• Title/Summary/Keyword: craniofacial cleft

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Tessier No. 2 Oblique Facial Cleft Not Associated with Cleft Lip or Palate: a Case Report (구순구개열과 관련되지 않은 Tessier 분류 2 안면열의 교정: 증례보고)

  • Park, Yong-Tae;Kye, Jun-Young;Kim, Seong-Gon;Kwon, Kwang-Jun;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.600-603
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    • 2010
  • Oblique facial cleft is extremely rare. The frequency was reported 1/1300 cases of facial cleft. The cleft appears to be bilateral in approximately 20% and more often on the right when unilateral. Oblique facial cleft is nearly always associated with cleft lip and palate. Thus, the case that is unilateral on the left and not associated with cleft lip or palate is very rare. We experienced a case of 2 years 6 months old Philippine girl who had oblique facial cleft that is not associated with cleft lip or palate. The probable cause and treatment is discussed with a review of literatures.

Genetic Analysis of TGFA, MTHFR, and IFR6 in Korean Patients Affected by Nonsyndromic Cleft Lip with or without Cleft Palate (CL/P)

  • Park, Jung-Young;Yoo, Han-Wook;Kim, Young-Ho
    • Genomics & Informatics
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    • v.5 no.2
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    • pp.56-60
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    • 2007
  • Nonsyndromic cleft lip with or without cleft palate (CL/P) is a common craniofacial birth defect that is the result of a mixture of genetic and environmental factors. While studies have identified a number of different candidate genes and loci for the etiology of CL/P, the results have not been consistent among different ethnic groups. To study the genetic association of the candidate genes in Korean patients affected by CL/P, we genotyped 97 nonsyndromic CL/P patients and 100 control individuals using single nucleotide polymorphic markers at the MTHFR, TGFA, and IRF6 genes. We report that the T3827C marker at TGFA showed significant association with nonsyndromic CL/P, but all the other markers tested were not significantly associated with nonsyndromic CL/P in Korean patients.

Biocreative Alveolar Molding Plate Treatment (BioAMP) for neonatal unilateral cleft lip and palate with excessively wide alveolar cleft and maxillary arch width

  • HyeRan Choo;HyoWon Ahn
    • The korean journal of orthodontics
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    • v.54 no.1
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    • pp.69-73
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    • 2024
  • Since its inception in Europe in the 1950s, alveolar molding treatment for neonates with complete cleft lip and palate has undergone significant evolution in both design and application methodology, demonstrating effectiveness in normalizing the alveolar cleft and nasal shape. However, excessively wide alveolar clefts accompanied by disproportionately wide total maxillary arch pose significant challenges when utilizing conventional alveolar molding methods involving cyclical adding and grinding of acrylic on molding plates. The current report introduces a novel alveolar molding method named Biocreative Alveolar Molding Plate Treatment (BioAMP), which can normalize the maxillary alveolar cleft and arch shape without laborious conventional acrylic procedures. BioAMP sets the target arch form and provides unrestricted space for natural growth of the maxillary alveolar bones while systematically reducing the total maxillary arch width in precise increments. Two exemplary cases are presented as proof-of-concept, showcasing the clinical innovation of BioAMP.

Modified Abbé flap for reconstruction of Cupid's bow and vermilion tubercle in secondary cleft lip deformity

  • Lee, Jun Won;Lee, Seong Joo;Suh, In Suck;Lee, Chong Kun
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.13-19
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    • 2018
  • Background: $Abb{\acute{e}}$ flap technique is one of the most challenging operations to correct horizontal deficiencies in secondary cleft lip deformity. Since its first introduction, the operative method was dynamically modified from simple variation to complete conceptual change, but conventional $Abb{\acute{e}}$ flap has many drawbacks in esthetic and functional aspect. Our purpose was reconstructing the symmetry of Cupid's bow and central vermilion tubercle with minimal sequalae. Methods: From 2008 to 2016, this technique was applied to 16 secondary cleft lip patients who had total or more than 60% of unilateral deficiency of Cupid's bow and central lip or tubercle pouting deficiency. A quadrangular-shaped flap was transferred from vermilion including skin and white line of central or contralateral lower lip. Pedicle division and insetting were made at 9 (unilateral) or 10 (bilateral) days after transfer. Secondary lip revision was done with open rhinoplasty after wound maturation. Results: Overall satisfaction was high with modified technique. Scar was minimally noticeable on both upper and lower lip especially. Balanced Cupid's bow and symmetric vermilion tubercle were made with relatively small size of flap compared to conventional $Abb{\acute{e}}$ flap. An accompanying benefit was reduced ectropion of lower lip, which made balanced upper and lower lip protrusion with more favorable profile. Conclusion: A new modified $Abb{\acute{e}}$ flap technique showed great satisfaction. It is worth considering in secondary cleft lip patient who has central lip shortage and asymmetry of upper lip vermilion border line. Our technique is one of the substitutes for correction of horizontal and central lip deficiency with asymmetric Cupid's bow.

Surgical Treatment of the Unilateral and Bilateral Cleft Lip Patients Using Mulliken Method: 10 Year Results (뮬리켄법을 이용한 일측성 및 양측성 구순열 환자의 수술: 10년 후의 결과)

  • Kim, Seok-Kwun;Kim, Tae-Heon;Park, Su-Sung;Lee, Keun-Cheol
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.11-21
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    • 2012
  • Purpose: Mulliken's method allows for normal nasal and lip growth, which in turn forms a natural shape of the philtrum. Therefore, we used a modified Mulliken's method to correct unilateral and bilateral cleft lip nasal deformities and followed the patients for 10 years. Methods: Ninety-one patients, who had undergone repair of unilateral and bilateral cleft lip and nasal deformity simultaneously using Mulliken's method during the time period from June 1997 to June 2009, were enrolled into this study. To follow-up of the growth of the lips and nose after the operation, the following 5 anthropometric measurements were analyzed: nasal tip protrusion, columellar length, upper lip height, cutaneous lip height, and vermilion mucosa height. Results: Using this method, we obtained a result that there was no significant difference in the development of the lip compared to the normal control group, and that the bilateral cleft lip patients' nasal projection and columellar length was shorter than that in normal persons. Both measures were statistically significant. Conclusion: Mulliken's method is a superb surgical technique, which enables the normal development of the nose and lip, which further allows for the innate philtrum appearance. The author's result does not seem to be meaningful, because the normal rate of nasal growth is slow before adolescence; however, we recommend additional follow-up and accordant treatment, if needed, once the nasal growth is complete.

A STUDY OF THE FACIAL CLEFT AND CASE REPORT OF FACIAL CLEFT PATIENT (안면열에 대한 고찰 및 안면열 환자의 교정 치험예)

  • Lim, Yong-Kyu;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.20 no.3 s.32
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    • pp.593-608
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    • 1990
  • Facial cleft is not a common anomaly of craniofacial region. But it is often accompanied with cleft lip and/or palate, so it seems important to orthodontist. Facial cleft is defined as a fissure or elongated opening of the facial region, and it's etiology is the failure of the fusion of the parts which will form the face in embryonic developmental period. Facial cleft can be classified according to the time of occurrence and the area involved during developmental period. It developes 1-2.5 weeks earlier than cleft lip and/or cleft palate. In facial cleft, the deformity is generally confined to the facial region, but sometimes deformity of other body region can accompany. The interaction of the facial cleft and the genetic anomaly is not confirmed, but genetic anomaly is known to be able to occur with the patient with other anomaly of body. As an orthodontist we should know the general considerations of facial cleft and it's treatment procedures other than orthodontic treatment.

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Assessment of the correlation between various risk factors and orofacial cleft disorder spectrum: a retrospective case-control study

  • Cheshmi, Behzad;Jafari, Zahra;Naseri, Mohammad Ali;Davari, Heidar Ali
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.26.1-26.6
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    • 2020
  • Background: Orofacial clefts (OFCs) comprise a wide range of malformations, including cleft lip, cleft palate, and cleft lip with cleft palate, which can vary in terms of etiology, severity, and disease burden. Objective(s): This study aimed to evaluate the correlation between various risk factors and orofacial cleft disorder spectrum in newborns. Study design: A total of 323 cases and 400 controls were enrolled in this study and evaluated in terms of the maternal history of abortion or miscarriage, child's sex, maternal and paternal age, maternal history of systemic disease, history of medication therapy during pregnancy, birth order, consanguineous marriage, and complications during pregnancy. Results: Analysis of the results suggested that consanguineous marriage, a maternal history of abortion/miscarriage, and complications during pregnancy could potentially increase the risk of OFCs in children (P < 0.05). However, the analyses revealed that the other variables could not potentially increase the risk of OFCs (P > 0.05). Conclusion(s): Multiple cofactors may simultaneously contribute to the formation of such abnormalities; therefore, a comprehensive, multidisciplinary care program is necessary to ensure a successful pregnancy period and the birth of a healthy newborn.

Treatment of multiple craniofacial osteomas by endoscopic approach

  • Yoo, Hyokyung;Doh, Gyeonghyeon;Kim, Baek Kyu
    • Archives of Craniofacial Surgery
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    • v.21 no.4
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    • pp.261-263
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    • 2020
  • Osteomas are benign osteogenic neoplasms that usually occur as solitary craniofacial lesions. Multiple osteomas are rare, particularly those that do not occur as part of an associated syndrome. We report a case of a 72-year-old woman who presented with multiple bony protrusions over the forehead and scalp. She denied any diagnosis of syndromes that are known to be associated with osteomas. Surgical excision was performed by endoscopically resecting more than 30 osteomas of the frontal and bilateral parietal bones. Compared with conventional surgical excision through a direct incision, endoscopic-assisted surgery is a simple and effective method for the treatment of multiple craniofacial osteomas and is associated with excellent cosmetic outcomes and no neurovascular complications.

Potential role of artificial intelligence in craniofacial surgery

  • Ryu, Jeong Yeop;Chung, Ho Yun;Choi, Kang Young
    • Archives of Craniofacial Surgery
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    • v.22 no.5
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    • pp.223-231
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    • 2021
  • The field of artificial intelligence (AI) is rapidly advancing, and AI models are increasingly applied in the medical field, especially in medical imaging, pathology, natural language processing, and biosignal analysis. On the basis of these advances, telemedicine, which allows people to receive medical services outside of hospitals or clinics, is also developing in many countries. The mechanisms of deep learning used in medical AI include convolutional neural networks, residual neural networks, and generative adversarial networks. Herein, we investigate the possibility of using these AI methods in the field of craniofacial surgery, with potential applications including craniofacial trauma, congenital anomalies, and cosmetic surgery.

Current concepts of craniofacial fibrous dysplasia: pathophysiology and treatment

  • Dong Yeon Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.2
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    • pp.41-51
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    • 2023
  • Fibrous dysplasia is an uncommon genetic disorder in which bone is replaced by immature bone and fibrous tissue, manifesting as slow-growing lesions. Sporadic post-zygotic activating mutations in GNAS gene result in dysregulated GαS-protein signaling and elevation of cyclic adenosine monophosphate in affected tissues. This condition has a broad clinical spectrum, ranging from insignificant solitary lesions to severe disease. The craniofacial area is the most common site of fibrous dysplasia, and nine out of 10 patients with fibrous dysplasia affecting the craniofacial bones present before the age of 5. Surgery is the mainstay of treatment, but the technique varies according to the location and severity of the lesion and associated symptoms. The timing and indications of surgery should be carefully chosen with multidisciplinary consultations and a patient-specific approach.