• 대한치과의사협회지
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• 제53권7호
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• pp.457-467
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• 2015

Patients with cleft lip and palate require interdisciplinary treatment to achieve successful rehabilitation. However, there are special difficulties in orthodontic treatment of adult cleft lip and palate patients: 1. Lack of Tissue, Bone, and Soft tissue; 2. Heavy Scar Tissue, Vestibule, and Palate; 3. Severe Anteroposterior discrepancy and Impaired Maxilla; 4. Distortion of Alveolar Ridge; 5. Abnormal Eruption Path and Malalignment of Tooth. Solving these problems, orthodontist should have differential diagnosis on extent of cleft site and residual deformities of adult cleft lip and palate patient. The tooth missing area in cleft site was commonly treated with a removable or fixed prosthesis, but this method is not stable to retain maxillary arch shape. To establish the more stable arch shape in cleft lip and palate, endosseous implants in the alveolar clefts with bone graft is helpful for management of adult cleft lip and palate patient.

• 대한구순구개열학회지
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• 제10권1호
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• pp.23-32
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• 2007

The classic triad of diagnostic signs of submucosal cleft palate which may be present are: 1) bifid uvula 2) short palate with no muscle in the midline and 3) hard palate with a submucous notching defect in the posterior midline. The treatment of submucous cleft palate are V-Y push back palatorrhaphy, and superior based pharyngoplasty implant in the posterior pharynx. The best speech results were in those children operated upon in the younger age group (especially at or before 2 years of age), thus pointing up the importance of early diagnosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권4호
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• pp.310-319
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• 2006

Submucosal type cleft palate is subdivision of the cleft palate. It is very difficult to find submucosal cleft, because when we exam submucosal type cleft palate patients, it seems to be normal. But in fact, there are abnormal union of palatal muscles of submucosal type cleft palate patients. Because of late detection, the treatment - for example, the operation or the speech therapy - for the submucosal type cleft palate patient usually becomes late. Some patients visited our hospital due to speech disorder nevertheless normal intraoral appearance. After precise intraoral examination, we found out submucosal cleft palate. We evaluated the speech before and after surgery of these patients. In this study, we want to find the objective characteristics of submucosal type cleft palate patients, comparing with the normal and the complete cleft palate patients. Experimental groups were 10 submucosal type cleft palate patients and 10 complete cleft palate patients who got the operation in our hospital. And, the controls were 10 normal person. The sentence patterns using in this study were simple 5 vowels. Using CSL program we evaluated the Formant, Bandwidth. We analized the spectral characteristics of speech signals of 3 groups, before and after the operation. In most cases, the formant scores were higher in experimental groups (complete cleft palate group and submucosal type cleft palate group) than controls. There were small differences when speeching /a/, /i/, /e/ between experimental groups and control groups, large differences when speeching /o/, /u/. After surgery the formant scores were decreased in experimental groups (complete cleft palate group and submucosal type cleft palate group). In bandwidth scores, there were no significant differences between experimental groups and controls.

• 대한구순구개열학회지
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• 제8권2호
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• pp.53-62
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• 2005

Submucosal type cleft palate is a kind of cleft palate. A submucosal cleft may result in shortening of the anteroposterior dimension of the hard or soft palates or both. The increased distance along with the lack of muscle connection in the soft palate usually accounts for the lack of palatopharyngeal function in patients with submucosal cleft. Resonance disorders which is found in cleft patients show hypernasality or hyponasality. Many cases of submucosal type cleft palate patients visit our clinics due to hypernasality. In this study, resonance disorders was evaluated through nasalance test. Experimental group was composed of submucosal type cleft palate patients. The patients were treated by a so-called combined therapy, i.e., operation and speech training. To observe the changing pattern by surgery, nasalance test was carried out one time before surgery and three times after surgery. Nasometer II was used as a examination. The questionaire was filled with single vowels & diphthongs. The mean nasalance score of the child was significantly lower than that of the adult at every vowel. An early age at operation (under 10 years) was that a better functional result was achieved with patients. The mean nasalance score of /i/ was highest and that of /a/ was the lowest. The result of corrective surgery in selected cases has achieved improvement in all cases. Hypernasality has been consistently diminished. he operation.

• Archives of Plastic Surgery
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• 제43권6호
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• pp.582-585
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• 2016

It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete cleft palate who spontaneously, without trauma or infection, presented with a palatal fistula at the age of 9 months.

• 대한구순구개열학회지
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• 제11권2호
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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.

• 치과방사선
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• 제15권1호
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• pp.51-57
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• 1985

The purpose of this study is to investigate possible correlation between the dental anomalies and site of cleft in cleft lip and palate. In this study, 142 patients who had cleft lip and/or cleft palate were examined. The results are as follows. 1. The incidence of missing tooth was high in the permanent dentition as compared to the incidence in the deciduous dentition. 2. There was not much difference of incidence of supernumerary tooth between deciduous and permanent dentition in the group of patients who had cleft lip and jaw with or without cleft palate. 3. In the group of patients who had cleft lip and jaw with or without cleft palate, the frequency of incidence of cleft sides was higer in unilateral than bilateral cases. And, incidence of left sides was higher than right sides. 4. The type of cleft between central incisor and canine with missing lateral incisor was most frequent in permanent dentition and the type of cleft between central and lateral incisor was most frequent in deciduous dentition. 5. The type of cleft associated with tooth position in deciduous dentition was not almost the same in the succeeding permanent dentition.

• Archives of Plastic Surgery
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• 제51권4호
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• pp.378-385
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• 2024

Background The best timing of closure of the hard palate in individuals with cleft lip, alveolus, and palate (CLAP) to reach the optimal speech outcomes and maxillary growth is still a subject of debate. This study evaluates changes in compensatory articulatory patterns and resonance in patients with unilateral and bilateral CLAP who underwent simultaneous closure of the hard palate and secondary alveolar bone grafting (ABG). Methods A retrospective study of patients with nonsyndromic unilateral and bilateral CLAP who underwent delayed hard palate closure (DHPC) simultaneously with ABG at 9 to 12 years of age from 2013 to 2018. The articulatory patterns, nasality, degree of hypernasality, facial grimacing, and speech intelligibility were assessed pre- and postoperatively. Results Forty-eight patients were included. DHPC and ABG were performed at the mean age of 10.5 years. Postoperatively hypernasal speech was still present in 54% of patients; however, the degree of hypernasality decreased in 67% (p < 0.001). Grimacing decreased in 27% (p = 0.015). Articulation disorders remained present in 85% (p = 0.375). Intelligible speech (grade 1 or 2) was observed in 71 compared with 35% of patients preoperatively (p < 0.001). Conclusion This study showed an improved resonance and intelligibility following DHPC at the mean age of 10.5 years, however compensatory articulation errors persisted. Sequential treatments such as speech therapy play a key role in improvement of speech and may reduce remaining compensatory mechanisms following DHPC.

• 말소리와 음성과학
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• 제6권2호
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• pp.65-71
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• 2014

The purpose of this study was to investigate whether young children with cleft palate differ from those of noncleft typically developing children in terms of expressive vocabulary size, phonological characteristics and lexical selectivity. A total of 12 children with cleft palate and 12 noncleft children who were matched by age and gender participated in the study. The groups were compared by size of expressive vocabulary reported on Korean version of MacArthur-Bates Communicative Development Inventories and the number of different words, consonant inventory, the percentage of words beginning with obstruents and vowels, nasal, and glottal sounds, and the percentage of words which do not include obstruents in a language sample. Also, correlation analysis were performed to examine the relationship between measures on size of expressive vocabulary and phonological characteristics. The results showed that expressive vocabulary size and consonant inventory for children with cleft palate produced significantly smaller than those for noncleft children. Children with cleft palate produced significantly more words beginning with vowel or which do not include obstruents, and fewer words beginning with obstruents than noncleft children. The two groups showed different results on significant correlations between measures on size of expressive vocabulary and phonological characteristics indicating that children with cleft palate show different lexical selectivity from their noncleft peers. The results suggest that children with cleft palate aged 18-30 months demonstrate a slower rate of lexical and phonological development compared with their noncleft peers and they develop lexical selectivity reflecting cleft palate speech. The results will have a clinical implication on speech-language intervention for young children with cleft palates.

• 대한구순구개열학회지
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• 제15권1호
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• pp.39-50
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• 2012

A submucous cleft palate(SMCP) is characterized by a midline deficiency or lack with/without incorrect positioning of muscular tissues in the soft palate, and by a bony defect in the midline or the center of the hard palate. Velopharyngeal incompetence(VPI) related to this SMCP has been managed by various surgical and prosthetic techniques. Because the individual diagnosis and treatment of SMCP patients was not easy to the speech pathologist and to the maxillofacial reconstructive surgeons, and for the better understanding and for the ideal approaches to the SMCP patients, we reviewed several recent articles about grading system in the SMCP caused by VPI, and summarized in this review article.