• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권2호
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• pp.163-168
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• 2001

Purpose : This study is conducted to evaluate the clinical success of secondary alveolar bone grafting using autogenous iliac particulate cancellous bone marrow in cleft maxilla. Materials and methods : We evaluated 107 cleft patients who had been admitted to the Dept. of Oral and Maxillofacial Surgery of Pusan National University Hospital from January 1, 1991 to January 31, 1999 and had been performed secondary alveolar bone grafting with autogenous particulated cancellous bone marrow from iliac crest. Results : 1. Men were 70 and women were 37, which shows 65.4% and 34.6% and the proportion of males to females was 1.9:1. Unilateral cases were 89(83.2%) and bilateral cases were 18(16.8%). 2. Age of bone grafting is widely distributed from 7 to 29, and the average was 13.2. 3. Success rate was 97.8% in unilateral cases, 94.4% in bilateral cases. Overall success rate was 96.7%. 4. We evaluated the bone graft contour by the percentage of bone attachment level adjacent to the alveolar cleft and the menial side showed 82.4% and the distal 87.7%. 5. The amount of notching the alveolar ridge at the grafted site through the ratio of notching length up to the most apical base to the length of proximal segment anatomic root was 0.19.

• Archives of Plastic Surgery
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• 제51권4호
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• pp.378-385
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• 2024

Background The best timing of closure of the hard palate in individuals with cleft lip, alveolus, and palate (CLAP) to reach the optimal speech outcomes and maxillary growth is still a subject of debate. This study evaluates changes in compensatory articulatory patterns and resonance in patients with unilateral and bilateral CLAP who underwent simultaneous closure of the hard palate and secondary alveolar bone grafting (ABG). Methods A retrospective study of patients with nonsyndromic unilateral and bilateral CLAP who underwent delayed hard palate closure (DHPC) simultaneously with ABG at 9 to 12 years of age from 2013 to 2018. The articulatory patterns, nasality, degree of hypernasality, facial grimacing, and speech intelligibility were assessed pre- and postoperatively. Results Forty-eight patients were included. DHPC and ABG were performed at the mean age of 10.5 years. Postoperatively hypernasal speech was still present in 54% of patients; however, the degree of hypernasality decreased in 67% (p < 0.001). Grimacing decreased in 27% (p = 0.015). Articulation disorders remained present in 85% (p = 0.375). Intelligible speech (grade 1 or 2) was observed in 71 compared with 35% of patients preoperatively (p < 0.001). Conclusion This study showed an improved resonance and intelligibility following DHPC at the mean age of 10.5 years, however compensatory articulation errors persisted. Sequential treatments such as speech therapy play a key role in improvement of speech and may reduce remaining compensatory mechanisms following DHPC.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권3호
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• pp.260-264
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• 1997

The congenital deformities of cleft lip and cleft palate have been known to afflict man since prehistoric time. Efforts to correct these abnormities have evolved over the centuries as scientific knowledge has advanced. Although there is no agreement as to when the surgery should be performed, most surgeons adhere to "rule of 10" : the infant must be 10 week old weigh 10 Ibs, have a hemoglobin value 10gm/dl and have a white blood cell count no greater than 10 $thousands/mm^3$. Consensus favors performing initial palatal surgery in the child when he is between 18 and 24 months old. The timing of cleft alveolus surgery is usually between 10 and 11 years old. In the period from 1992 to 1996, 38 patients with cleft lip and cleft palate treated at the department of oral and maxillofacial surgery, Chosun university, dental hospital were analysed clinically. The obtained results were as follows. 1. The ratio of male to female was 1.92 : 1 (25/23) 2. The ratio of cleft lip, cleft palate and cleft lip & palate was 1.5 : 1 : 2.5 (12/8/18) 3. The ratio of unilateral to bilateral cleft lip was 5 : 1 (25/5) 4. The ratio of left to right side in unilateral cleft lip was 1.5 : 1 (15/10)

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권4호
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• pp.295-309
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• 2006

The present study was aimed to evaluate the incidence, etiological factors, and management of cleft lip and palate. Two hundred and twenty patients with cleft lip and/or cleft palate who were treated at Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, during the period between January 1994 and December 2003 were reviewed. The ratios of cleft lip : cleft lip with cleft palate : and cleft palate were 0.4:1.1:1. Males were more common than females in cleft lip (1.3:1) and cleft lip and palate (2.5:1), while females were more common than males in cleft palate (1:1.3). In the cleft side, left clefts were more prevalent than right clefts (cleft lip 1.3:1, cleft lip and palate 1.6:1). Unilateral clefts were more common than bilateral clefts in cleft lip (79:21). Cleft lip and cleft palate were more common in those with blood type A (34.5%) than those with other types. There was no significant relationship between birth season and frequency of clefts. The clefts were common in the first-born (48.8%), and in mothers aged between 25 and 29 (51.7%). Medication (24.7%) and stress (16.7%) during the first trimester were noted. Positive familial history was noted in 13 cases (5.9%). Thirty-two cases (15%) were associated with other congenital anomalies, in which tonguetie (40.6%) and congenital heart disease (21.9%) were most common. Among 100 patients with cleft palate, 77 patients had middle ear disease (77%), which occurred predominently in the incomplete cleft palate. Seventy-six among the 77 patients received myringotomy and ventilation tube insertion, and the remaining one received antibiotic medication only. Cleft lips were treated primarily at 3 to 6 months, and cleft palates were at 1 to 2 years. Treatment regimens included modified Millard method mainly in the cleft lip, and Wardill V-Y, Dorrance method, and Furlow method in the cleft palate. The percentage of palatal lengthening as type of cleft palate was greater in the incomplete cleft palate group (11.2%) than in the complete cleft palate group (9.6%). The percentage of palatal lengthening as operating method was no difference between the Furlow method (10.9%) and the push back method (10.7%). As postoperative complications, hypertrophic scar was most frequent in the cleft lip, and oronasal fistula in the cleft palate. In summary, it was shown that medication and stress during the first trimester of pregnancy were frequently associated with cleft lip and cleft palate, adequate timing and selection of method of operation are important factors to obtain morphologically and functionally good results. Furthermore prevention and treatment of middle ear disease are important in cleft palate patients because of its high co-occurrence.

• 대한소아치과학회지
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• 제23권3호
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• pp.729-735
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• 1996

Cleft lip and palate is the most common malformation in the craniofacial region. The patients with cleft lip and palate have functional problem such as, speech, feeding and respiratory as well as esthetic problem. So, treatment should be done by multidiciplinary team approach. The role of pediatric dentist in the team is advicement for feeding method, guidance of normal growth, caries control and preventive orthodontics. In cleft lip and palate patients, maxillary arch after cheiloplasty is usually collapsed by excessive tension of the scar. This collapse increase the difficulty of later orthodontic treatment. Therefore, the maxillary arch segments should be moved and retaind to normal position as soon as cheiloplasty is done to reduce the need and difficulty of orthodontic treatment. This concept is called by the early orthopedic treatment in cleft lip and palate. Also, this orthopedic appliance works as feeding applince to normal feeding and weight gain We reported two cases of early orthopedic treatment with favorable result in complete bilateral cleft lip and palate patients after cheiloplasty. Patients showed normal weight and their maxillary arch widths were increased.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.35.1-35.7
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• 2015

After cleft lip repair, many patients suffer from nasolabial fistulas, asymmetrical nasal floor, or an indistinct nostril sill, as well as intraoral wound dehiscence and subsequent scar contracture of surgical wounds leading to vestibular stenosis. For successful primary nasolabial repair of complete cleft deformity of the primary palate, cleft surgeons need special care in reconstructing the sound nasal floor. Especially when the cleft gap is wide or when any type of nasoalveolar molding therapy was not performed, three-dimensional reconstruction of the nasal floor is critical for a balanced nasal shape. In this study, the author describes an effective method for reconstructing a double-layered nasal floor using two mucosal flaps from both sides of the fissured upper lip. This is a report of six patients with unilateral or bilateral complete cleft of the primary palate with a detailed description of the surgical technique and a literature review.

• 대한구순구개열학회지
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• 제13권2호
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• pp.63-76
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• 2010

After introduction of Delaire's basic philosophy, to consider the normal and pathologic anatomy, the role of some structures, such as nasal septum, musculature, and tongue, and some functions, such as dental occlusion or nasal respiration, which play important roles in maxillary and particularly premaxillary growth, on the Korean Journal of cleft lip and palate in 2009, Delaire's primary functional cheilorhinoplasty (FCR) in the unilateral and bilateral cleft lip patients was summarized and introduced according to already published literatures and lectures. This paper will be the second publishment of Delaire philosophy with Korean language.

• 대한두개안면성형외과학회지
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• 제21권2호
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• pp.106-108
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• 2020

Premature fusion of one or other of the minor sutures can subtly influence the shape of the human skull. Although infrequently reported or not clinically recognized, it can such contribute to a variety of craniofacial dysmorphisms. We herein report a case of late presenting, isolated bilateral synostosis of the squamosal suture dysmorphologies whose presentation mimics aspects of sagittal synostosis.

• 대한두개안면성형외과학회지
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• 제19권3호
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• pp.227-230
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• 2018

"Paraffinoma" is a well-recognized complication of paraffin oil injection into various body parts for an aesthetic purpose. After a variable latency phase, paraffinoma can present as a wide range of clinical symptoms. This paper is a case report of surgical excision of the paraffinoma and subsequent reconstruction of the associated skin defect on bilateral preauricular cheeks, manifesting 50 years after a primary injection.

• 대한치과교정학회지
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• 제31권1호
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• pp.63-69
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• 2001

구순열 및 구개열은 두개 악안면 부위에서 가장 자주 발생되는 선천성 기형으로 적절한 의료진의 확보와 의료 정책의 수립을 위해서 정착한 환자 수를 파악하는 것이 필요하다. 그러나, 기존의 국내 발생률 추정 연구는 표본선정의 문제점과 이 질환이 갖는 높은 유산율과 사산율 및 다양한 형태로 인한 분류의 어려움과 한국 내에서의 특수성 중 하나인 장애아들의 해외 입양으로 인해 정확한 환자 수의 파악이 어려웠다. 따라서, 한국인에서의 체계적인 유병률 연구가 필요하리라 사료되며, 대부분의 구순열 및 구개열 환자에서 필요한 교정 치료의 수혜 정도를 파악할 필요성이 있다고 사료된다. 이에 본 연구에서는 한국 성인 남자에서 구순열 및 구개열 환자에 대한 유병률과 이들에 대한 교정치료 수혜율을 조사하고자, 1998년도 병무청 징병 검사자 중 1979년도에 출생한 자만을 연구대상으로 하여 서울, 광주, 대구 부산의 성인 남자 218,322명에 대해 3단계 검사를 실시한 후 다음과 같은 결과를 얻었다. 1. 1979년 생 한국 성인남자에서 구순열 및 구개열 환자의 유병률은 1000명당 0.65명이었다. 2. 전후방적 심도에 따라 1000명당 각각의 유병률은 구순열이 0.26명, 구순구개열이 0.36명,구개열이 0.03명이었다. 구순열과 구순구개열은 비슷한 정도의 유병률을 보였으나, 구개열은 이에 비해 낮은 유병률을 보였다. 3. 횡적 심도에 따라 1000명당 각각의 유병률은 좌측 파열이 0.35명, 우측 파열이 0.16명, 양측 파열이 0.12명이었다. 좌측 파열은 우측 파열에 비해 매우 뚜렷하게 높은 유병률을 보였으며, 양측 파열은 편측 파열에 비해 낮게 나타났다. 4. 구순열 및 구개열 환자 중 성인남자에서의 한국 내 교정치료 수혜율은 $35\%$였으며, 구순열, 구개열, 구순구개열의 순으로 $28\%,\;29\%\;67\%$였다. 구순열이나 구개열과 같이 단독 발생된 경우보다 파열의 심도가 심한 구순구개열의 경우에서 교정치료 수혜율이 높게 나타났다.