• Archives of Plastic Surgery
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• 제44권3호
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• pp.210-216
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• 2017

Background In treating minor-form or microform cleft lip, obtaining an optimal result is a challenge because of the visible scarring caused by traditional surgery. We present a refined method using muscle overlapping with a minimal skin incision in patients younger than 3 years, a group characterized by thin muscle. Methods The surgical technique involves restoration of the notched vermillion using Z-plasty, formation of the philtral column using overlapping of an orbicularis oris muscle flap through an intraoral incision, and correction of the cleft lip nasal deformity using a reverse-U incision and V-Y plasty. A single radiologist evaluated ultrasonographic images of the upper lip. Results Sixty patients were treated between September 2008 and June 2014. The age at the time of operation ranged from 6 to 36 months (mean, 26 months). The follow-up period ranged from 8 to 38 months (mean, 20 months) in minor-form cases and from 14 to 64 months (mean, 37 months) in microform cases. A notched cupid's bow was corrected in 10 minor-form cases and 50 microform cases. Ultrasonographic images were obtained from 3 patients with minor-form cleft lip and 9 patients with microform cleft lip 12 months after surgery. The average muscle thickness was 4.5 mm on the affected side and 4.1 mm on the unaffected side. Conclusions The advantages of the proposed procedure include the creation of an anatomically natural philtrum with minimal scarring. This method also preserves the continuity and function of the muscle and provides sufficient augmentation of the philtral column and nostril sill.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.406-415
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• 2010

Purpose: The secondary correction of cleft lip nasal deformity still presents a difficult surgical problems. The present study was aimed to investigate the usefulness of Bardach's technique for secondary correction of cleft lip nasal deformity. Materials and Methods: The subjects were eight patients with unilateral and bilateral cleft lip nasal deformity, who had secondary correction by using Bardach's rhinoplasty technique. Age range was from 2 to 21 years and mean age was 10.6 years. There were 3 boys and 5 girls. Six patients had bilateral and two patients had unilateral cleft lip. Facial photographs were taken before and twenty days after the operation. By using Adobe photoshop, the columella height and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. Results: The degree of improvement of the columella length and the nostril width after Bardach's technique was $70.39{\pm}50.14%$ and $-22.93{\pm}0.15%$ respectively. Bardach's technique resulted in projecting the nasal tip, lengthening the columella, medially advancing the alar bases, restructuring the lower lateral cartilages, and changing orientation of the nostrils from horizontal to oblique. The profile view shows projection of the nasal tip, lengthening of the columella, and the change in the nasolabial angle. The scars remained at the philtrum were matter little in compared with improvement of the nasal appearance. Conclusion: These results indicate that Bardach's technique is an useful surgical technique for secondary correction of cleft lip nasal deformity.

• 대한소아치과학회지
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• 제37권4호
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• pp.545-550
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• 2010

Freeman-Sheldon Syndrome(FSS)은 드물게 발생하는 선천성 유전 질환으로 휘파람을 부는 듯한 특징적인 안모로 인해 'Whistling face syndrome'으로 불리워진다. 또한 편평한 안모, 긴 인중(philtrum), 낮은 비연골이 나타나 두드러진 안면이상을 보이고, 내반족(club foot, 內反足), 손가락의 관절구축(joint contracture)으로 인한 풍차 모양의 손을 가지며, 지능은 보통 정상이다. 본원에 내원한 환아는 이 질환의 특징적 양상인 구강 주위 근육의 수축으로 소구증 및 개구제한, 높은 구개 및 부정교합, 치열의 심한 총생을 보여 구강위생이 매우 불량하였고 치과치료에 비협조적이었다. 소아치과적 행동조절 및 구강위생관리, 섭식장애의 상담으로 치과적 문제는 다소 개선되었으나, 안과 및 정형외과, 신경정신과, 교정과, 마취과적 문제로 인해 다양한 협진이 필요하며 계속적인 관찰 및 치료가 요구되기에 이를 보고하는 바이다.

• 대한구순구개열학회지
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• 제10권2호
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• pp.67-74
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• 2007

After Tennison introduced a triangular flap method which, for the first time, preserved the Cupid's bow, Randall gave this method a sound mathematical basis. This method is also called as an inferior triangular cheiloplasty which is characterized by making a small triangular flap from the lateral border of cleft destined to be fitted into an incision on the medial side of cleft. He postulated that the height obtained was equal to the sum of the median of the two triangles used in the cheiloplasty. Using this technique, a 22 month-old male patient with incomplete unilateral cleft lip was corrected primarily. The deviation of the columella and flattening of the nostril on the cleft side were minimal. The operation was done under general anesthesia and patient was healed uneventfully. We tried to improve the symmetry and esthetic feature of philtrum, nostril sill, alar-facial groove, preventing the notch formation on the nostril floor, and to reconstruct the muscle sling in the upper part of lip. The shape of Cupid's bow was restored, and the symmetry of columella was regained as a result. In summary, the inferior triangular cheiloplasty is effective to correct the primary unilateral cleft lip, results in the restoration of favorable anatomy and function.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.574-580
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• 2008

Purpose: Philtral deformity is a stigma of secondary cleft lip nose. It occurs from the false arrangement of orbicularis oris muscle and the scar of previous operation. Various methods have been used to correct this deformity. We successfully corrected philtral deformity using overlapping of orbicularis oris muscle flap. Methods: From November 2000 to August 2007, we performed 39 cases of correction of philtral deformity in secondary cleft lip nose with overlapping of orbicularis oris muscle flap. Their age ranged from 5 to 53 years old. Existing scar tissue of previous operation was deepithelialized and preserved as scar flap. Lateral orbicularis oris muscle flap was elevated, advanced and overlapped upon medial muscle flap after dissection of orbicularis oris muscle of both sides. Reconstruction of philtral column was made from overlapping area by fixation of end part of lateral muscle flap to the point between philtral dimple and column. The degree of muscle flap advancement was decided by correction state of lateral muscle bulging. Correction of nostril floor depression or whistle deformity was also performed with preserved scar flap, if necessary. Results: Realignments of orbicularis oris muscle were possible in the majority of the patients and final results of philtral reconstruction were satisfactory mostly. Correction of nostril floor depression and whistle deformity was also achieved. Additional correction was performed later to 4 patients in whom insufficient reconstruction was noted. No significant complication was observed. Conclusion: More natural and symmetric philtrum was acquired with overlapping of orbicularis oris muscle flap. To the authors' knowledge, it is an easy and effective method for correction of philtral deformity through anatomical rearrangement of distorted orbicularis oris muscle with relatively simple procedure.

• 사상체질의학회지
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• 제22권2호
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• pp.37-47
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• 2010

1. Objectives: We aimed to derive constitutional facial characteristics with front and side picture of the people in this study 2. Methods: Through November 2007 to July 2009, we obtained front and side face photograph data of 715 male/female constitution confirmed subjects within the age range of 10-80 from 19 oriental medical facilities in the country. According to sex, we divided the subjects into two groups, real constitution group and non-constitution group. We analyzed significant variables of distance, angle and ratio of facial point through unpaired T-test. 3. Results: There are different significant variables according to Sasang Constitution and even though they are much different between sex, the interpretation of the meaning of those variables are similar with the written characteristics of ancient Writing. The face size of the Taeeumin is bigger than that of the non-Taeeumin, and especially they have long length from mouth to mandible angle. Soeumin have small jaw area, long philtrum and narrow facial feature like egg. Soyangin has developed forehead and glabella, short jaw, long eye side. Taeyangin has developed forehead, weak nose especially side end of nose, long eye side. 4. Conclusions: Sasang Constitutional facial characteristics are different between man and woman but there are much similarity with the facts as known on the interpretation of significant variables characteristics.

• 복식문화연구
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• 제12권6호
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• pp.933-944
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• 2004

This study was aimed to provide the fundamental and various measurement data of the head and face for male children. Two hundred forty one male children, aged nine to twelve years, participated for this study. The 31 regions on the head and face of the subjects were directly measured by the expert experimenters. Through factor analysis, the six factors were extracted upon factor scores and those factors comprised $67.47\%$ for the total variances. The first factor was described the general height elements for the mouth and the environs of the mouth. The second factor was described the general height around the nose, forehead and eyes. The third factor was described the height of the ear environs. The forth factor contained the length around the sinciput to the occiput, the head thick and the head circumstance. The fifth factor was described the general width of the outer head and the corner of the eyes. The last factor contained the depth of the mouth and nose. Four clusters as their head and face shape were categorized using six factor scores by cluster analysis. Type 1 was characterized by the shortest head and face width, surface length and girth, and the shorter length of head, but the highest position of chin, philtrum, upper lip. Type 2 was characterized by the shortest head and face length and thickness, and the lowest position of the forehead, eye, nose, mouth, ear environs, but that had wider width of head and face. Type 3 was characterized by the longest and the widest head and face type, and the highest position of the mouth. Type 4 was characterized by longer length of head and face, and the widest head girth and largest head thickness, and the highest position of the forehead, eye, nose environs. And this type had the widest width of nose and mouth, and the longest head surface length.

• 대한치과보철학회지
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• 제58권4호
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• pp.363-368
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• 2020

적절하지 않은 위치에 식립된 임플란트의 보철물은 심미적, 기능적 문제를 나타낼 수 있으나 이를 해결하기는 어려운 때가 많다. 이러한 경우에 재식립 혹은 연조직 및 경조직 이식을 포함하는 외과적 방법을 고려해 볼 수 있지만 결과 예측이 힘들며 긴 치유 기간 및 술 후 불편감과 추가적인 수술 비용이 동반된다. 반면, 보철적 방법으로는 치은 색상의 세라믹이 포함된 고정성 보철물을 제작하거나 가철성 보철물인 gingival mask 제작 등을 생각해볼 수있다. 본 증례에서는 80세의 남환이 과도하게 구개측으로 식립된 임플란트로 인한 상순과 보철물 사이의 음식물 저류에 대한 불편감 및 심미적인 부분에 대한 불만족을 주소로 내원하였고, gingival mask를 제작하여 단 기간 내에 만족스러운 결과를 얻었기에 이를 보고하고자 한다.

• 대한소아치과학회지
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• 제23권3호
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• pp.601-608
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• 1996

저자는 전반적인 치아우식증을 주소로 개인 의원에서 경희대학교병원 소아치과에 의뢰된 10세 여아에서 Robinow syndrome 의 드문 증례의 치료를 시행하고 문헌을 고찰하여 다 음과 같은 결론을 얻었다. 1. 전신소견으로 전두부 돌출, 양안격리, 넓은 안검렬, 들창코 등을 보이는 태아모습의 특정적 안모와 작은키, 짧은 팔, 굽은 손가락, 생식기의 미발육 등이 관찰되었고 전반적인 발육지연이 있었다. 2. 구내소견으로 치아우식, 치아총생, 구개수의 미발육, 수술받은 구개열, 구호흡이 관찰되었다. 3. 이 증후군에서 드물게 보여지는 정신지체, 청각장애, 삼출성 중이염을 동반하였다. 4. 가족력은 발견할수 없었다. 5. 전신마취하에 전반척인 치과치료와 이비인후과치료를 함께 시행하였다. 6. Robinow 증후군은 여러 합병증을 수반할 수 있으므로 타과와의 협력하에 전반적인 검사를 시행하고 포괄적인 협력진료가 요구된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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• pp.401-406
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• 1999

편측성 혹은 양측성 구순구개열환자에서 일차 구순 성형술후 나타나는 이차 구순 기형은 세심한 관찰을 통한 문제점에 대한 정확한 인식을 통해 상순, 홍순부, 피부와 근육등의 적절한 교정술로 심미성, 기능적 회복을 이룰 수 있다. 저자들은 이차 구순 기형으로 나타난 구륜근의 부정유합, 휘파람 변형과 부족한 입술등에 대해 적절한 성형술로 심미적, 기능적으로 양호한 결과를 얻었기에 보고하는 바이다.