• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.72-76
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• 2008

Purpose: Authors evaluated results of palatoplasty by speech analysis in bilateral, unilateral complete, and unilateral incomplete and submucous cleft palate patients. Methods: The speech outcomes were studied in 15 bilateral, 28 unilateral complete, and 46 unilateral incomplete and submucous cleft palate patients who underwent push-back palatoplasties from January 1998 to July 2004. The patients were divided into 2 groups as 3 to 6, 7 to 10-year-old and compared with 20 normal children(control groups were divided into 10 children on each side). Nasal emission test, hypernasality test, and articulation test were done by speech evaluation table which was composed of 39 different words. Results: In all speech evaluation tests, the group of bilateral cleft palate patients got the worst score. And 7 to 10-year-old groups got better score when compared to the same type cleft palate. Conclusion: Bilateral cleft palate patients have many more speech problems than other patients. In cleft palate patients, the speech problem was improved with ages, postoperatively. And the speech therapy can improve the operative outcomes.

• The Journal of the Korean dental association
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• v.12 no.3
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• pp.183-188
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• 1974

The authors had treated 68 case of cleft lip and cleft palate patients including 44 male patients and 24 female patients. There ware 55 cases of unilateral cleft lip patients and 13 cases of bilateral cleft lip patients, and 37 cases with together cleft lips and cleft palates among 68 cases were observed. We had accomplished that 'Plastic Cheiloplasty', surgical closures of cleft lips and cleft palates had been performed by using of Millard's, Hagedorn's, LeMesurier's and Veau's methods with Z-plasty.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.518-524
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• 2019

Background Anterior palatal repair performed during cleft lip repair using a vomerine flap may assist in recruiting additional soft tissue for subsequent completion of palatoplasty, especially in patients with a wide cleft. We present our early results in the hope of triggering a re-evaluation of this technique regarding its advantages for maxillary growth through further studies of patients with a wide cleft. Methods A retrospective analysis of patients with complete unilateral and bilateral cleft lip and palate was performed, including cleft and palatal measurements taken during initial surgery (lip repair together with anterior palate repair) and upon completion of palatoplasty. Results In total, 14 patients were included in this study, of whom nine (63.3%) had unilateral cleft lip and palate and five (37.5%) had bilateral cleft. All patients had a wide cleft palate. Lip and anterior palate repair was done at a median age of 3 months, while completion of palatoplasty was done at a median age of 10.5 months. Measurements taken upon completion of palatoplasty showed significant cleft width reduction in the mid-palate and intertubercle regions; however, the palatal arch distances at nearby landmarks showed non-significant marginal changes. Conclusions Anterior palate repair using a vomerine flap significantly reduced the remaining cleft width, while the palatal width remained. Further research is warranted to explore the long-term effects of this technique in wide cleft patients in terms of facial growth.

• Speech Sciences
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• v.1
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• pp.237-259
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• 1997

Cleft Palate speech appears to have hyper/hyponasality with velopharyngeal insufficiency and articulation disorders. Previous studies on Cleft Palate speech have shown that speech tends to have lower airflow and air pressure. To examine the aerodynamic characteristics of Cleft Palate speech, Aerophone II Voice function Analyzer was used. We measured sound pressure level, airflow, air pressure and glottal power. Three Cleft Palate adults and five normal adults participated in this experiment. The test words are composed of: (1) the sustained vowel /o/ (2) /CiCi/, where C is one of three different stop consonants in Korean (3) /bimi/. Subjects were asked to produce /bimi/ five times without opening their lips. All the data was statistically tested by t-test for Cleft Palate patients before operation groups and control groups and paired t-test for Cleft Palate patients before and after operation groups. The results were as follow: (1) Cleft Palate patients generally speak with incomplete oral closure and lower oral air pressure. As a result, the SPL of Cleft Palate before operation is 3 dB lower than control groups. (2) Airflow of Cleft Palate in phonation and articulation is lower than that of control groups. However, it increased after operation. Lung volume and mean airflow in phonation are significantly increased (p<0.05). (3) Although velopharyngeal function (velar opening rate) of Cleft Palate is poor in comparison with control groups, it was recovered after operation. In this event maximum flow rate and mean airflow rate are significantly increased (p<0.05). (4) Air pressure of Cleft Palate in speech is lower than that of control groups. In general, the air pressure of Cleft Palate increased after operation. In this event air pressure of glottalized consonant is significantly increased (p<0.04). (5) Glottal Power(mean power, mean efficient and mean resistant) of Cleft Palate patients is lower than that of control groups. But mean efficient and mean resistant of Cleft Palate patients increased significantly (p<0.05) after operation.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.2
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• pp.59-67
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• 2003

A cephalometric study was performed to reveal differences between skeletal Class III malocclusion patients and cleft lip and palate patients, The material for this study consisted of 16 males (mean age 19.8, range 17-29) and 9 females(mean age 19.4, range 16-27) with cleft lip and palate, and 222 Skeletal Class III malocclusion patients(males 106, females 116), Cephalometric tracing and measurements were done by one investigator. Results were followed: 1. Cleft lip and palate group had more retrusive maxilla than the skeletal Class III malocclusion group. 2, Cleft lip and palate group had smaller effective maxillary and mandibular length than skeletal Class III malocclusion group, and the difference was more prominent in the mandible than in the maxilla. 3. Dental compensation was not observed in the upper incisors of cleft lip and palate group and in the lower incisors it was smaller than skeletal Class III group. 4, In the Gonial angle and lower anterior facial height values, there was no significant difference between cleft lip and palate and skeletal Class III malocclusion group. These results can be used in orthodontic treatment planning and orthognathic surgery for the cleft lip and palate patients.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.385-388
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• 2005

In cleft lip and/or palate patients with the complex congenital heart diseases, surgical repair of the cleft lip and/or palate has been postponed after the open heart surgery because the heart problem of the patient might cause more complications associated with anesthesia and surgery. There has been little report about experiences in the surgical management of these patients and optimal time of surgical intervention. Authors are introducing the experiences of performing corrective surgery of cleft lip and/or palate in the patients with congenital heart diseases before and after the open heart surgery. We managed five patients from May 1992 to March 2004. Two patients were male and the rest were female. One of them had cleft lip alone and others had cleft lip and palate. Two of them underwent delayed cleft lip and/or palate surgery after open heart surgery, and the rest had immediate intervention for cleft lip and/or palate. There was no complication during the operation and postoperative period. There would be no need to delay the corrective surgery of the cleft lip and/or palate after the open heart surgery, if solid medical team approach was available with the pediatric cardiologist and the anesthesiologist.

• The Journal of the Korean dental association
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• v.11 no.2
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• pp.117-121
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• 1973

The authors had treated 45 cases of cleft lip and cleft palate patients including 30 male patients and 15 female patients. There were 41 cases of unilateral cleft lip patients and 4 cases of bilateral cleft lip patients, and 4 cases with together cleft lips and cleft palates among the total 45 cases were showed. We had accomplished that surgical plastic closures of cleft lips and cleft palates had been performed by using of Millara's, Hagedorn's, Meyer's, LeMesurier's and Veau's methods with Z-plasty.

• Korean Journal of Cleft Lip And Palate
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• v.2 no.1_2
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• pp.15-22
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• 1999

It is well known that the postoperative skeletal instability after Le Fort I osteotomy for advancement of maxilla in the cleft patients is one of the major surgical problems. So we had tried to compare the amount of relapse after Le Fort I advancement surgery in the horizontal and vertical positional change, angular change of reference points between cleft patients and non-cleft patients. Longitudinal records of 10 consecutive cleft patients (test group) and 20 non-cleft patients (control group) were analyzed. Lateral cephalograms were taken preoperatively, immediately postoperatively, and 2, 6, 12 months postoperatively. We measured horizontal and vertical changes (ANS, PNS, AI) and angular change (SNA) of the reference points and lines. In the test group, horizontal relapse of ANS, PNS, AI point are 36.4%, 37.5%, 32.0% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 25.3%, 32.3%, 39.1% respectively at 12 months postoperatively. The angular change of SNA is 33.6% at 12 months postoperatively. In the control group, horizontal relapse of ANS, PNS, AI point are 23.8%, 30.2%, 21.7% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 22.7%, 27.3%, 25.1% respectively at 12 months postoperatively. The angular change of SNA is 22.2% at 12 months postoperatively. The cleft patients have a larger tendency of skeletal and dental relapse compared with non-cleft patients after Le Fort I surgery. So the oral and maxillofacial surgeons must keep in mind these facts in order to minimize the relapse phenomenon from the beginning of surgical planning to postoperative care.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.124-131
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• 2002

Speech characteristics of patients with cleft palates are resonance disorders, articulatory disorders and voice disorders. The purpose of this study is to find the acoustic, physiological and articulatory characteristics of cleft palate speakers. Thirteen control groups and 3 cleft palate patients participated in this experiment. Test words were composed of simple vowels and consonants imbedded in low vowel /a/, /p 'ap'i/ and /sasi/ according to the evaluation experiments. CSL, Video fluoroscopy, Fiberscope and Nasometer were used to analyze VOT, vowel formants, profiles of articulator, VP port images and nasalance. The results are as follows : (1) The nasalance of cleft palate patients in the high vowel /i/, stop sounds and fricative sounds were 60%, 34.8% and 44.1%, respectively. These values were higher than those of the control group. (2) Posterior articulatory movements /k'a/ in patients with cleft palates showed backward movement in comparison with the control group on Video Fluoroscopic images and palatograms. These results suggested that patients with cleft palate have the compensatory oral sounds to close the VP port. (3) The VOT in patients with cleft palates was longer than that of the control group.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.4
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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.