• 제목/요약/키워드: Cleft surgery

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Bone and Soft Tissue Changes after Two-Jaw Surgery in Cleft Patients

  • Yun, Yung Sang;Uhm, Ki Il;Kim, Jee Nam;Shin, Dong Hyeok;Choi, Hyun Gon;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
    • Archives of Plastic Surgery
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    • 제42권4호
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    • pp.419-423
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    • 2015
  • Background Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). Methods Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. Results The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was $-4.1^{\circ}$ before surgery, and increased to $2.5^{\circ}$ after surgery. The mean nasolabial angle was $72.7^{\circ}$ before surgery, and increased to $88.7^{\circ}$ after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. Conclusions Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.

제2열 새열 낭종으로 오인되었던 편도암의 낭성 경부 임파절 전이 1예 (A Case of Cystic Lymph Node Metastasis of Tonsil Cancer Mimicking 2nd Branchial Cleft Cyst)

  • 박승범;노민호;반원우;반명진;박재홍
    • 대한두경부종양학회지
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    • 제31권2호
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    • pp.86-90
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    • 2015
  • Cystic lymph node metastasis of head and neck squamous cell carcinoma(HNSCC) which presumed to be mainly originated from oropharynx including Waldeyer's ring may present as a benign cystic mass on lateral neck such as branchial cleft cyst. Branchial cleft cyst is one of the most common lateral neck cystic mass which may result in regional infection or lymph adenopathy. Many of previously reported literatures showed the incidence of cystic lymph node metastasis from oropharynx including Waldeyer's ring. Preoperative imaging studies and fine needle aspiration cytology cannot provide the accurate results until excision of cystic mass for the diagnostic or therapeutic purpose. Recently, we experienced the rare case of cystic lymph node metastasis from ipsilateral tonsil, which mimicked infected 2nd branchial cleft cyst. Thus, we reported our experience with presentation of case and review of literatures.

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구순구개열 환자에서 상악전방골 신장술 (Distraction Osteogenesis of Maxillary Anterior Segment in Cleft Lip and Palate Patients)

  • 김유진;천강용;김수호;박형욱;황순정
    • 대한구순구개열학회지
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    • 제15권2호
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    • pp.89-96
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    • 2012
  • Le Fort 1 osteotomy or maxillary advancement with distraction osteogenesis (DO) is main treatment strategy for cleft palate patients with maxillary hypoplasia. Maxillary DO allows greater maxillary advancement within physiological limit than Le Fort 1 osteotomy. Moreover, it is better for velopharyngeal function. However, there is a greater tendency for an increase in nasal sound when maxilla is advanced excessively. Therefore, the advancement of anterior maxillary segment using DO has been utilized. It offers advantages such as an increase in the length of the palate, a prevention of the change in palatopharyngeal depth, and a preservation of the velopharyngeal function. Moreover, it will obliterate the necessity of bone graft, and it prevents the occurrence of oronasal or oroantral fistula. Finally, it stimulates the regeneration of the soft and hard tissue of alveolus, and subsequently makes possible to place implant.

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