• Title/Summary/Keyword: Cleft surgery

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Double-layered reconstruction of the nasal floor in complete cleft deformity of the primary palate using superfluous lip tissue

  • Park, Young-Wook;Kwon, Kwang-Jun;Kim, Min-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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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.

A Case of Second Branchial Cleft Cyst Presenting as a Parapharyngeal Cystic Mass (부인두강 낭성 종물로 발현된 제2새열 낭종 1례)

  • Kim, Byung Ha;Do, Nam Yong;Cho, Sung Il;Park, Jun Hee
    • Korean Journal of Bronchoesophagology
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    • v.18 no.2
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    • pp.60-63
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    • 2012
  • Second branchial cleft cysts are usually present as a fluctuant neck mass along the anterior border of the sternocleidomastoid muscle. When they are found in this typical location, accurate diagnosis on initial presentation is not difficult. Parapharyngeal presence of the branchial cleft cyst is very rare. We report a case of second branchial cleft cyst presenting as a parapharyngeal cystic mass in 51-year-old male. Before coming to our clinic, the patient had been diagnosed as parapharyngeal abscess, resulting in several attempts at removal. However, symptoms and parapharyngeal abscess recurred. We performed complete surgical resection of the parapharyngeal cystic mass via transoral approach only with oropharyngeal incision. The cystic mass was located in the parapharyngeal space and did not have tract-like structure. Histopathologic examination confirmed that the excised cyst was branchial cleft cyst. Patient discharged without any surgical complication and there was no evidence of recurrence for 2 years follow-up.

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Open rhinoplasty in cleft nasal repair (구순열 환자에서의 개방형 비성형술)

  • Lee, Jong-Ho;Jeon, Se-Il;Myung, Hoon;Lim, Koo-Young;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pil-Hoon;Kim, Myung-Jin;Nam, Il-Woo;Kim, Jong-Won;Min, Byong-Il
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.1
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    • pp.17-22
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    • 2000
  • While in endonasal rhinoplasty transection and resection of nasal structures is primarily used for correction of nasal deformities, open rhinoplasty is performed using stures and repositioning of nasal structures in the repair of severe nasal deformities. We reviewd our experiences in the repair of cleft nasal deformities from 1991 to 1999 year in our institute, and compared the results of open rhinoplasty with endonasal rhinoplasty. In overall 164 cases of rhinoplasty in cleft nasal repair, open rhinoplasty was done in 13 cases. Male patients were 10, female 3(age between 6 to 34 years old). In this article, our experience, together with review of literatures of open rhinoplasty in the cleft nasal deformities are reported.

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An Adult Cleft Lip and Plate Patient Using a Maxillary Distractor by $Synthes^{(R)}$ : Report of a case ($Synthes^{(R)}$상악골 신장기를 이용한 성인 구개구순열 환자의 치험례)

  • Kim, Jun-Yeong;Lee, Bu-Gyu
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.1
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    • pp.21-32
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    • 2009
  • Generally, an adult cleft lip or/and palate patient shows some amount of maxillary deficiency due to limitation of bony growth caused by heavy scars resulted from previous operations such as a cheiloplasty and/or a palatoplasty at an early child age. To solve the problem, advancement of the maxilla is usually required during orthognathic surgery. However, severe tensional force resulted from heavy scars on the palate and/or the lip, as well as the bony defect at the cleft area limited sufficient advancement of the maxillary segment and finally caused relapse of the reposed maxilla. Therefore, distraction osteogenesis of the maxilla was introduced for the successful maxillary advancement inthose kinds of patients. As both hard and soft tissues can be simultaneously and gradually extended with this technique, tensional force caused by heavy scars opposed to forward movement of the maxilla can be reduced to an extent not to develop severe relapse of the advanced maxilla. Since distraction osteogenesis of the maxilla was applied as one of standard protocols for the treatment of the patients with severe maxillary hypoplasia dueto cleft lip and/or palate, the devices for the distraction was improved to control the vectors of distraction with better and more stable. We have treated a 23-year-old male cleft patient with a severe maxillary hypoplasia using a newly developed a maxillary distraction device and a RP model for a pre-operative simulation surgery. As a result, we could successfully move the maxilla as we designed pre-operatively and also reduce much of operation time. Therefore, we report of the case to share our experience with colleagues.

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Change in nostril ratio after cleft rhinoplasty: correction of nostril stenosis with full-thickness skin graft

  • Suh, Joong Min;Uhm, Ki Il
    • Archives of Craniofacial Surgery
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    • v.22 no.2
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    • pp.85-92
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    • 2021
  • Background: Patients with secondary deformities associated with unilateral cleft lip and nose might also suffer from nostril stenosis due to a lack of tissue volume in the nostril on the cleft side. Here, we used full-thickness skin grafts (FTSGs) to reduce nostril stenosis and various methods for skin volume augmentation. We compared the changes in the symmetry of both nostrils before and after surgery. Methods: From February 2016 to January 2020, 34 patients underwent secondary cheiloplasty and open rhinoplasty for secondary deformities of the unilateral cleft lip and nose with nostril stenosis. FTSG was used on the nostril floor, nasal columella, and alar inner lining. The measured nasal profile included the nostril surface, nostril circumference, width of the nostril floor, and distance from the alar-facial groove to the nasal tip. The "overlap area," which was defined as the largest overlapping area when the image of the cleft nostril was flipped to the left and right and overlaid on the image of the normal side nostril, was also calculated. The degree of symmetry was evaluated by dividing the value of the cleft side by that of the normal side of each measured profile and expressed as "ratios." Results: The results of all profile ratios, except for the nostril floor width, became significantly close to 1, which represents full symmetry. The overlap area ratio improved from 62.7% to 77.3%, meaning that the length and width of the nostril as well as the overall shape became similar (p< 0.05). Conclusion: When performing cleft rhinoplasty with nostril stenosis, FTSG is useful to achieve symmetry in the nostril size and shape. Skin grafting is simpler to perform than the other types of local flap, and the results are generally satisfactory.