• Archives of Plastic Surgery
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• v.42 no.6
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• pp.704-708
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• 2015

Background Various techniques for lengthening short columellae have been used for bilateral cleft nose repair. However, previous methods have not yielded satisfactory results. We performed a full-thickness skin graft to lengthen short columellae during secondary cleft nose repair in adult patients. Methods Ten bilateral cleft lip and nose patients underwent secondary cheiloplasty with open rhinoplasty between July 2008 and August 2014. The patients underwent a full-thickness skin graft on the medial crura to elongate the columella. The average age of the patients at the time of surgery was 22.2 years. Nasal profiles were evaluated before and after the operation using the photogrammetric method. Results The nasal profiles were improved in all patients, and all skin grafts were well taken, with the exception of one patient. Columellar height, nostril height, and columella-lip angle increased, and nasal width decreased significantly. The ratios of columellar height to nasal height, columellar height to nasal width, and nasal height to nasal width increased to a statistically significant extent. Conclusions Columella lengthening with a full-thickness skin graft is a simple and effective method for the repair of severely short columellae in bilateral cleft nose patients. We had satisfactory outcomes, with good color matching and aesthetically pleasing contours.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.390-395
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• 1994

The author evaluated the nasal asymmetry after primary operations in the patients with unilateral cleft lip using full face photographs. The results are as follows : 1. Nasal deviation angle is average 2.98+3.01 degree(ranged from 0 to 10 degree), significantly different from control group(p<0.05). 2. Nasal deviation angle is average 5.1% when inter-medial canthal distance is 100%, significantly different from control group(p<0.05). 3. Difference in nostril size between cleft and noncleft side is 2.1% when inter-medial canthal distance is 100%, significantly different from control group(p<0.05). 4. Nasal attractiveness analysis shows higher points in difference in nostril size, nasal deviation, nasal form in that order. 5. Nasal asymmetry after primary operations in the patients with unilateral cleft lip using full face photographs is related with Nasal deviation angle, Nasal deviation distance and Difference in nostril size between cleft and noncleft side.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.2
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• pp.168-172
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• 1998

Several kinds of surgical methods have been used to treat the submucous cleft palate with hypernasality. The purpose of this study was to evaluate the double opposing Z-plasty which is one of the newly established surgical methods by Dr. Furlow in three cases of submucous cleft palate with hypernasality operated in this department. There were a number of advantage of double opposing Z-plasty. The surgery is adaptable for use in early patient. Midfacial growth retardation and complication were not seen in all cases. Hypernasality was improved subjectively. Using the nasometer, the nasalance score of the postoperative period was compared with that of before surgery, much improvement were noted in 'Ah', 'PaPa'. And fiberoptic endoscope was used to evaluate the velopharyngeal closure pattern. Velopharyngeal closure pattern with velum was improved dramatically, Double opposing Z-plasty seem to be a good procedure for the treatment of submucous cleft palate with hypernasality.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.303-308
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• 2008

Purpose: The purpose of this study is to develop three-dimensional computerized anthropometry(3DCA) and to compare its reliability and accuracy 3DCA with manual anthropometry(MA) for measurement of lips and nasal deformities in unilateral cleft lips and palate(UCLP) patients. Methods: Samples were consisted of six UCLP patients whose facial plaster models were available immediately before and 3 months after the cleft lip surgery. MA of the facial plaster models was carried out using an electronic caliper. In 3DCA, three-dimensional auto-measuring program was used to digitize landmarks and to measure three-dimensional virtual facial models (3DVFM), which was generated with a laser scanner and 3D virtual modeling program. Intraclass correlation coefficients(ICC) were calculated to evaluate reliability and reproducibility of the variables in both methods, and Wilcoxon's signed rank test was done to investigate the difference in values of the same variables of facial models of each patient between two methods. Results: All ICC values were higher than 0.8, so both methods could be considered reliable. Although most variables showed statistical differences between two methods(p<0.05), differences between mean values were very small and could be considered not significant in clinical situation. Conclusion: In clinical situation, 3DCA can be an objective, reliable and accurate tool for evaluation of lips and nasal deformities in the cleft patients.

• Archives of Craniofacial Surgery
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• v.21 no.1
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• pp.64-68
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• 2020

The coexistence of craniofacial cleft and bilateral choanal atresia has only been reported in three cases in the literature, and only one of those cases involved a Tessier number 3 facial cleft. It is also rare for bilateral choanal atresia to be found in adulthood, with 10 previous cases reported in the literature. This report presents the case of a 19-year-old woman with a Tessier number 3 facial cleft who was diagnosed with bilateral choanal atresia in adulthood. At first, the diagnosis of bilateral choanal atresia was missed and septoplasty was performed. After septoplasty, the patient's symptoms did not improve, and an endoscopic examination revealed previously unnoticed bilateral choanal atresia. Computed tomography showed left membranous atresia and right bony atresia. The patient underwent an operation for opening and widening of the left choana with an image-guided navigation system (IGNS), which enabled accurate localization of the lesion while ensuring patient safety. Postoperatively, the patient became able to engage in nasal breathing and reported that it was easier for her to breathe, and there were no signs of restenosis at a 26-month follow-up. The patient was successfully treated with an IGNS.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.2
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• pp.141-150
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• 2004

The cleft lip and palate charity operation team visited Binh Duong General Hospital in Vietnam from 17th Dec to 25th Dec 2004. Total 25 cleft lip and palate patients (male : female = 15:10) were undergone the operation. The mean age of the patients was 13.6 year. The types of surgical operation were primary cheilorrhaphy (8 cases), primary palatorrhaphy(10 cases), pharyngoplasty(2 cases), scar revision(3 cases), alveolorrhaphy(2 cases). There were no intraoperative and immediate postoperative complications. The year 2004 was the 10th charity operation in the same area so it is meaningful to review the start of this charity mission and the course, and the future of our activity.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.400-406
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• 2017

Background The purpose of this study was to evaluate changes in nasal growth after the implementation of a preoperative nasal retainer in patients with bilateral incomplete cleft lip. Methods Twenty-six infants with bilateral incomplete cleft lip and cleft palate were included in the study. A preoperative nasal retainer was applied in 5 patients from the time of birth to 2.6-3.5 months before primary cheiloplasty. Twenty-one patients who were treated without a preoperative nasal retainer were placed in the control group. Standard frontal, basal, and lateral view photographs were taken 3 weeks before cheiloplasty, immediately after cheiloplasty, and at the 1- and 3-year postoperative follow-up visits. The columella and nasal growth ratio and nasolabial angle were indirectly measured using photographic anthropometry. Results The ratio of columella length to nasal tip protrusion significantly increased after the implementation of a preoperative nasal retainer compared to the control group for up to 3 years postoperatively (P<0.01 for all time points). The ratios of nasal width to facial width, nasal width to intercanthal distance, columellar width to nasal width, and the nasolabial angle, for the two groups were not significantly different at any time point. Conclusions Implementation of a preoperative nasal retainer provided significant advantages for achieving columellar elongation for up to 3 years postoperatively. It is a simple, reasonable option for correcting nostril shape, preventing deformities, and guiding development of facial structures.

• Archives of Craniofacial Surgery
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• v.19 no.1
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• pp.3-12
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• 2018

Background: Millard's rotation-advancement repair, which is used by many surgeons, can make a natural philtral column, but most surgeons use a modification of the rotation-advancement flap. The purpose of this article is to introduce a modification utilized by the authors and to provide detailed surgical procedure. Methods: We retrospectively reviewed 82 patients' medical records and presented surgical technique and outcomes. The main features of the authors' strategy are emphasizing horizontal length of the lip, orbicularis oris muscle duplication for improving the definition of the philtral column, overcorrection of domal portion than the non-cleft side in order to compensate for the recurrence during growth. Two judges rated two times the appearance of the patients' nose and lip using Asher-McDade aesthetic index. Intra- and interobserver reliabilities were determined using Cohen's kappa statistics. Results: All patients recovered eventually after surgery; however, two patients have a minor complications (wound infection in one patient, wound disruption due to trauma in the other patient). The improvement of the aesthetic results can be achieved with this modified Millard technique. Total mean scores of the Asher-McDade index was 2.08, fair to good appearance. The intraobserver reliabilities were substantial to almost perfect agreement and the interobserver reliabilities were moderate to almost perfect agreement. Conclusion: We modified Millard method for repair of complete unilateral cleft lip. The surgical outcomes were favorable in long-term follow-up. We hope our technique will serve as a guide for those new to the procedure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.5
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• pp.241-253
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• 2019

This study evaluated and compared the donor site morbidity following minimally invasive and conventional open harvesting of iliac bone for secondary alveolar bone grafting in cleft palate patients. A thorough electronic search of PubMed, Google Scholar, EMBASE, and an institutional library and manual search of various journals was done; Inclusion criteria: 1) full-text articles using a minimally invasive or conventional open harvesting technique for iliac bone for secondary alveolar grafting in cleft palate patients and 2) articles published between January 1, 2001 and June 30, 2017 and Exclusion criteria: 1) articles published in languages other than English, 2) case reports, case series, animal studies, in vitro studies, and letters to the editor, and 3) full-text article unavailable even after writing to the authors. Preliminary screening of 274 studies excluded 223 studies for not meeting the eligibility criteria. Of the remaining 51 studies, 19 were removed for being duplicates. Of the remaining 32 studies, 15 were excluded after reading the abstract. Of the 17 studies that were left, 2 were excluded because they were in a language other than English, and 2 were excluded because the study group did not mention cleft palate patients. Thus, 13 studies providing results for a total of 654 patients were included in this qualitative synthesis. Minimally invasive bone graft harvest techniques are better than the conventional open iliac bone harvest method because they offer shorter operative time, decreased requirement for pain medications, less pain on discharge, and a shorter hospital stay.

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2003.06a
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• pp.40-40
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• 2003