• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.3
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• pp.267-272
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• 2009

Bone grafting the alveolar cleft allows for stability and continuity of the dental arch, provides bone for eruption of permanent teeth or placement of dental implants, and gives support to the lateral ala of the nose. Closure of residual oronasal fistula can occur simultaneously. Repair of alveolar clefts can occur at a variety of stages defined as primary, early secondary, secondary, and late. Most centers perform this surgery as secondary bone grafting. Autogenous bone provides osteogenesis, osteoinduction and conduction and is recommended for grafting to the cleft alveolus and several donor sites are available. The surgeon should select the best flap design considering the amount of mucosa available, blood supply and tension-free closure, and the extent of the oronasal communication. The authors provide a comprehensive understanding of alveolar clefts and their repair by reviewing the historical perspective, objectives for treatment, timing, source of graft, presurgical orthodontics, surgical techniques, postoperative care, and complications.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.2
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• pp.131-135
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• 2003

Severe maxilla1y deficiency can be caused by cleft lip and palate(CLP), other craniofacial deformities, atrophy in the edentulous maxilla, and trauma. Patients with maxillary deficiency present a difficult treatment challenge. Traditionally, this skeletal deformity has been treated by Le Fort osteotomy, skeletal repositioning, and fixation with mini-plates and screws. The drawbacks of this method include a limited amount of anterior maxillary advancement often requiring simultaneous mandibular setback, the inability to create new bone, and minimal soft tissue adaptation to the new position, all of which increase the potential of relapse in case of large advancement. The alternative method of maxillary distraction osteogenesis offers promising results for successfully treatment of these patients while potentially minimizing the risk of relapse.

• Korean Journal of Cleft Lip And Palate
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• v.13 no.1
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• pp.11-22
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• 2010

키르기즈스탄은 옛 실크로드의 한 가운데에 위치한 중앙아시아 국가로서 소련연방이 해체된 뒤 1991년에 독립한 신독립국(Newly Independent States, NIS)의 일원이다. 대한민국과의 공식적인 수교가 1992년에 이루어진 이후 18년이 지났지만 키르기즈스탄 거주 한국인의 숫자는 약 900명에 불과하며 특히 이들 중 대부분은 수도인 비쉬켁(Bishkek)에 살고 있다. 남 키르기즈스탄 제 1의 도시이자 옛 실크로드의 중심지로 유명했던 오쉬(Osh)시에는 2009년 말 기준 약 50여명의 한국인이 살고 있다. 한국얼굴기형환자후원회의 후원으로 구순구개열 자선수술팀은 2002년~2009년까지 11개국, 19회의 자선수술 활동을 다녀왔으나 중앙아시아 국가로의 방문은 키르기즈스탄이 최초였다. 많은 봉사활동국에서 지역적, 문화적 그리고 의료환경적인 어려움이 있었지만 2008년 12월, 2009년 7월 두 번의 키르기즈스탄 오쉬시로의 활동도 예외는 아니었다. 본 논문에서는 최초의 중앙아시아 키르기즈스탄 구순구개열 자선봉사활동에 대한 자세한 보고를, 준비과정에서부터 활동 완료시점까지 서술하고자 한다.

• Korean Journal of Cleft Lip And Palate
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• v.15 no.2
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• pp.97-108
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• 2012

Velopharyngeal insufficiency (VPI) is improper closure of velopharynx during the phonation and swallowing due to various causes, especially appeared in cleft palate patients. The several surgical techniques and speech therapy can be considered in treatment of VPI. The surgical techniques such as Furlow's double opposing Z-plasty, pharyngeal flap, push-back palatoplasty, etc. have been widely used when the speech therapy is not so much effective. However, there is considerable variability in the methods for evaluation and in success criteria making difficult to compare among surgical techniques. This article reviewed the recent articles about comparing the surgical techniques in treatment of VPI. Although there is no significant difference in speech assessment by speech pathologist, Furlow's double opposing Z-plasty is a useful technique especially diminishing hypernasality and nasal emission.

• Korean Journal of Cleft Lip And Palate
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• v.11 no.1
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• pp.23-30
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• 2008

From 2001 year, our department has been participated medical charity for cleft lip and palate patients with Japanese team, on general hospital of Quang Nam Province in Tamky, Vietnam. Also we started medical service with student volunteer in Hue University Hospital, sisterhood relationship with Chonbuk National University, from 2006. The central area of Vietnam is a hard fought-field during the Vietnam war, many chemical weapons (defoliant etc.) were used during war. As the mountain region lose currency, this area was still retarded. We would like to introduce the medical charity service of our department and the classification of operated patients and performed operation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.4
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• pp.321-328
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• 2011

This study is to evaluate the growth and development of the maxilla advanced by transoral distraction osteogenesis of cleft lip and palate children. Subjects are two patients diagnosed as maxillary hypoplasia with cleft lip and palate, and followed up over 5 years after distraction. At the age of 11.4 years (mean), the distraction had been rendered and periodically taken lateral cephalograms were analysed to trace the growth of the maxilla. This cephalometric study showed continuous growth and development of the distracted maxilla to be stable through long term follow-up.

• Korean Journal of Cleft Lip And Palate
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• v.2 no.1_2
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• pp.23-28
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• 1999

The author presents Bardach' s technique for the residual unilateral cleft lip nasal deformity, The key to a successful and stable correction of the nasal deformity is to lengthen the columella on the cleft side and to mobilize alar cartilage from its surrounding tissue, creating a symmetric shape and length, The major advantages of the technique are lengthening of the cleft columella and creation of a symmetric and well-projected nasal tip.

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2003.06a
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• pp.39-39
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• 2003

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.6
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• pp.421-433
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• 2002

In order to elucidate the pathogenesis of cleft lip and palate, first of all, it is necessary to understand the developmental mechanisms of growth factors and extracellular matrix proteins in the tissues of cleft lip and palate. We have performed immunohistochemical studies on human cleft lip and palate tissues to elucidate the pathogenetic implications of cleft lip and palate. 16 specimens from postnatal human cleft lip and palate subjects and 17 specimens from autopsy of prenatal human cleft lip and palate were fixed in 10% buffered formalin, embedded in paraffin. The sections were routinely stained by hematoxylin and eosin, also stained by PAS, and followed by immunohistochemical stainings using the antiseras of growth factors and extracellular matrix proteins such as PCNA, S-100, c-erb-B2, MMP-3, MMP-10, HSP-70, transglutaninase-C, E-cadherin, VEGF, vWF. Both the prenatal and postnatal specimens of cleft lip and palate showed dysplastic proliferation of the basal cell layer, increased infiltration of melanocytes into mucosal epithelium, sebaceous gland hyperplasia ingrowing into the muscular tissue of lip and palate, and fatty infiltration into the submucosal deep connective tissue. The strong reactions of MMP-3 and HSP-70 were detected in the tissues of cleft lip and palate, especially increased in degenerating muscle bundles, while the immunostainings of PCNA and c-erb-B2 were weakly positive in the tissues of cleft lip and palate. These data suggest that the retrogressive tissue degeneration around the cleft areas persistently exist during the prenatal and postnatal period after cleft formation, and the sebaceous gland hyperplasia and fatty infiltration with the intense expression of MMP-3 and HSP-70 is closely related to the muscular degeneration around the cleft area.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.1
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• pp.55-62
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• 2007

Radical paring of the cleft edge during primary cleft lip operation or repeated secondary surgeries can result in tightness of the upper lip. In case, the degree of the resulting side-to-side tension is very severe, the possibility of a lip switch flap must be considered. When the lip tightness accompanies a loss of more than two-thirds of the Cupid's bow, an Abbe flap is an alternative. The disadvantages of Abbe flap are scar formation on the lower lip, design of incision line on the upper lip, disharmony of colors, and the dysfunction of the orbicularis muscle. These problems have been recognized in the literature and extreme discretion has been advised in its application. We experienced four cases of Abbe flap operation which were designed differently to correct the secondary unilateral or bilateral cleft-lip nasal deformities. The Abbe flap operations resulted in removal of the scars and tightness of the upper lip, reconstruction of the Cupid's bow, lengthening of the columella, and therefore secondary cleft-lip nasal deformity could be corrected. It is thought that carefully applied Abbe flap is an appropriate method to relieve horizontal tightness or flattening of the upper lip which occured after primary operation of cleft lip.