• 제목/요약/키워드: bilateral cleft lip and palate

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악안면 기형환자에서 내측 익돌근 근력측정 및 의미분석 (Analysis of the resistant muscle force against distraction in the maxilla-facial deformities)

  • 정필훈;홍종락;배용철
    • 대한구순구개열학회지
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    • 제4권2호
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    • pp.45-50
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    • 2001
  • Recents reports have demonstrated that force and direction is important during mandibular distraction osteogenesis. The purpose of this study was to evaluate the resistant force of internal pterygoid muscles and inquire into relationship between internal pte'Ygoid muscles and cephalometric parameters. Eighty four patients with class III malocclusion underwent bilateral sgittal splitting of ramus with intraoral vertico-sagittal ramal osteotomy. A spring scale were used for measuring for resistence of internal pterygoid mescles after splitting of ramus. Skeletal-dental cephalometric analysis was made following statistic package was used for correlation between resistence and cephalometric parameters. The resistant force of right internal pterygoid muscle was greater than left muscle in Korean with class III malocclusion and the force had a linear regression relationship with facial depth (distance between nasion and gonion). The results suggested that facial depth has significant correlation of the resistance of internal pterygoid muscle (p<0.05).

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Rare Giant Upper Lip Epidermal Cyst in a Patient Wearing a Denture

  • Kim, Jong Chan;Hong, In Pyo
    • 대한두개안면성형외과학회지
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    • 제17권4호
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    • pp.222-224
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    • 2016
  • Epidermal cysts are intradermal or subcutaneous cystic tumors that frequently occur in the face, scalp, neck, and body trunk. Acquired cases of epidermal cyst commonly occur as a result of various surgical operations, chronic irritation, or trauma, all of which may trigger the occurrence of the invagination of squamous epithelium. A 57-year-old man presented with a palpable mass $7cm{\times}2cm$ in size in the upper lip. The patient had a 3-year history of wearing a denture to restore missing bilateral maxillary central and lateral incisors, accompanied by inflammatory findings on the buccal mucosa due to chronic lip irritation. The resected oval-shaped cyst had a size of $5.5cm{\times}3.0cm{\times}2.5cm$, and it was an encapsulated mass with a well-defined margin. The histopathology was typical of epidermal cyst. This case of a rare giant upper lip epidermal cyst in a patient wearing a denture may be of interest to clinicians.

Y-형 전방 기저 설 피판과 장골 이식을 이용한 양측성 치조열의 이단계 재건술 (Two stage reconstruction of bilateral alveolar cleft using Y-shaped anterior based tongue flap and iliac bone graft)

  • 이종호;김명진;강진한;강나라;이종환;최원재;최진영
    • 대한구순구개열학회지
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    • 제3권1호
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    • pp.23-31
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    • 2000
  • 전방 기저 설피판은 비교적 큰 구개 결손을 폐쇄하는데 안전하고 효과적이었으며 후에 장골 이식을 위한 건전한 피복을 제공하였다. 그리고 치조열 결손의 순측면까지 완전히 피복하기 위한 목적으로 양측성 치조열에 적용되도록 재단된 Y-형의 변형은 결과가 믿을 만하였으며 합병증도 무시할 만 하였다.

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A case of severe mandibular retrognathism with bilateral condylar deformities treated with Le Fort I osteotomy and two advancement genioplasty procedures

  • Nakamura, Masahiro;Yanagita, Takeshi;Matsumura, Tatsushi;Yamashiro, Takashi;Iida, Seiji;Kamioka, Hiroshi
    • 대한치과교정학회지
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    • 제46권6호
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    • pp.395-408
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    • 2016
  • We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

Silicone Implant-Based Paranasal Augmentation for Mild Midface Concavity

  • Kim, Joo Hyun;Jung, Min Su;Lee, Byeong Ho;Jeong, Hii Sun;Suh, In Suck;Ahn, Duk Kyun
    • 대한두개안면성형외과학회지
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    • 제17권1호
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    • pp.20-24
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    • 2016
  • Background: Midface concavity is a relatively common facial feature in East Asian populations. Paranasal augmentation is becoming an increasingly popular procedure for patients with mild concavity and normal occlusion. In this study, we evaluate clinical outcomes following a series of paranasal augmentation. Methods: A retrospective review was performed for patients with Class I occlusion who had undergone bilateral paranasal augmentation using custom-made silicone implants, between October 2005 and September 2013. Patient charts were reviewed for demographic information, concomitant operations, and postoperative complications. Preoperative and postoperative (1-month) photographs were used to evaluate operative outcome. Results: The review identified a total of 93 patients meeting study criteria. Overall, aesthetic outcomes were satisfactory. Five-millimeter thick silicone implant was used in 81 cases, and the mean augmentation was 4.26 mm for this thickness. Among the 93 patients, 2 patients required immediate implant removal due to discomfort. An additional 3 patients experienced implant migration without any extrusion. Nine patients complained of transient paresthesia, which had resolved by 2 weeks. There were no cases of hematoma or infection. All patients reported improvement in their lateral profile and were pleased at follow-up. Complications that arose postoperatively included 9 cases of numbness in the upper lip and 3 cases of implant migration. All cases yielded satisfactory results without persisting complications. Sensations were fully restored postoperatively after 1 to 2 weeks. Conclusion: Paranasal augmentation with custom-made silicone implants is a simple, safe, and inexpensive method that can readily improve the lateral profile of a patient with normal occlusion. When combined with other aesthetic procedures, paranasal augmentation can synergistically improve outcome and lead to greater patient satisfaction.

Treacher Collins 증후군 환아에서 급성 기도 폐색 (ACUTE AIRWAY OBSTRUCTION IN AN INFANT WITH TREACHER COLLINS SYNDROME: REPORT OF A CASE)

  • 유선열;서일영;황웅;김선국
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권5호
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    • pp.422-427
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    • 2004
  • 안검열의 외하방 편위, 관골 형성부전, 하악골 형성부전, 하악 후퇴증, 소이증, 설하수, 구개열 등의 소견으로 간헐적인 청색증, 흉곽 함몰, 급성 기도 폐색에 의한 호흡곤란과 연하곤란 등의 임상 소견을 나타낸 Treacher Collins 증후군을 가진 환아에서 출생직후에 구강저골막하박리술과 설구순접합술을 이용한 외과적 치료를 시행한 결과 급성 기도 폐색에 의한 호흡곤란과 수유장애의 해소 뿐만 아니라 혀의 전방 재위치 등 만족할 만한 결과를 얻을 수 있었다. 향후 성장이 완료될 때까지 주기적 경과 관찰을 시행할 예정이며, 성장과정 중에 발생할 두개안면기형에 대해서는 정신사회학적 측면을 고려하여 가능한 한 조기에 교정해주고, 어느 일부분에 국한된 수술보다는 안면윤곽을 고려하여 복합적인 수술을 시행해야 할 것으로 사료된다.

Oculodentodigital syndrome의 1 증례 (OCULODENTODIGITAL SYNDROME : A CASE REPORT)

  • 강호승;정태성;김신
    • 대한소아치과학회지
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    • 제26권3호
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    • pp.492-498
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    • 1999
  • Oculodentodigital syndrome은 Lohmann에 의해 최초로 보고된 후, 눈과 코, 치아와 골격의 이상을 포함하는 'dysplasia oculo-dento-digitalis'라는 용어로 1957년 Meyer-Schwickerath 등에 의해 명명된 다소 희귀한 유전성 질환이다. 이 질환은 대부분 상염색체 우성이며, 많은 증례에서 다양한 변이를 보인다. 임상적인 양상으로서, (1) 독특한 안모형태, (2) 소안구증, (3) 합지증과 수지절의 굴절, (4) 법랑질 형성부전, (5) 가늘고 광택없는 모발 등으로 특징지을 수 있다. 본 증례는 지능은 정상이나 행동조절이 어려우며 교합면의 과도한 마모, 치아우식을 주소로 부산대학교병원 소아치과에 의뢰된 환자로 합지증에 대한 수술기왕력을 가지고 있었으며, 상기의 임상적 특징을 모두 보이고 있다. 이에 치과적 치료로써 법랑질 형성부전치아에 대한 수복치료와 초진시부터 전 치아에 걸쳐 주기적인 불소도포를 실시하였고, 차후 전치부의 심미수복을 계획하고 있다.

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Treacher Collins 증후군 환아의 증례보고 (TREACHER COLLINS SYNDROME : A CASE REPORT)

  • 박지현;김승혜;송제선;김성오;이제호
    • 대한소아치과학회지
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    • 제37권3호
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    • pp.374-380
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    • 2010
  • Treacher Collins 증후군(TCS)은 25,000명에서 50,000명당 1명의 빈도로 비교적 드물게 발생하는 난치성 질환이다. 이질환은 정상적인 부모에게서 돌연변이로 발생하거나 상염색체 우성으로 유전된다고 알려져 있다. 하악과 상악, 협골의 발육부전, 부정교합, 양측성 이개 기형, 안검렬의 반몽고증 사면(antimongoloid slant)이 특징적이며, 종종 구순열, 구개열, 외이도 폐쇄, 중이와 내이의 기형에 의한 청각소실, 왜소증, 심장과 골격의 이상 등을 동반한다. 또한, 인두의 형성부전, 소구, 거설증, 악골의 기형에 기인하여 수면 중 무호흡증, 만성 폐쇄성 무호흡증 등의 호흡 장애가 있을 수 있으며, 전신마취 유도 시에 기관내 삽관이 어렵다고 보고된 바 있다. 치과의사는 관련 신드롬에 대한 충분한 이해를 통해 환자에게 보다 안전하게 치료를 제공해야 하며 구강 건강 관리 및 선천성 안면 기형에 대한 문제 해결을 돕기 위해 적절한 치료 및 안면 수술에 관련된 가이드를 제시해야 한다. 본 증례는 전반적인 치아우식을 주소로 연세대학교 치과병원 소아치과에 내원하여 외래에서 치아우식 치료를 받은 TCS 환아에 대한 것으로, 문헌 고찰을 통해 얻은 다소의 지견을 함께 보고하는 바이다.