• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.3
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• pp.238-246
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• 2007

This study is aimed to elucidate the abnormal growth pattern of human fetal maxilla with cleft lip and palate (CLP). Total 71 fetal maxillae with CLP were obtained from aborted human fetuses. They were examined radiologically for the dimensional changes of maxillary trapezoid (MT) formed by maxillary primary growth centers (MxPGC)(Lee et al., 1992). In palatal radiogram of the CLP maxilla, the MT was traced by the anterior and posterior MxPGCs, and the dimensions of anterior and posterior maxillary widths, maxillary length, and MT length (MTL), and MT area were measured for evaluation of the basic growth pattern of the developing maxilla. The growth of anterior and posterior MxPGCs was severely retarded in the prenatal maxillae with CLPs, showing abnormal shape of MT. Cleft lip subjects without cleft palate also showed arrested growth of MT. Unilateral cleft lipalveolar cleft or cleft palate (UCL-AC/CP) and bilateral cleft lip-alveolar cleft or cleft palate (BCL-AC/CP) showed enhanced abnormal MT pattern. The abnormality of MT was most marked in BCL-AC/CP. It was also observed that the craniofacial malformations other than CLPs produced abnormal MT. In conclusion, the MT growth of prenatal CLP maxilla was severely arrested and resulting in abnormal MT shape on the palatal radiogram. BCL-AC/CP showed more protruded nasal septum than other types of CLPs, while UCL-AC/CP showed severe deviation of the protruded nasal septum towards the non-cleft side. Cleft lip only subjects also showed the abnormal growth of MT. These data suggest that the MT is primarily involved in CLPs, and MT shape could be utilized as a sensitive indicator for the analysis of maxillary malformation in different types of CLPs.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.189-196
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• 1992

Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.

• Proceedings of The Korean Cleft Lip And Palate Association
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• 1997.06a
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• pp.45-45
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• 1997

• Korean Journal of Cleft Lip And Palate
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• v.16 no.1
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• pp.1-8
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• 2013

Purpose : To introduce a more effective and efficient protocol for protraction of maxillary complex in CLP patient and demonstrate it by case presentation. Methods : Miniplates are placed on zygomatic buttress and anterior part of mandible, at the time of secondary alveolar bone graft. During the night time, the orthopedic force is applied by wearing elastics from maxillary miniplates to facemask (500 g per side). During the day time, the intermaxillary elastics connecting maxillary miniplates to mandibular miniplates are applied (200 g per side). During the orthopedic treatment, dental alignment is possible. Results and conclusion : By the new protocol, the intermaxillary relation and occlusion are improved due to the stable intraoral anchorage and better cooperation of patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.366-370
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• 1996

Bilateral cleft lip reconstruction can be performed in one-or two-stages. The choice depends on the surgeon's proficiency and experience. However the type and severity of the cleft must be considered. Complete or incomplete symmetric, bilateral clefts in which the premaxilla is within the alveolar arch or slightly protruded can be successfully treated with simultaneous lip reconstruction on both sides. There are some advantages that one-stage lip reconstruction facilitates creation of a symmetric and balanced lip, retraction of protruding premaxilla and the parent's psychologic satisfaction. However, there are some disadvantages such as micrognathia of the upper jaw by severe scar formation and poor adaptation of flap margins by severe tension. The surgeon must be able to judge and exploit the advantages offered by one-stage approach. We present the case report of one-stage reconstruction of primary bilateral cleft lip with literature reviews.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.4
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• pp.407-413
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• 2000

To evaluate the stability after orthognathic surgery in cleft lip and palate patients using rigid fixation, 20 patients underwent primary repair in childhood and later developed a jaw deformity and malocclusion that required orthognathic surgery were reviewed. Two groups, one of 10 patients performed Le Fort I osteotomy with sagittal split ramus osteotomy and one of 10 patients with sagittal split ramus osteotomy of the mandible, were evaluated. Each group had unilateral cleft only and all alveolar cleft sites had been grafted with autogeneous bone before the orthognathic surgery. The amount of surgical movement and relapse were compared in both horizontal and vertical dimensions. Two-jaw surgery group was more stable than mandibular surgery only group in mandibular position (p< 0.05). Statistically significant relapse was observed in mandibular skeletal point in mandibular surgery group (p<0.05). There was no statistically significant relapse in the skeletal point of two-jaw surgery group. However, the correlation between the horizontal surgical movement and relapse was detected (r = 0.88). This correlation indicates the need of overcorrection. The presence of scar tissues and relatively deficient maxillary bone could be attributed to this close relation between the surgical change and relapse.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.2
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• pp.118-122
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• 2005

Background and Objectives The compensatory articulation not only influences general speech intelligibility, but also prevents precise assessment of the velopharyngeal function. This study was performed to investigate frequently affected phonemes, prevalence and the characteristics of compensatory articulation in the patients with cleft palate having velopharyngeal insufficiency. Material and Method An archival review was taken on 103 cleft palate subjects. Their age ranged from 2.6 to 63 years (mean age of 9.8 years). They were grouped into two : preschool group (n=71) and older patient group (n=32). The prevalence and patterns of compensatory articulation were examined on oral high pressure consonants such as plosives, fricatives and affricates. Results : Compensatory errors were observed in $49.5\%$ of the subjects and were mostly glottal stops with the exception of 4cases who had pharyngeal fricatives in addition to glottal stops. The most frequently substituted phonemes were velar plosives and tense sound. There was no significant difference of prevalence in both groups. However, errors for bilabial and alveolar plosives were more frequently observed in preschool group. Conclusion High prevalence of compensatory articulation observed in both preschool and older age group indicates that their articulation errors tend to remain unless appropriate speech therapy is provided. To improve speech intelligibility of the patients with cleft palate having velopharyngeal insufficiency, it is advisable to address and correct the compensatory articulation errors in their earlier ages.

• Korean Journal of Cleft Lip And Palate
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• v.15 no.2
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• pp.69-82
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• 2012

Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.8.1-8.4
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• 2016

Congenital alveolar synechiae is a rare anomaly mostly presenting in association with cleft palate. Owing to reduced mouth opening, feeding difficulties, and compromised airway in extreme cases along with presentation in early neonatal period, these patients present unique challenges to the surgeon as well as the anesthetist. Here, we discuss the surgical and anesthetic management of this entity in a 12-month-old female child.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.155-157
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• 2007

Objective : There are close relationship between intraoral abnormal structure and speech-functional problem. Patients with cleft palate & ankyloglossia are typical examples. Patients with abnormal structure can be repaired toward normal structure by operation. Ankyloglossia may cause functional limitation - for example, speech disorder - even if adequate surgical treatment were done. And, each individuals have each speech disorders. The objective of this study is to evaluate the speechs of childrens with ankyloglossia, and to determine whether ankyloglossia is associated with articulation problem. We wanted to present criteria for indication of frenectomy. Study design The experimental group is composed of 10 childrens who visited our department of oral and maxillofacial surgery, dental hospital, Chonbuk university, due to ankyloglossia and articulation problem,. The average age is 5 Y 7M, M : F ratio is 4 : 1 at the time of speech test. The VPI consonant discrimination degree, PPVT, PCAT, Nasometer II, Visi-Pitch test result were obtained from each group. Result : There was significant difference for 'language development' through PPVT. Except 3 members of experimental group, all remainder showed retardation for 'language development'. For 'errored consonant rate', data showed more higher scores in alveolar consonant. There 'consonant error' in experimental group, mostly showed 'alveolar consonant', also a major modality of 'consonant error' was mostly distortion. Conclusion : We can judge the severity of ankyloglossia patient by examinig language development degree & speech test of 'alveolar consonant' . And we can make a decision for frenulotomy using these results.