• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.1
• /
• pp.66-70
• /
• 2005

Cupid's bow, upper lip, columella, and ala of nose are esthetically important, in which their symmetrical plasties determine success or failure of the surgery in cleft lip and palate patients. Z-palsty and its modifications are simple and effective. The double Z-plasty is economical in surgical time and esthetics in reconstructing the cupid's bow compared with other methods. We report a 29-year-old male patient who represented reversed cupid's bow and whistle deformity after the primary repair of the cleft lip. He was corrected the cupid's bow using a double Z-plasty. The reversed cupid's bow was corrected to a normal shape and the whistle deformity disappeared. The tightness of the upper lip was relieved after the operation. The double Z-plasty was esthetically successful because the procedure was limited in the vermilion and did not produce a new scar on the skin. Furthermore, the lip tubercle became protuberant. The cupid's bow was symmetrically smoothly curved at 4 years after the operation. These results indicate that the double Z-plasty is simple, less traumatic to the surrounding tissues, and suitable for the correction of whistle deformity.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.2 no.2
• /
• pp.158-162
• /
• 2003

Purpose: The purpose of this study was to analyze the treatment results of snapping hip caused by a tight iliotibial tract using Z-plasty . Materials 8nd Methods: Five patients (seven hips) were treated by Z-plasty using Brignall and Stainsby's method from March, 1995 to May,2002 There were three males and two females and their average age at operation was 24.4 years. All patients complained of snapping, pain, and difficulty of squatting with attaching both knees . The average of follow-up was one year and four months. The local anesthesia was done in three patients (3 hips) and epidural anesthesia in two patients (4 hips). Results: Snapping was absent, squatting with attaching both knees was possible, and pain relief was excellent in all patients. One patient (one hip) experienced occasional aching associated with exercise but it is not serious. Conclusion: This Z-plasty of iliotibial band was an excellent surgical technique for the symptomatic snapping hip.

• Journal of Chest Surgery
• /
• v.42 no.3
• /
• pp.292-298
• /
• 2009

Background: Surgery for mitral valve disease in children carries both technical and clinical difficulties that are due to both the wide spectrum of morphologic abnormalities and the high incidence of associated cardiac anomalies. The purpose of this study is to assess the outcome of mitral valve surgery for treating congenital mitral regurgitation in children. Material and Method: From 1997 to 2007, 22 children (mean age: 5.4 years) who had congenital mitral regurgitation underwent mitral valve repair. The median age of the patients was 5.4 years old and four patients (18%) were under 12 months of age. 15 patients (68%) had cardiac anomalies. There were 13 cases of ventricular septal defect, 1 case of atrial septal defect and 1 case of supravalvar aortic stenosis. The grade of the preoperative mitral valve regurgitation was II in 4 patients, III in 15 patients and IV in 3. The regurgitation was due to leaflet prolapse in 12 patients, annular dilatation in 4 patients and restrictive leaflet motion in 5 patients. The preoperative MV Z-value and the regurgitation grade were compared with those obtained at follow-up. Result: MV repair was possible in all the patients. 19 patients required reduction annuloplasty and 18 patients required valvuloplasty that included shortening of the chordae, papillary muscle splitting, artificial chordae insertion and cleft closure. There were no early or late deaths. The mitral valve regurgitation after surgery was improved in all patients (absent=10, grade I=5, II=5, III=2). MV repair resulted in reduction of the mitral valve Z-value ($2.2{\pm}2.1$ vs. $0.7{\pm}2.3$, respectively, p<0.01). During the mid-term follow-up period of 3.68 years, reoperation was done in three patients (one with repair and two with replacement) and three patients showed mild progression of their mitral reguration. Conclusion: our experience indicates that mitral valve repair in children with congenital mitral valve regurgitation is an effective and reliable surgical method with a low reoperation rate. A good postoperative outcome can be obtained by preoperatively recognizing the intrinsic mitral valve pathophysiology detected on echocardiography and with the well-designed, aggressive application of the various reconstruction techniques.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.12 no.2
• /
• pp.158-160
• /
• 2001

Ankyloglossia is the presence of a lingual frenulum, which can range from a mucous membrane band to a short and thick band and, in extreme cases, to fusion of the tongue to the floor of the mouth. The effects of such a condition, in addition to speech defects and occasionally restriction of sucking, including dental deformities, such as open bite, or even prognathism. Treatment is surgical. The preferred treatment is horizontal sectioning of the frenulum down to the lingual septum and then suturing of the mucosa. The main problem after the healing of surgical wound is adhesion and contracture. Adhesion restrict the movement of tongue like tongue-tie. Z-plasty at the site of incision can solve this problem by changing the direction of scar. We have experienced a patient with ankyloglossia with speech defect, who underwent frenuloomy by Z-plasty. So we present a surgical treatment of Ankyloglossia using Z-plasty and discuss the treatment with a review of literature.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.14 no.1
• /
• pp.10-15
• /
• 2003

Background and Objectives : Ankyloglossia, commonly known as tongue-tie, is the result of a short, fibrous lingual frenulum or highly attached geioglossus muscle. This condition may cause sucking and swallowing problems, articulation disorders, interference with the tongue's cleansing action, increased the potential for caries, and inability to lick the lips, play a wind instrument, and 'french kiss' Treatment is surgical procedure. In the most cases, horizontal sectioning and mucosal suture(the conventional procedure) is preferred, but in some cases, the Z-plastic procedure is effective. This study is aimed to compare the result of the two procedures. Materials and Methods : Twenty tongue-tie patients underwent operation. Ten patients were treated with the Z-plastic procedure and ten patients were treated with the conventional method randomly. We checked preoperative mobile tongue length, postoperative mobile tongue length, operation time and postoperative wound states. Results : Among the 20 cases of tongue-tie, 2 cases are excepted due to pre-operative state, thus we compared 18 cases of tongue-tie patients. There is no statistically significant difference between the two procedures except in operation time. The Z-plastic procedure apparently needs a little more operating time. Conclusion : Patients treated with the Z-plastic procedures appeared to have better outcomes, but the data shows no statistical significance except in operating time. Consequently, the Z-plastic procedure is indicated in a limited amount of cases.

• The Journal of the Korean dental association
• /
• v.10 no.6
• /
• pp.379-383
• /
• 1972

Patient, S.B. moon, an 20-years old female was first seen S.N.U. Dental Hospital in January 1971 because of masticatory dysfunction, cosmetic unfiguration due to mandibular micrognathia. Her Complaint was 'bird face' due to under development of the jaw. A bilateral Z-shape sliding osteotomy was performed with the patient under the general Anesthesia.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.2
• /
• pp.137-144
• /
• 1994

Inselecting scars for treatment, attention be paid not only to the features of the defect as seen objectively but also to the element of the defect most disturbing to the patient. We revised the scar tissues with simple elliptical excision, Z-plasty, modified Z-plasty, W-plasty and hand dermabrasion in varialbe pattern of scars and got the favorable results. The success rate of scar revision usually depends on the patient's subjective judgement. We must inform our patient the limitation of scar revision and importance of postoperative care. The oral and maxillofacial surgeons must resolve the variable scars which re involved in variable operations and traumas.

• Korean Journal of Cleft Lip And Palate
• /
• v.15 no.2
• /
• pp.97-108
• /
• 2012

Velopharyngeal insufficiency (VPI) is improper closure of velopharynx during the phonation and swallowing due to various causes, especially appeared in cleft palate patients. The several surgical techniques and speech therapy can be considered in treatment of VPI. The surgical techniques such as Furlow's double opposing Z-plasty, pharyngeal flap, push-back palatoplasty, etc. have been widely used when the speech therapy is not so much effective. However, there is considerable variability in the methods for evaluation and in success criteria making difficult to compare among surgical techniques. This article reviewed the recent articles about comparing the surgical techniques in treatment of VPI. Although there is no significant difference in speech assessment by speech pathologist, Furlow's double opposing Z-plasty is a useful technique especially diminishing hypernasality and nasal emission.

• Archives of Plastic Surgery
• /
• v.38 no.4
• /
• pp.408-414
• /
• 2011

Purpose: To correct breast ptosis, reduction mammoplasty and mastopexy have been developed in a way that minimizes complications. Recently, as the mean age of breast cancer occurrence is decreasing, the need for breast reconstruction in patients with breast cancer is rising. If mastopexy is performed with breast reconstruction at the same time, the size of the normal breast and the new one is not quite different. We decided to apply Z-plasty, which is a widely-used technique in plastic surgery to lengthen or change the direction of tension of the tissue. Methods: From March 2008 to December 2009, we performed breast reconstruction in 6 patients with breast cancer and scar contracture. After breast reconstruction, mastopexy with Z-plasty was applied to correct the asymmetry. The new nipple-areolar complex is placed on the line connecting the midclavicle and the current nipple. The inferior border of the new areola corresponds with the inferior border of the original areola, and the superior border about 2 cm upward the original superior border. We drew two oblique lines connecting the medial end of the incision line lower to the nipple-areola complex and the lateral end of the inframammary fold for Z-plasty. The excess tissue between these two lines was removed and the new triangular flaps were put together. Results: The average age of patients was 42.6 years, aged from 36.1 to 48.1 The weight of removed tissue was between 54g and 95 g, with the mean of 74 g. The average distance from the midclavicle to the nipple was 24 cm before surgery, and 21 cm after the surgery. The average operation time per patient (1 mastopexy) was 45 minutes, and the patients were satisfied with the size and shape. Conclusion: Applying Z-plasty for the mastopexy on the normal breast ptosis is a relatively simple way to achieve symmetry in patients who need breast reconstruction.

• Journal of Chest Surgery
• /
• v.29 no.10
• /
• pp.1081-1089
• /
• 1996

Pulmonary atresia with intact ventricular septum has continued to have a high surgical mortality and morbidity. This mAy attribute to the non-uniformity of the anomaly. We reviewed a total of 34 infants with pulmonary atresla and intact ventricular septum managed in this hospital between 1987 and 1995. Mean age and body weight were 57.2 (range, 3-208) days and 4.1 (range, B.3∼6.8) kg. The preoperative Z-value of the diameter of the tricuspid valve was less than -2 in 85.2% of patients and less than -4 in 33. 3% . It is well correlated w th right ventricular cavity size (n=27. r10.68, p< 0.05). Coronary artery-right ventricular fistulas were identified in 3 patients, and right ventricular dependency was suspected in 1 Over All hospital mortality was 23.5%(8/34), although it decreased to 16.6%(4124) in 1990s. Subsequent procedures were performed in 6 patients between 3 days and 58 months after Initial palliation : one bidirectional cavopulmonary shunt and 1 Fontan operation after systemic-pulmonary shunt, 3 transannular patch + atrial septal defect closure and 1 additional systemic-pulmonary shunt after polmonary valvectomy or valvotomy. Changes of Z-values of the diameter of tricuspid valve have been followed up in 11 patients between 1 and 66 months postoperatively. Z-values were increased In 5 out of 8 transannular right ventriculAr outflow tract enlargement group and in 1 out of 3 pulmonary valvectomy or valvotomy group. Our data suggest that tailoring a treatment to right ventricular cavity size and coronary anom lies may improve the surgical outcome. A Z-value of the tricuspid valve diameter could be used.