• Child Health Nursing Research
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• v.2 no.2
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• pp.45-57
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• 1996

A serious disease in a family influences the entire family member given the fact that the members closely interact with each other. Especially in terms of pediatric nursing, study on family gains importance as the need to care of families whose children with developmental disabilities and chronic disease This study was done based on The Resiliency Model of Family Adjustment and Adaptation(McCubbin, 1991) is intended to examine the stress of parents whose children suffer from cleft lip or /and cleft palate. It also helps them to cope with the stress and analyze the relationship between the stress and coping This study used Family Inventory of Life Events and Changes (FILE) and Coping Health Inventory for Parents(CHIP) for measuring family stress and coping. The two instruments are revised to fit the social and cultural environment of Korean culture. Data collection was done from April 18, 1996 to May 18, 1996 at 8 University medical centers located in Seoul. Those who answered questionnaires were 84 parents whose children have cleft lip or /and cleft palate. SPSS PC+ was used to analyze the data collotted. Programs used for data analysis were t-test, ANOVA, Pearson correlation coefficient. The study is summarized as follows .1. The average score of family stress is 10.46(percentage of the full score 24.90) and 'finance and business strains'(3.25), and 'intrafamily strains'(2.65) ranked the highest. The average score of family's coping is 1.93, which is close to the answer of' moderately helpful' and they are measured to put their utmost efforts to' intergration and cooperation of family and optimistic definition on the situation'. 2. There is no significant statistical correlation between the family stress and coping. 3. Mothers show more stress than fathers in the parts of 'illness and family care strains' and 'losses'(t〓-2.34, t〓-2.32, p<.05). 4. Fathers show more willingness to cope with the stress than mothers do in the parts of' seeking social support','self-esteem','emotional comfort' 5. Mothers are more stress than fathers in the parts of family stress and its coping with it by usual traits(t〓-2.78, p<.05). Parents with religion are measured to cope more willingly than those who are not 6. Income of a family shows positive correlationship with family coping (r〓.28, p<.05). The study shows that gender difference is significant variable in studying on family stress and coping. Mothers get more stress than fathers, which has much to do with the fact that they are in charge of raising children and keeping houseworks. Accordingly, managing family crisis and its survival can be induced by giving support for the mothers, studying fathers including the rest of the family members and giving nursing care and arbitration ; religious background is also considered to be one of the important factors in family stress , judging from the relationship between family income and family's coping, caring given to suffering children is needed on societal levels. The above considerations bring up the need to have a longitudinal study of children with congenital anomaly including cleft lip or /and cleft palate and their families about family stress and coping. Resiliency programs on family system and their effectiveness and the relationship between the enlarged families with social and cultural values reflecting Korean tradition are also needed to be studied.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.353-360
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• 2009

The principles for repair of bilateral cleft lip and nasal deformity are 1) symmetry, 2) primary muscular continuity, 3) proper philtral size and shape, 4) formation of the median tubercle and vermilion-cutaneous ridge from lateral labial elements, and 5) primary positioning of the alar cartilages to construct the nasal tip and columella. The authors underscore the essential role of preoperative premaxillary positioning for the synchronous closure of the cleft lip and primary palate, and describe Mulliken's operative technique. We discuss three-dimensional adjustments based on predicted fourth-dimensional changes. In a consecutive series of 50 patients, no revisions were necessary for philtral size or columellar length. Preoperative premaxillary positioning and primary repair of bilateral cleft lip and nasal deformity may impair maxillary growth. Nevertheless, a symmetric nasolabial appearance, rather than emphasis on maxillary growth, is the priority for the child with bilateral cleft lip.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.513-520
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• 1995

Two thousand-two hundred-forty-three cases of various lesions of the oral and maxillofacial region in children under 16 years of age were reviewed. The lesions were classified by 10 groups; osteomyelitis, cysts, benign tumors, malignant tumors, fibro-osseous lesions, developmental disturbances, antral lesions, TMJ lesions, salivary gland lesions, and other lesions. The obtained results were as follows; 1. Developmental disturbances, especially cleft alveolus and palate, was the most common lesions (25.7％), followed by cysts (22.5％), antral lesions (12.7％), benign tumors (11.9％) and osteomyelitis (9.3％). 2. With the time, the incidence of osteomyelitis and malignant tumors has been decreased, but that of developmental disturbances, cysts and antral lesions has been increased. 3. The sex distribution was relatively equal for the entire series, with male predominence in cysts, malignant tumors, developmental disturbanes and salivary gland lesions and with female predominence in TMJ lesions. 4. Children with malignant tumors and osteomyelitis were somewhat younger and those with TMJ lesions were somewhat older. 5. Heading the list of each group except osteomyelitis was dentigerous cyst, odontoma, malignant lymphoma, fibrous dysplasia, cleft alveolus and palate, inflammatory change, degenerative change of condylar process, sialolithiasis and simple bone cyst respectively.

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.71-75
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• 2011

A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.

• The korean journal of orthodontics
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• v.51 no.5
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• pp.337-345
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• 2021

Objective: To investigate the phenotypes and predominant skeletodental pattern in pre-adolescent patients with Pierre-Robin sequence (PRS). Methods: The samples consisted of 26 Korean pre-adolescent PRS patients (11 boys and 15 girls; mean age at the investigation, 9.20 years) treated at the Department of Orthodontics, Seoul National University Dental Hospital between 1998 and 2019. Dental phenotypes, oral manifestation, cephalometric variables, and associated anomalies were investigated and statistically analyzed. Results: Congenitally missing teeth (CMT) were found in 34.6% of the patients (n = 9/26, 20 teeth, 2.22 teeth per patient) with 55.5% (n = 5/9) exhibiting bilaterally symmetric missing pattern. The mandibular incisors were the most common CMT (n = 11/20). Predominant skeletodental patterns included Class II relationship (57.7%), posteriorly positioned maxilla (76.9%) and mandible (92.3%), hyper-divergent pattern (92.3%), high gonial angle (65.4%), small mandibular body length to anterior cranial base ratio (65.4%), linguoversion of the maxillary incisors (76.9%), and linguoversion of the mandibular incisors (80.8%). Incomplete cleft palate (CP) of hard palate with complete CP of soft palate (61.5%) was the most frequently observed, followed by complete CP of hard and soft palate (19.2%) and CP of soft palate (19.2%) (p < 0.05). However, CP severity did not show a significant correlation with any cephalometric variables except incisor mandibular plane angle (p < 0.05). Five craniofacial and 15 extra-craniofacial anomalies were observed (53.8% patients); this implicated the need of routine screening. Conclusions: The results might provide primary data for individualized diagnosis and treatment planning for pre-adolescent PRS patients despite a single institution-based data.

• Journal of Interdisciplinary Genomics
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• v.3 no.2
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• pp.30-34
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• 2021

Campomelic dysplasia (CD) is a rare genetic disorder characterized by multiple skeletal anomalies and the abnormal development of male reproductive organs. To date, the SOX9 gene is the only known causal gene for CD, and approximately 90 causative mutations in SOX9 have been identified worldwide. CD is diagnosed based on clinical characteristics of skeletal dysplasia (e.g., short bowed long bones, kyphoscoliosis, bell-shaped thoracic cage with 11 pairs of ribs, and hypoplastic scapulars), typical facial features of Pierre Robin sequence with cleft palate, and gonadal dysgenesis in 46,XY individuals. Most patients with CD exhibit life-threatening respiratory failure owing to laryngotracheomalacia and hypoplastic thorax during the neonatal period. Although fatal complications decrease after infancy, several medical conditions continue to require proper management. A better understanding of this rare but lethal condition may lead to more appropriate treatments for patients.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.1
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• pp.17-25
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• 2003

Correction of the cleft-lip nasal deformity is a difficult task that requires clear understanding of the associated complex anatomy and function as well as the operation time, the selection of an operation method, On the expectation that it helps enhance understanding the current trend of cleft-rhinoplasty, authors analyzed secondary rhinoplasty between 1999 and 2002, In both the unilateral and bilateral cleft lip rhinoplasty, we reviewed the timing of repair, site of correction and it's major technique, incision or approach method, autogenous cartilage graft method, All patients with a septal deviation did not have a septal surgery, We were active in alar and nasal tip surgery and passive in septal and dorsal deformity correction, And for children, we used a conservative method but for adults, we used radical approach, Most surgeries are focused on esthetic goal and we thought that objective evaluation for nasal obstruction was needed for bener and predictable outcome.

• Archives of Craniofacial Surgery
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• v.24 no.3
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• pp.133-138
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• 2023

White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery. Instead of revision surgery, the patient was treated with targeted EOM exercises focusing on the inferior rectus muscle and inferior oblique muscle. The patient was instructed to slowly move her pupils from the central point to the upper and outer sides, then in a straight line from the central point to the lower and inner sides before returning to the center point. On the 28th postoperative day, 2 weeks after initiating the exercises, the patient's EOM motion fully recovered. This case highlights the effectiveness of EOM exercises as a non-surgical treatment approach for improving recurrent EOM movement limitations in the absence of soft tissue herniation following surgical management of blowout fractures in children.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.133-139
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• 2012

This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.89-93
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• 2019

Preterm infants have higher possibility of undergoing endotracheal intubation after birth than normal children due to medical conditions. Developmental disturbances of primary incisors following intubation can occur as crown malformation, enamel defects, delayed eruption, displacement of dental follicle in crypt, groove formation of palate or alveolar ridge, acquired cleft palate, and dental arch distortion. This clinical report presents the effect of intubation on primary dentition of preterm infants. A 2-year-old girl with cerebral palsy and premature birth history visited our clinic with chief complaint of unerupted primary upper incisor. A 1-year-old boy with cerebral palsy, status epilepticus and premature birth history visited our clinic due to crown malformation. Developmental disturbances of primary incisors in these cases were not related to the patients' systemic disease, and there were no history of dental trauma. A long term endotracheal intubation prior to tooth eruption might have caused local trauma on alveolar ridge. It is very important to monitor dental problems of preterm infants who had experienced endotracheal intubation during neonatal period. Due to influences on both primary and permanent teeth, periodic re-evaluation of affected areas and establishment of comprehensive treatment plans are necessary.