• Archives of Plastic Surgery
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• v.48 no.6
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• pp.630-634
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• 2021

To date, there have been no reports of patients showing a Tessier number 7 cleft with unilateral complete cleft lip and palate. Furthermore, no studies have established the sequence, plan, or timing of surgical methods for treating patients presenting the above anomalies simultaneously. We report a case of a Tessier number 7 cleft with unilateral complete cleft lip and palate. Two months after birth, lip adhesion was performed on the unilateral complete cleft lip and total excision was performed on the skin tag. At 4 months of age, Tessier number 7 cleft was corrected. At 6 months of age, surgery involving two small triangular flaps was performed on the unilateral incomplete cleft lip after performing lip adhesion. At 13 months of age, two-flap palatoplasty with a vomer flap was performed on the complete cleft palate. At 6 years of age, open rhinoplasty was performed on the unilateral cleft lip nose deformity. At 9 years of age, bone grafting was performed for the alveolar cleft. At follow-up appointments up to 13 years of age, there were no major complications. Here, we present this patient, surgical procedures and timelines, and show our results demonstrating good postoperative outcomes.

• Korean Journal of Cleft Lip And Palate
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• v.5 no.1
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• pp.27-42
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• 2002

This study was designed to evaluate the morphology and the position of the mandible in the complete unilateral cleft lip and palate patients, Craniofacial skeletal morphology pattern was analyzed on the lateral cephalometric radiographs of the 50 subjects of complete unilateral cleft lip and palate, the 50 normal and 50 class III, Each group was divided into child and adult sub-groups, All the data were tested statistically. The results were as follows: I, In the comparison with the normal group, complete cleft group showed smaller angular, condylar length, clockwisely rotated mandible and larger NMe/SGo(p<0.01). 2, In the comparison with the class III group, the complete cleft group showed significantly smaller angular, condylar, ramal, body length of the mandible(p<0,01). 3. As for the position of the mandibular condyle to the cranial base, the class III group was the most anterior, the normal group was the most posterior and the complete cleft group was in the middle(p<0.05). 4. In the comparison with child group, the normal adult group showed smaller mandibular angle and mandibular plane angle, but not the other two groups. And the complete cleft group and the class III group showed the similar change. The normal and class III group showed increased XiCd/XiPog, but not the complete cleft group(p<0.01).

• Korean Journal of Cleft Lip And Palate
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• v.2 no.1_2
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• pp.1-4
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• 1999

• Korean Journal of Cleft Lip And Palate
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• v.3 no.1
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• pp.37-41
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• 2000

• 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.

• Korean Journal of Cleft Lip And Palate
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• v.13 no.2
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• pp.77-84
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• 2010

Vomer flap is used to repair anterior hard palate in complete cleft lip and palate patients. As the midline structure located in between the two cleft segments of hard palate, the vomer flap is very useful because of its vicinity to cleft site and their ease of execution when it is done with primary cheiloplasty simultaneously. In addition, the quality of tissue is very similar to that of the nasal mucosa with good vascularity. In cases of simultaneous repair of cleft lip with anterior palate using vomer flap, the hard palate can be repaired at the same time with primary cheiloplasty which is earlier period than other techniques. With simultaneous close of cleft lip and cleft hard palate by vomer flap, subsequent palatoplasty does not require wide dissection, and consequently chance of oronasal fistula formation will be minimized. Additionally, surgical time will be reduced and, the harmful effects on mid-facial growth will be diminished. In this article, we will introduce the comprehensive vomer flap technique with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.1
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• pp.13-15
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• 2014

Epithelial cysts are benign epithelium-lined lesions that contain fluid or semisolid material. Most epithelial cysts in the oral cavity occur in the anterior part of the mouth floor. Cysts arising on the uvula in a cleft palate patient are rare. Intraoral examination in a 14-month-old boy with a complete cleft lip and palate revealed a cystic lesion on the right uvula. The lesion was excised and push-back palatorrhaphy with Z-plasty on the uvula was performed. Histopathological examination diagnosed an epithelial cyst. We report a case of an epithelial cyst of uvula in a patient with a unilateral complete cleft lip and palate.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.518-524
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• 2019

Background Anterior palatal repair performed during cleft lip repair using a vomerine flap may assist in recruiting additional soft tissue for subsequent completion of palatoplasty, especially in patients with a wide cleft. We present our early results in the hope of triggering a re-evaluation of this technique regarding its advantages for maxillary growth through further studies of patients with a wide cleft. Methods A retrospective analysis of patients with complete unilateral and bilateral cleft lip and palate was performed, including cleft and palatal measurements taken during initial surgery (lip repair together with anterior palate repair) and upon completion of palatoplasty. Results In total, 14 patients were included in this study, of whom nine (63.3%) had unilateral cleft lip and palate and five (37.5%) had bilateral cleft. All patients had a wide cleft palate. Lip and anterior palate repair was done at a median age of 3 months, while completion of palatoplasty was done at a median age of 10.5 months. Measurements taken upon completion of palatoplasty showed significant cleft width reduction in the mid-palate and intertubercle regions; however, the palatal arch distances at nearby landmarks showed non-significant marginal changes. Conclusions Anterior palate repair using a vomerine flap significantly reduced the remaining cleft width, while the palatal width remained. Further research is warranted to explore the long-term effects of this technique in wide cleft patients in terms of facial growth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.257-268
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• 2021

Objectives: Cleft lip and palate is a common congenital anomaly that impairs the aesthetics, speech, hearing, and psychological and social life of an individual. To achieve good aesthetic outcomes, presurgical nasoalveolar molding (NAM) has become important. Currently, the intraoral NAM technique is widely practiced. Numerous modifications have been made to intraoral NAM techniques, but the original problem of compliance leading to discontinuation of treatment remains unsolved. Therefore, the present study compared an extraoral NAM technique with the intraoral NAM technique. Materials and Methods: Twenty infants with complete unilateral cleft lip and palate were included and divided into two equal groups. Group A received the intraoral NAM technique, and Group B received the extraoral NAM technique. Pre- and postoperative extraoral and intraoral measurements were recorded. Results: Groups A and B did not differ significantly in any extraoral or intraoral parameter. Conclusion: The extraoral NAM technique is as effective as the intraoral NAM technique in achieving significant nasal and alveolar changes in complete unilateral cleft lip and palate patients. Additionally, it reduces the need for frequent hospital visits for activation and the stress associated with the insertion and removal of the intraoral NAM plate, thereby improving compliance.

• Korean Journal of Cleft Lip And Palate
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• v.15 no.2
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• pp.61-68
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• 2012

Cleft lip and palate is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation advancement flap method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, Millard's rotation advancement flap method has its advantage in designing the flap using the patient's anatomic landmarks. For performing this rotation advancement technique, skillful operation is needed to obtain esthetically satisfactory results. Vomer flap sometimes is used to repair anterior hard palate in complete cleft lip and palate patients. Vomerine tissue is readily available in the vicinity of the palatal defect and elevation of the vomerine flap is relatively simple procedure. In this article, we will introduce the comprehensive vomer flap technique conjunction with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with Millard's rotation advancement method and vomer flap.