• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 1997년도 종합학술대회
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• pp.32-32
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• 1997

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권4호
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• pp.309-312
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• 2016

Patients with cleft lip and palate (CLP) must undergo corrective surgeries during infancy and early childhood. Many patients with CLP undergo orthognathic surgery during their childhood for correction of skeletal asymmetries or pharyngoplasty with a pharyngeal flap to improve the quality of speech and velopharyngeal function. During orthognathic surgeries, nasotracheal intubation is performed under general anesthesia. In our case report, the patient had undergone palatoplasty and pharygoplasty previously. During the orthognathic surgery, a flexible fiberoptic bronchoscope-guided nasotracheal tube was inserted through the pharyngeal flap ostium; however, active bleeding occurred in the nasopharynx. Bleeding occurred because the flap was torn. After achieving hemostasis, the surgery was completed successfully. Thus, if a patient may show the potential for velopharyngeal port obstruction, nasotracheal intubation should be performed with utmost care.

• 대한구순구개열학회지
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• 제7권1호
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• pp.25-34
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• 2004

본 연구는 선천성 구개열 환자에서 구개성형술후 구개 길이가 어느 정도 연장되는지 알아보기 위하여 시행되었다. 199i년 4월부터 2004년 4월까지 10년동안 전남대학교병원 구강악안면외과에서 치료 받은 구개열 환자 중 추적조사가 가능한 112명을 대상으로 역학적 특성, 사용된 구개성형술식, 구개 길이의 연장 정도 및 술후 합병증에 대하여 임상기록을 조사하고 분석하였다. 불완전구개열 및 완전구개열 환자의 비는 1.6:1이었다. 성별분포는 완전구개열에서는 남자가 2.1배 많았고, 불완전구개열에서는 여자가 1.2배 많았다. 불완전구개열에서는 Dorrance법과 Wardill법을, 완전구개 열에서는 Wardill법과 Furlow법, two flap법, Perko법을 많이 사용하였다. 구개열 형태별 구개 길이의 연장 정도는 불완전구개열에서 평균 5.84 m(11.295) 연장되어 완전구개열에서의 평균 4.71 w(9.f%)보다 1.13 mm(1.6%) 더 많이 연장되었으나 통계학적 유의성은 없었다. 구개성형술식에 따른 구개 길이의 연장 정도는 Furlow법에서 5.70 m(10.9%) 연장되어 push back법에서의 5.33 in(10.7%)보다0.37 mm(0.2%) 더 많이 연장되었으나 역시 통계학적 유의성은 없었다. 술후 합병증으로 구개누공이 27예(24%b)로 가장 많이 발생하였다. 이상의 결과에서 구개성형술후 구개 길이가 3.5%부터 24.0%까지 평균 10.8% 연장되어 언어 기능에 기여함을 알 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권4호
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• pp.430-435
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• 2000

Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.384-389
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• 1994

A female child with unilateral midpalatal cleft was successfully treated by Wardill V-Y pushback palatal flap and superiorly based pharyngeal flap simultaneously. The advantages of this method are to prepare the favorable background of postoperative speech correction and additional nasal lining. We can try this simultaneous operation in delayed cleft palate repair.

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 1997년도 종합학술대회
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• pp.36-36
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• 1997

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 1997년도 종합학술대회
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• pp.40-40
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• 1997

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 2002년도 종합학술대회
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• pp.42-42
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• 2002

• 대한두개안면성형외과학회지
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• 제19권3호
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• pp.163-167
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• 2018

Velopharyngeal insufficiency (VPI) is a common complication after primary palatoplasty. Although the several surgical treatments of VPI have been introduced, there is no consensus guide to select the optimal surgical treatment for VPI patients. The selection of surgical treatment for VPI depends on a multimodal patient evaluation, such as perceptual speech evaluation, nasometery and nasoendoscopy. We can provide more adequate treatment for VPI through the deeper understanding of anatomy and physiology in VPI.

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 1998년도 종합학술대회
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• pp.21-21
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• 1998