• Title/Summary/Keyword: cleft lip and cleft palate

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Congenital unilateral hypoplasia of depressor anguli oris muscle in adult

  • Oh, Suk Joon
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.265-269
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    • 2019
  • Congenital hypoplasia of the depressor anguli oris muscle is a rare cause of asymmetrical crying facies in newborns. The clinical manifestations range from mild to severe asymmetry and may persist up to adulthood. In the current case, the patient did not exhibit other congenital anomalies or paralysis of other branches of the facial nerve. This adult patient presented with severe asymmetrical lower lip deformity during full mouth opening since birth. A chromosomal study for the detection of 22q gene deletion yielded negative results. The electromyography findings of the lower lip were insignificant. Depressor labii inferioris muscle resection was not effective, but bidirectional (horizontal and vertical) fascia lata grafting improved the aesthetic appearance of the asymmetrical lower lip. The patient showed improved lower lip symmetry during full mouth opening at 1 year after the surgery. Therefore, the details of this rare case are reported herein.

FACIAL ASYMMETRY OF UNILATERAL CLEFT LIP AND PALATE PATIENTS (편측성 순구개열자의 안면비대칭에 관한 연구)

  • Son, Woo-Sung;Kim, Mi-Kyung
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.13-18
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    • 1995
  • Craniofacial asymmetry was analyzed in 39 patients with complete unilateral cleft lip and palate(UCLP). The samples are devided into three groups nine below 9 years, twenty three from 9 years 1 month to 14 years and seven over 14 years group. Seventeen measurements were obtained from the tracing of PA X-ray cephalometric headfilms to evaluate the asymmetric characteristics and changes accdording to aging in UCLP. The obtained results were as follows. 1. Facial asymmetry in UCLP is variable(1.22-3.47 $mm/^{\circ}$) and the length from midsagitta1 reference line to maxillary 1st molar, to upper central incisor and the length of mandibular ramus showed significant asymmetry 2. Nasal septum and anterior nasal spine were deviated In the cleft side and the lower border of nasal cavity was 1ower in cleft side. 3. The deviation of nasal septum was continued significantly till after 14 years old.

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TREATMENT OF THE CHILD WITH ROBINOW SYNDROME UNDER GENERAL ANESTHESIA : A CASE REPORT (Robinow 증후군 환아의 전신마취를 이용한 치료증례보고)

  • Park, Jae-Hong;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.601-608
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    • 1996
  • Robinow syndrome or fetal face syndrome is a rare inherited disorder characterized by short stature, mesomelic brachymelia, hypoplastic genitalia, and a typical facial appearence ("fetal face") with frontal bossing, hypertelorism, ear abnormalities, a short upturned nose, long philtrum, micrognathia, and macrocephaly. Intraoral features have included quite a few dental cavities, crowding, hypoplastic uvula, cleft lip or/and cleft palate, gingival hyperplasia, alveolar hyperplasia, enamel hypoplasia, delayed eruption, and congenital missing of the permanent teeth. We report on a 10 years old girl with Robinow syndrome. The patient had most of the typical anomalies of the syndrome and negative family history but, in addition, had mental retardation, hearing loss, and serous otitis media. Intraoral findings included dental cavities, crowding, hypoplastic uvula, repaired cleft palate, and mouth breathing. Dental treatment and V-tube insertion(by dept. of ENT) were performed under general anesthesia. In all cases of Robinow syndrome, thorough evaluation and united treatments with medical specialists should be performed.

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MANDIBULAR DISTRACTION OSTEOGENESIS IN AN INFANT WITH PIERRE ROBIN SEQUENCE: REPORT OF A CASE (Pierre Robin sequence 환아에서 하악골신장술)

  • Ryu, Sun-Youl;Kwon, Jun-Kyong;Kim, Sun-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.460-467
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    • 2008
  • Pierre Robin sequence as a symptom triad of micrognathia, glossoptosis, and cleft palate results in upper airway obstruction and feeding problems. If mild, it is often managed in the prone position. When positional treatment fails, however, surgical intervention such as tongue-lip adhesion, tracheostomy, and mandibular distraction osteogenesis is mandatory to relieve airway obstruction. There has been growing interest in the application of distraction osteogenesis for the management of craniofacial abnormalities. The mandibular distraction osteogenesis to newborns may prevent the airway obstruction, decrease the potential tracheostomy, and reduce the likehood of orthognathic surgery after growth. We experienced an infant with Pierre Robin sequence who showed mandibular hypoplasia, glossoptosis, incomplete cleft palate, intermittent cyanos is, depression of the chest, and respiratory difficulty associated with airway obstruction. We treated the airway obstruction by tongue-lip adhesion at 2 weeks of age, and treated the mandibular retrognathism and depression of the chest byusing internal mandibular distraction osteogenesis at 7 month of age. The mandible moved forwardly, the upper airway space was enlarged, and the antero-posterior distance of the mandible was elongated after the mandibular distraction. Mandibular distraction osteogenesis may be a promising technique to avoid the need of tracheostomy and orthognathic surgery, and to correct airway obstruction in infants with congenital craniofacial malformation.

Polymorphisms of TERT and CLPTM1L and the Risk of Hepatocellular Carcinoma in Chinese Males

  • Su, Ling-Yan;Li, Xue-Lian;Shen, Li;Zhang, Yue;Zhao, Meng-Meng;Yin, Zhi-Hua;Su, Hong-Ying;Zhou, Bao-Sen
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8197-8201
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    • 2014
  • Background: Telomerase reverse transcriptase (TERT) and cleft lip and palate trans-membrane 1 like (CLPTM1L) genes located on chromosome 5p15.33 are known to influence the susceptibility to various cancers. Here, we examined the association of TERT and CLPTM1L single nucleotide polymorphisms (SNPs) with hepatocellular carcinoma (HCC). Materials and Methods: Genotyping of TERT SNP rs2736098 and CLPTM1L SNP rs401681 was performed using TaqMan allelic discrimination assays in a case-control study of 201 HCC cases and 210 controls in a Chinese male population. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression analyses. Results: Both the rs2736098 T allele of TERT and the rs401681 T allele of CLPTM1L were associated with a significantly increased risk of HCC (adjusted odds ratio [OR]=1.605, 95% confidence interval [CI]=1.164-2.213; adjusted OR=1.399, 95%CI=1.002-1.955, respectively). Individuals carrying both TERT and CLPTM1L risk genotypes had an even higher risk of HCC (adjusted OR=4.420, 95%CI= 2.319-8.425). The TERT rs2736098 T allele was also significantly associated with the level of the HCC clinical indicator alpha-fetoprotein (P=0.026). Conclusions: Our results show that genetic variants of TERT and CLPTM1L may contribute to HCC susceptibility in Chinese males.

Effect of speech therapy of patient with Velopharyngeal incompetence using CPAP (CPAP를 활용한 비인강폐쇄부전 환자의 언어치료 효과)

  • Oh Yoo-Kyung;Lee Yong-keun;Park Rae-Yon;Kim In-Soo;Shin Hyo-Keun;Kim Hyun-Gi
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.1
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    • pp.39-44
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    • 2005
  • Velopharyngeal incompetence(VPI) is that soft palate and muscle of posterolateral pharyngeal wall can not close velopharyngeal port properly. Thing that prior to treatment for patient with VPI is to evaluation about nasopharyngeal closing function. This data is important for making a treatment plan and assesment of treatment effect to improve nasopharyngeal closing function. There are two ways of VPI assessment. The one is subjective method by auditory finding, the other is objective method by using equipment for language test. Using only subjective way is not adequate for evaluation of VPI because of low trust, so doing both two methods simultaneously help to make a diagnosis and assessment exactly. CPAP is effective method to treat hypernasality. This new treatment technique intensify oropharyngeal muscle for nasopharyngeal closing by direct resistance training. Becase conventional treatments have limitation, so many research about treatment effectiveness of CPAP are being studied. This study aims that we compare our result from Korean VPI patients with result about treatment effect in other advanced country, to make CPAP Treatment Questionares and to find ways that improve oropharyngeal closing function an[1 maximally increase language treatment effect.

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Reconstruction of a large lower lip defect using a combination of Abbe and staircase flaps: a case report

  • Moon, Bo Min;Pae, Woo Sik
    • Archives of Craniofacial Surgery
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    • v.22 no.6
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    • pp.324-328
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    • 2021
  • Lip defects often occur following wide excision as a surgical treatment for squamous cell carcinoma of the oral cavity. Defects larger than one-half of the lip cannot be closed primarily and require flap surgery. Reconstruction of the oral sphincter function can be achieved by means of a local flap using the like tissue, rather than with a free flap utilizing different tissues. A defect of the lower lip requires reconstruction using different techniques, depending on its size and location. Herein, we present the case of a patient exhibiting a lip defect spanning more than two-thirds of the lower lip, after a wide resection due to squamous cell carcinoma. The defect was reconstructed using an Abbe flap and a staircase flap. Revision was performed after 16 days. The patient's oral competencies were fully restored 3 months postoperatively, and the esthetic results were ideal. Based on our experience, a combination of the Abbe and staircase flaps can produce excellent functional and esthetic outcomes in the reconstruction of a lower lip with a large defect. It can serve as a reliable reconstruction option for defects spanning more than two-thirds of the lower lip, not including the oral commissures.

Facial artery: anatomical variations in the perioral region in cadavers

  • Vu Hoang Nguyen;Lin Cheng-Kuan;Tuan Anh Nguyen;Trang Huu Ngoc Thao Cai
    • Archives of Craniofacial Surgery
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    • v.24 no.6
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    • pp.266-272
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    • 2023
  • Background: In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. Methods: We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. Results: The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA's branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. Conclusion: Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.

Enzyme-Histochemical Study of Philtral Orbicularis Oris Muscle Fiber Types in Korean Male Cadaver (한국인 성인남성 사체에서 시행한 인중 구륜근 섬유들의 효소-조직화학적 분석)

  • Yu, Myung-Sook;Park, Jung-Min;Lee, Hee-Su;Lee, Suk-Keun;Kang, Ji-Young;Eo, Mi-Young;Lee, Jong-Ho;Kim, Soung-Min
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.2
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    • pp.47-56
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    • 2009
  • The orbicularis oris muscle (OOM) is a very important muscle that originate from the second branchial arch and is innervated by the facial nerve. The aim of this study was to elucidate distribution types of two muscle fibers that composing OOM by using enzyme-histochemical examinations and tried to make a basis for a clinical application. The fresh frozen tissues from the superior and inferior portions of the OOM were taken from post mortem 65-year-old Korean male adult. Total five different sagittal sections were used on the midline of the philtrum, the middle portion of lower lip, the mouth corner, and each midlateral side of upper and lower mouth. We used enzyme-histochemical staining such as Periodic Acid-Schiff (PAS), Succinic Dehydrogenase (SDHase), reduced Nicotinamide Adenine Dinucleotide-Tetrazolium Reductase (NADH-TR), Adenosine Triphosphatase (ATPase) in pH 9.4, 4.6 and 4.3, and Modified Gomori Trichrome. There were about 30.24 % type 1 muscle fiber and 65.40 % type 2 muscle fiber in the midline of the philtrum (p < 0.05). Enzyme-histochemical staining is very useful and innovative method to elucidate characteristics of muscle fibers. We expect that chiloplasty and reconstruction of the lip portions for cleft lip patients, based on these results, are better to recovery function and aesthetic. However, we have some problems as an intramuscular variability and the inter-individual variation etc. Therefore we have to make progress these studies continuously to overcome these problems.

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