn- or polydactyly of hands, and a urogenital anomaly. However, an arachnoid cyst, pinpoint dimple on the midline of the forehead, a right-sided supernumerary nipple and auricular pit, polydactyly of the right foot, adducted thumb, and flexion restriction of the proximal interphalangeal joint with a simian line in both hands were observed additionally.

Repair of Unilateral Incomplete Lesser Form Cleft Lip (편측성 불완전 소구순열의 치료)

  • Park, Hye Jeong;Jung, Hwi-Dong;Mulliken, John Butler;Jung, Young-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.178-183
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    • 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.

Staged lower lip reconstruction following gangrenous stomatitis in an immunosuppressed patient

  • Jin, Han Byeol;Yang, Jeong Yeol;Kim, Kyung Sik;Kim, Seung Hong;Choe, Joon;Chung, Jee Hyeok
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.222-226
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    • 2018
  • A 70-year-old male with a history of diabetes mellitus, hypertension, and coronary stent insertion visited our hospital 7 days after biting his lower lip. Swelling and inflammation had worsened despite debridement and antibiotic treatment. On the 8th hospital day, fungal infection with Candida albicans and superimposed bacterial infection with Klebsiella pneumoniae were found on tissue culture. Extensive necrosis resulted in a defect of approximately 3/4 of the entire lower lip and a full-layer skin defect from the vermilion to the gingivobuccal sulcus at the right corner of the mouth. To correct drooling, incomplete lip sealing, and trismus, staged reconstruction was performed with consideration of cosmetic and functional features. The treatment process using staged reconstruction and antifungal treatment for an extensive lower lip defect caused by fungal stomatitis is described.

Manufacturing Technique of the Avalokitesvara Bodhisattva Mural Painting in Geungnakjeon Hall, Daewonsa Temple, Boseong

  • Yu, Yeong Gyeong;Jee, Bong Goo;Oh, Ran Young;Lee, Hwa Soo
    • Journal of Conservation Science
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    • v.38 no.4
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    • pp.334-346
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    • 2022
  • The manufacturing technique was studied through the structure and material characteristics of the walls and the painting layers of the Avalokitesvara Bodhisattva mural of Geungnakjeon Hall, Daewonsa Temple. The mural is painted and connected to the earthen wall and the Junggit, and the wall is composed of wooden laths as a frame, the first and middle layers, the finishing layer, and the painting layer. The first layer, middle layer, and finishing layer constituting the wall were made by mixing weathered soil and sand. It was confirmed that the first layer had a high content of loess below silt, and the finishing layer had a high content of fine-sand and very fine sand. For the painting layer, a ground layer was prepared using soil-based mineral pigments, and lead white, white clay, atacamite, minium, and cinnabar (or vermilion) pigments were used on top of it. The Avalokitesvara Bodhisattva mural was confirmed to belong to a category similar to the soil-made buddhist mural paintings of Joseon Dynasty. However, it shows characteristics such as a high content of fine sand in the finishing layer and overlapping over other colors. Such material and structural characteristics can constitute important information for future mural conservation status diagnoses and conservation treatment plans.

Mucosal Roofing Flap Reconstruction to Minimize Horizontal Lip Length Loss and Preserve Mouth Opening in Lower Lip Squamous Cell Carcinoma (아랫입술의 편평세포암 환자에서 아랫 입술 폭 손실을 최소화하고 입벌림 기능을 보존하기 위한 새로운 점막지붕 피판 재건술)

  • Jong Hyup Kim;In Chang Koh;Soo Yeon Lim;Hoon Kim
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.23-26
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    • 2023
  • Lower lip reconstruction in cases with a full-thickness defect over one-third of the vermilion is challenging. Numerous conventional techniques have been applied with unsatisfactory surgical outcomes because of microstomia and oral commissure blunting due to shortened horizontal lip length. Herein, we present a case in which a full-thickness lower lip defect of more than one-third of the horizontal lip length was covered with a novel mucosal roofing flap reconstruction to minimize the loss of horizontal lip length and to preserve mouth opening. No recurrences or metastases were observed during 3 years and 6 months of follow-up, with horizontal lower lip length maintained and mouth opening of 2.5 finger breadths.

Analysis of Pigments in the Buseoksa Josadang Murals in Yeongju

  • Song, You Na;Lee, Han Hyoung;Baek, Na Yeon;Jung, Cham Hee;Park, Min Jeong;Chung, Yong Jae
    • Journal of Conservation Science
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    • v.36 no.1
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    • pp.47-59
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    • 2020
  • Scientific analysis was conducted to identify the paint pigments used in the Buseoksa Josadang murals. optical microscopy(OM), X-ray fluorescence(XRF), XRF mapping, scanning electron microscopy-energy dispersive X-ray spectroscopy(SEM-EDS), and Raman spectroscopy were performed to examine the pigments. The results confirmed that the Josadang murals consist of two paint layers wherein the pigments were distinct for most colors. It was estimated that celadonite, white clay, red ochre, cinnabar and minium, synthetic green pigment containing tin and zinc paratacamite, or botallackite were used in the upper layer. In addition, bone white, celadonite, red ochre, azurite, cinnabar or vermilion, and gold were identified in the lower layer. In addition, as Zn and Sn were detected in the green pigments extracted from the top layer of the paint, it is believed that Josadang murals were repainted over the original paint layer at some point after the 17th century. In addition, white pigments containing calcium phosphate were found in all the colors in the bottom layer, which is the original paint layer. These results are significant because this is the first time that white pigments are found in Korean traditional paintings. Additionally, the information revealed about the pigments in this study will serve as areference for the pigments used in the Goryeo period.

REPAIR OF BILATERAL CLEFT LIP AND NOSE: PRINCIPLES AND METHODS OF MULLIKEN (양측 구순열비의 교정술: Mulliken의 원칙과 방법)

  • Jung, Young-Soo;Mulliken, John B.;Sullivan, Stephen R.;Padwa, Bonnie L.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.4
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    • pp.353-360
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    • 2009
  • The principles for repair of bilateral cleft lip and nasal deformity are 1) symmetry, 2) primary muscular continuity, 3) proper philtral size and shape, 4) formation of the median tubercle and vermilion-cutaneous ridge from lateral labial elements, and 5) primary positioning of the alar cartilages to construct the nasal tip and columella. The authors underscore the essential role of preoperative premaxillary positioning for the synchronous closure of the cleft lip and primary palate, and describe Mulliken's operative technique. We discuss three-dimensional adjustments based on predicted fourth-dimensional changes. In a consecutive series of 50 patients, no revisions were necessary for philtral size or columellar length. Preoperative premaxillary positioning and primary repair of bilateral cleft lip and nasal deformity may impair maxillary growth. Nevertheless, a symmetric nasolabial appearance, rather than emphasis on maxillary growth, is the priority for the child with bilateral cleft lip.

Comparison of computer-based treatment prediction with true results in bimaxillary protrusion cases (치조성 양악 전돌 환자에서 컴퓨터를 이용한 치료 결과 예측의 정확성)

  • Lee, Rhi-na;Lim, Yong-Kyu;Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.32 no.3 s.92
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    • pp.155-163
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    • 2002
  • This study was performed to assess the accuracy of computer-based treatment prediction for soft tissue profile using Quick Ceph Image $Pro^{TM}\;&\;Quick\;Ceph\;2000^{TM}$ in bimaxillary protrusion cases. The Ore- and post-treatment lateral cephalograms of 21 female adults treated by low first premolar extraction were imaged and 9 landmarks and 27 specific soft tissue mesurements were digitized for comparing actual treatment results with computer simulations. The results of this study showed that Quick Ceph Image $Pro^{TM}\;&\;Quick\;Ceph\;2000^{TM}$ tends to overestimeate horizontal changes and underestimate vertical changes. In the computer simulation, upper lip showed rolling tendency. The upper lip measurements were disposed to be regular direction hut lower lip measurements were varied case by case even if it was statistically insignificant.

MAXILLOFACIAL ESTHETICS BY THREE DIMENSIONAL FACIAL MORPHOMETRICS (삼차원적 안모형태의 미적분석)

  • Lee, Sang-Han;Kwon, Tae-Geon;Baek, Sang-Heum
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.606-612
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    • 2000
  • This study was performed to investigate the average anthropometric value of normal Korean men and women and to compare the preceding literatures. Additionally, average Korean profilogram was made to serve as a template for diagnosis of facial form. Eighty five Korean subjects(41 men, 44 women) aged between 21 to 26 were selected by members of the author's department on the basis of intact dentition and Class I occlusion without facial asymmetry. Frontal and lateral photographs were taken under standardized condition with digital camera. The image was magnified and adjusted according to the FH plane of cephalometric radiographs and digitized using personal computer. To compare the Western beauty, 25 esthetically pleasing female was selected to measure various angle and distance of the face. 1. It was possible to calculate the mean coordinate value of Korean normal samples which enables the direct visualization and comparison with the use of template. The method in this study was easy to applicate under the Microsoft $Windows^{(R)}$ bases. 2. Maxillary vertical hypoplasia, upper and lower lip protrusion was characteristics of Korean norms and relatively narrow alar base distance, less conspicuous nasal projection was observed. As the vermilion exposure and upper lip length was more than western norm, chin looks shorter than western. To compare the Korean and Western esthetically pleasing profile, facial convexity and nose was less conspicuous in Korean women.

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