• 대한두개안면성형외과학회지
• /
• 제19권1호
• /
• pp.13-19
• /
• 2018

Background: $Abb{\acute{e}}$ flap technique is one of the most challenging operations to correct horizontal deficiencies in secondary cleft lip deformity. Since its first introduction, the operative method was dynamically modified from simple variation to complete conceptual change, but conventional $Abb{\acute{e}}$ flap has many drawbacks in esthetic and functional aspect. Our purpose was reconstructing the symmetry of Cupid's bow and central vermilion tubercle with minimal sequalae. Methods: From 2008 to 2016, this technique was applied to 16 secondary cleft lip patients who had total or more than 60% of unilateral deficiency of Cupid's bow and central lip or tubercle pouting deficiency. A quadrangular-shaped flap was transferred from vermilion including skin and white line of central or contralateral lower lip. Pedicle division and insetting were made at 9 (unilateral) or 10 (bilateral) days after transfer. Secondary lip revision was done with open rhinoplasty after wound maturation. Results: Overall satisfaction was high with modified technique. Scar was minimally noticeable on both upper and lower lip especially. Balanced Cupid's bow and symmetric vermilion tubercle were made with relatively small size of flap compared to conventional $Abb{\acute{e}}$ flap. An accompanying benefit was reduced ectropion of lower lip, which made balanced upper and lower lip protrusion with more favorable profile. Conclusion: A new modified $Abb{\acute{e}}$ flap technique showed great satisfaction. It is worth considering in secondary cleft lip patient who has central lip shortage and asymmetry of upper lip vermilion border line. Our technique is one of the substitutes for correction of horizontal and central lip deficiency with asymmetric Cupid's bow.

• 대한두개안면성형외과학회지
• /
• 제13권1호
• /
• pp.11-21
• /
• 2012

Purpose: Mulliken's method allows for normal nasal and lip growth, which in turn forms a natural shape of the philtrum. Therefore, we used a modified Mulliken's method to correct unilateral and bilateral cleft lip nasal deformities and followed the patients for 10 years. Methods: Ninety-one patients, who had undergone repair of unilateral and bilateral cleft lip and nasal deformity simultaneously using Mulliken's method during the time period from June 1997 to June 2009, were enrolled into this study. To follow-up of the growth of the lips and nose after the operation, the following 5 anthropometric measurements were analyzed: nasal tip protrusion, columellar length, upper lip height, cutaneous lip height, and vermilion mucosa height. Results: Using this method, we obtained a result that there was no significant difference in the development of the lip compared to the normal control group, and that the bilateral cleft lip patients' nasal projection and columellar length was shorter than that in normal persons. Both measures were statistically significant. Conclusion: Mulliken's method is a superb surgical technique, which enables the normal development of the nose and lip, which further allows for the innate philtrum appearance. The author's result does not seem to be meaningful, because the normal rate of nasal growth is slow before adolescence; however, we recommend additional follow-up and accordant treatment, if needed, once the nasal growth is complete.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권2호
• /
• pp.163-168
• /
• 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
• /
• 제40권5호
• /
• pp.542-545
• /
• 2013

Background The aims of alveolar bone grafting are closure of the fistula, stabilization of the maxillary arch, support for the roots of the teeth adjacent to the cleft on each side. We observed nostril base augmentation in patients with alveolar clefts after alveolar bone grafting. The purpose of this study was to evaluate the nostril base augmentation effect of secondary alveolar bone grafting in patients with unilateral alveolar cleft. Methods Records of 15 children with alveolar clefts who underwent secondary alveolar bone grafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 were reviewed. Preoperative and postoperative worm's-eye view photographs and reconstructed three-dimensional computed tomography (CT) scans were used for photogrammetry. The depression of the nostril base and thickness of the philtrum on the cleft side were measured in comparison to the normal side. The depression of the cleft side pyriform aperture was measured in comparison to the normal side on reconstructed three-dimensional CT. Results Significant changes were seen in the nostril base (P=0.005), the philtrum length (P=0.013), and the angle (P=0.006). The CT measurements showed significant changes in the pyriform aperture (P<0.001) and the angle (P<0.001). Conclusions An alveolar bone graft not only fills the gap in the alveolar process but also augments the nostril base after surgery. In this study, only an alveolar bone graft was performed to prevent bias from other procedures. Nostril base augmentation can be achieved by performing alveolar bone grafts in children, in whom invasive methods are not advised.

• 대한구순구개열학회:학술대회논문집
• /
• 대한구순구개열학회 1998년도 종합학술대회
• /
• pp.31-31
• /
• 1998

• 대한구순구개열학회:학술대회논문집
• /
• 대한구순구개열학회 2002년도 종합학술대회
• /
• pp.40-40
• /
• 2002

• 대한구순구개열학회:학술대회논문집
• /
• 대한구순구개열학회 2002년도 종합학술대회
• /
• pp.36-36
• /
• 2002

• 대한구순구개열학회:학술대회논문집
• /
• 대한구순구개열학회 2002년도 종합학술대회
• /
• pp.39-39
• /
• 2002

• 대한구순구개열학회:학술대회논문집
• /
• 대한구순구개열학회 2002년도 종합학술대회
• /
• pp.25-25
• /
• 2002

• 대한두개안면성형외과학회지
• /
• 제18권4호
• /
• pp.287-291
• /
• 2017

Preauricular sinus is a congenital malformation that is very commonly encountered among the general population and it has especially high prevalence among Asians when compared to other ethnic groups. It can often go unnoticed or easily overlooked by the patient or even by doctors because most of them are asymptomatic and is most of the time only a tiny pit that can be trivial in terms of aesthetics. We report a very rare and unique case that has no precedence what so ever; hence no reported case in the literature: an ectopic preauricular sinus in a facial cleft and microsomia patient.