• Title/Summary/Keyword: Cleft surgery

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Speech Outcome and Timing of Furlow Palatoplasty in Cleft Palate (Furlow 구개성형술을 시행한 구개열에서 언어발달과 적절한 수술시기)

  • Jin, Ung Sik;Kim, Suk Wha;Lee, Soung Joo
    • Archives of Plastic Surgery
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    • v.33 no.1
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    • pp.67-74
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    • 2006
  • Palatoplasty using Furlow's double-opposing Z-plasty has been performed from June, 1995 to September, 1999 at Seoul National University Children's Hospital. The goal of this study is to determine the optimal timing of repair and cleft severity affecting velopharyngeal function. This is the retrospective study of patients operated by the second author. The mean age of patients was 10.53 months. The patients could be divided into three groups-isolated cleft palate(n=70), unilateral cleft lip and palate(n=88), and bilateral cleft lip and palate(n=42). To evaluate the velopharyngeal function, we used two parameters, speech evaluation and cineofluorography using DSR(digital subtraction radiography). Also, to determine the relevance between cleft severity and speech development, we measured the distance between maxillary tuberosities and cleft margins. Among 200 patients, about 96% had no or minimal hypernasality and 87% had no or mild nasal emission. The cleft width and length of soft palate seemed not to be related with the speech development. Palatoplasty at the age under 12 months resulted in less 'nasal emission' and better 'articulation' of the parameters that were assessed at the age of 7 years. It can be concluded Furlow palatoplasty shows satisfactory results and also it seems that it is better to perform the operation before the age of 12 months.

Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods

  • Al-Zajrawee, Mustafa Zahi;Aljodah, Mohammed Abd-Alhussein;Hassan, Qays Ahmed
    • Archives of Plastic Surgery
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    • v.46 no.2
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    • pp.114-121
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    • 2019
  • Background Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle. Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a modification of the Millard and Manchester techniques. Patients with a very wide cleft lip and protruded or rotated premaxilla were excluded from this study. We analyzed 30 normal children for a comparison with our patients in terms of anthropometric measurements. Results By the end of the follow-up period (between 9 and 19 months), all our patients had obtained a full central segment with adequate white roll in the central segment and a deep gingivolabial sulcus, and we obtained nearly normal anthropometric measurements in comparison with age-matched normal children. Conclusions We recommend this modified technique for the treatment of bilateral cleft lip deformity.

Congenital Cleft Lip Repair Based on Delaire Philosophy II: Functional Cheilo-rhinoplasty (Delaire 개념에 기반한 선천성 구순열의 치료 II: 기능적 구순비성형술)

  • Kim, Soung-Min;Seo, Mi-Hyun;Eo, Mi-Young;Lee, Suk-Keun;Myoung, Hoon;Lee, Jong-Ho;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.13 no.2
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    • pp.63-76
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    • 2010
  • After introduction of Delaire's basic philosophy, to consider the normal and pathologic anatomy, the role of some structures, such as nasal septum, musculature, and tongue, and some functions, such as dental occlusion or nasal respiration, which play important roles in maxillary and particularly premaxillary growth, on the Korean Journal of cleft lip and palate in 2009, Delaire's primary functional cheilorhinoplasty (FCR) in the unilateral and bilateral cleft lip patients was summarized and introduced according to already published literatures and lectures. This paper will be the second publishment of Delaire philosophy with Korean language.

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Primary repair of untreated cleft palate in an elderly patient: a case report

  • Lee, Jun Sang;Lee, Jae-Yeol;Kim, Yong-Deok;Song, Jae-Min;Choi, Won Hyuk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.1
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    • pp.47-50
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    • 2021
  • Untreated adult or elderly cleft lip and palate patients are rarely seen, but studies on delayed primary palatal closure have been performed in the less developed Asian and African countries, where access to medical care is difficult. A 64-year-old woman visited our clinic with untreated cleft palate with a 40×20-mm-wide defect in the medial palate. Two-flap palatoplasty under general anesthesia was performed to close the cleft palate. After 1 month, the result was favorable without any complications including oronasal fistula. Cleft palate primary repair in an elderly patient is rare and has some surgical problems that are associated with a wide range of defects, but good results can be obtained if surgery is performed well with appropriate considerations.

Anthropometric Analysis of Unilateral Cleft Lip Patient (편측성 구순열 환아의 안모 계측 연구)

  • Koh, Kwang-Moo;Leem, Dae-Ho;Baek, Jin-A;Ko, Seung-O;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.392-400
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    • 2011
  • Purpose: Cleft lip and palate is one of the most frequent hereditary deformities of the maxillofacial region which can arise in facial and jaw abnormalities as well as malocclusion and speech problems. In particular, unilateral cleft lip and palate is characterized by midface deformity resulting in maxillary anterior nasal septal deviation and nasal deformity. The aim of this study is to analyze the facial deformity of untreated unilateral cleft lip patients for contribution to primary cheiloplasty. Methods: Thirty-three patients with unilateral cleft lip and palate were impressioned before operation and facial casts were made. The casts were classified into complete cleft lip and incomplete cleft lip groups and each group were classified into affected side and normal side. Anthropometric reference points and lines were setted up and analysis between points and lines were made. Results and Conclusion: The obtained results were as follows: 1. The intercanthal width had no significant difference between the incomplete and complete cleft lip groups. 2. Cleft width and alar base width were greater in the complete group, and nasal tip protrusion was greater in the incomplete group. 3. Involved alar width and nostril width were greater in the complete group and in both complete and incomplete groups, involved alar width and nostril width were greater than the non-involved side. 4. The lateral deviation of the subnasale was greater in the complete group in both involved and non-involved sides. 5. The nasal laterale was placed inferiorly in both cleft groups. 6. The subnasale was deviated to the non-involved side in both cleft groups. 7. The nose tip was deviated to the non-involved side in both cleft groups and had greater lateral deviation in the complete cleft group. 8. The midpoint of cupid's bow had no vertical difference between complete and incomplete groups, but had a greater lateral deviation in the complete group. 9. In the complete cleft group, correlation between differences in cleft width and nostril width and columella height difference were obtained.

Management of Alveolar Cleft

  • Kyung, Hyunwoo;Kang, Nakheon
    • Archives of Craniofacial Surgery
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    • v.16 no.2
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    • pp.49-52
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    • 2015
  • The alveolar cleft has not received as much attention as labial or palatal clefts, and the management of this cleft remains controversial. The management of alveolar cleft is varied, according to the timing of operation, surgical approach, and the choice of graft material. Gingivoperiosteoplasty does not yet have a clear concensus among surgeons. Primary bone graft is associated with maxillary retrusion, and because of this, secondary bone graft is the most widely adopted. However, a number of surgeons employ presurgical palatal appliance prior to primary alveolar bone graft and have found ways to minimize flap dissection, which is reported to decrease the rate of facial growth attenuation and crossbite. In this article, the authors wish to review the literature regarding various advantages and disadvantages of these approaches.

Craniofacial Centre of Children's Hospital Boston and Sequential Management for Cleft Lip and Palate (Children's Hospital Boston의 Craniofacial Centre와 구순구개열 환자의 순차적 치료순서)

  • Jung, Young-Soo
    • Korean Journal of Cleft Lip And Palate
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    • v.11 no.2
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    • pp.59-63
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    • 2008
  • Craniofacial Centre at Children's Hospital Boston is a worldwide leader in the care of children and adolescents with craniofacial anomalies especially with cleft lip and/or cleft palate, which provides a team approach to the evaluation, diagnosis and treatment of children and adults with congenital (present at birth) or acquired facial deformities. This is staffed by an experienced team of clinicians, such as in oral and maxillofacial surgery, plastic surgery, neurosurgery, dentistry, audiology, speech and language pathology, genetics, psychiatry, otolaryngology, and social work, all with specialized training in the care of children with craniofacial anomalies. Here, there is a short introduction of history, attending surgeons, works, and sequential treatment for cleft lip/palate patients about this institution.

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A comprehensive review of surgical techniques in unilateral cleft lip repair

  • Tae-Suk Oh;Young Chul Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.3
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    • pp.91-104
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    • 2023
  • Unilateral cleft lip is a common congenital anomaly that affects the appearance and function of the upper lip and nose. Surgical repair of cleft lip aims to restore the normal anatomy and functionality of the affected structures. In recent years, several advances have been made in the field of cleft lip repair, including new surgical techniques and approaches. This comprehensive review discusses the surgical management of patients with unilateral cleft lip and palate and provides step-by-step instructions for the surgical procedures.

Treatment of Otitis Media in Cleft Palate (구개열 환자에 있어 중이염의 치료)

  • Pang, Kang-Mi;Ji, Young-Min;Kim, Seong-Min;Myoung, Hoon;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pil-Hoon;Kim, Myung-Jin;Hwang, Soon-Jung
    • Korean Journal of Cleft Lip And Palate
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    • v.10 no.2
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    • pp.89-96
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    • 2007
  • Otitis media with effusion is known to be very common among children with cleft palate and is the common cause of acquired hearing loss in childhood. The purpose of the present study was to examine the anatomic variances, incidence and treatment of middle ear disease in children with cleft palate. In Korea, before 4-year-old age, the prevalence of otitis media was as high as 91.7%. Common treatments for otitis media were conservative or surgical treatment. The medical treatment options include the use of decongestants, antihistamines, antibiotics and mucolytics. Surgical treatment options include grommet insertion, myringotomy. Unlike the case for children without clefts, cleft patient has a higher incidence of recurrence, so surgical treatment between the age of 3 month and 6 month was recommended. The effect of palatoplasty on middle ear disease has remained controversial. Early and periodic evaluation on the symptomatic infection or significant of hearing loss was recommended.

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