• Title/Summary/Keyword: Cleft lip and palate

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IMMUNOHISTOCHEMICAL DETECTION OF GROWTH FACTORS AND EXTRACELLULAR MATRIX PROTEINS IN THE DEGENERATING TISSUES OF PRE-AND POSTNATAL HUMAN CLEFT LIP AND PALATE (태생 및 생후 구순.구개열에 나타나는 조직변성에 대한 성장인자와 세포외 기질 단백의 면역조직화학적 연구)

  • Min, Bong-Gi;Lee, Suk-Keun;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.6
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    • pp.421-433
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    • 2002
  • In order to elucidate the pathogenesis of cleft lip and palate, first of all, it is necessary to understand the developmental mechanisms of growth factors and extracellular matrix proteins in the tissues of cleft lip and palate. We have performed immunohistochemical studies on human cleft lip and palate tissues to elucidate the pathogenetic implications of cleft lip and palate. 16 specimens from postnatal human cleft lip and palate subjects and 17 specimens from autopsy of prenatal human cleft lip and palate were fixed in 10% buffered formalin, embedded in paraffin. The sections were routinely stained by hematoxylin and eosin, also stained by PAS, and followed by immunohistochemical stainings using the antiseras of growth factors and extracellular matrix proteins such as PCNA, S-100, c-erb-B2, MMP-3, MMP-10, HSP-70, transglutaninase-C, E-cadherin, VEGF, vWF. Both the prenatal and postnatal specimens of cleft lip and palate showed dysplastic proliferation of the basal cell layer, increased infiltration of melanocytes into mucosal epithelium, sebaceous gland hyperplasia ingrowing into the muscular tissue of lip and palate, and fatty infiltration into the submucosal deep connective tissue. The strong reactions of MMP-3 and HSP-70 were detected in the tissues of cleft lip and palate, especially increased in degenerating muscle bundles, while the immunostainings of PCNA and c-erb-B2 were weakly positive in the tissues of cleft lip and palate. These data suggest that the retrogressive tissue degeneration around the cleft areas persistently exist during the prenatal and postnatal period after cleft formation, and the sebaceous gland hyperplasia and fatty infiltration with the intense expression of MMP-3 and HSP-70 is closely related to the muscular degeneration around the cleft area.

A survey of trend in cleft lip and palate management in oral & maxillofacial surgery in Korea. (한국 구강악안면외과 수련병원의 구순구개열 환자의 치료경향에 관한 조사)

  • Choi Jin-Young;Jeong Jae-Hwa;Min Byong-Il
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.2
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    • pp.67-73
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    • 2000
  • The purpose of this survey was to obtain an overall view of the status of cleft lip and palate management in Oral and Maxillofacial Surgery(OMFS) in Korea. Korea Cleft lip and Palate Association conducted mailed survey which was composed of 29 questions conceming pre-operative and post-operative management in CLP surgery and completed by 58 training hospital. Of 58 questionnaires sent, 23 were returned(response rate of 40%). Authors compared this results with those of other similar surneys, which reveal much difference between OMFS and Plastic Surgery(PS) in CLP treatment. In OMFS, many surgeons were in favor of presugical orthopaedics than lip adhesion to manage protruded premaxilla. It reflects interdisciplinary team approach between OMFS and orthodontic department reduces the need of lip adhesion through presurgical orthopaedics. Timing of palatal surgery was later than that of PS, which reflects concern for an impediment of maxillaty growth. To our knowledge, this survey may be the first on organization and management for cleft patient in OMFS in Korea.

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Gene Targeting Mouse Genetic Models for Cleft Lip and Palate (구순구개열 발생의 분자유전학 연구를 위한 유전자 표적/적중 생쥐모델의 이용)

  • Baek, Jin-A
    • Korean Journal of Cleft Lip And Palate
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    • v.11 no.2
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    • pp.65-70
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    • 2008
  • Cleft lip and/or palate are common birth defects in humans and the causes including multiple genetic and environmental factors are complex. Combinations of genetic, biochemical, and embryological approaches in the laboratory mice are used to investigate the molecular mechanisms underlying normal craniofacial development and the congenital craniofacial malformations including cleft lip and/or palate. Both forward and reverse genetic approaches are used. The forward genetic approach involves identification of causative genes and molecular pathways disrupted by uncharacterized mutations that cause craniofacial malformations including cleft lip and/or cleft palate. The reverse genetic approach involves generation and analyses of mice carrying null or conditional mutations using the Cre-loxP mediated gene targeting techniques.

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THE USE OF CLASSIFICATION IN PRIMARY AND SECONDARY CLEFT LIP AND NOSE DEFORMITIES IN MEDICAL RECORDS (구순구개열 환자의 의무기록시 분류법의 도입)

  • ChoiI, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.198-204
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    • 1999
  • The treatment of cleft lip and palate patients requires multidisciplinary coorperation, and the involved clinicians rely on the completeness and accuracy of the patient's medical records in developing comprehensive treatment plans. There are so many classifications in cleft lip and palate but each classification has advantages and disadvantages. Furthermore there are few classification or assessment in secondary cleft lip and palate deformities. A modification of Kenahan's Y classification in primary cleft lip and palate and new classification in secondary cleft lip and palate deformities are proposed as a simple and reproducible method. These reproducible classification may be used to facilitate not only storing and analyzing of medical informations in computer but also the planning of secondary repairs

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A STUDY ON THE CRANIOFACIAL MORPHOLOGY OF OPERATED CONGENITAL CLEFT LIP & PALATE (외과적 수술을 받은 선천성 구순 구개열자의 두개 안면 형태에 관한 연구)

  • To, Song-Hee;Sohn, Byung-Wha
    • The korean journal of orthodontics
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    • v.23 no.4 s.43
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    • pp.543-564
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    • 1993
  • A cephalometric study was undertaken to reveal significant differences of craniofacial morphology of operated congenital cleft lip and palate subjects and control subjects. The material for this study consisted of 73 subjects with operated congenital cleft lip and palate subjects(53 males, 20 females) and 110 control subjects (7 males, 34 females) ranging from 3 to 14 years old. Each group was divided into four age groups (3-5, 6-8, 9-11, 12-14 year) and analyzed by Cohen's method and Burstone's method. The following conclusions were obtained ; 1. In Wit's appraisal, there was no difference the cleft lip and palate subjects and the control subjects. 2. In the cleft lip and palate subjects, they had smaller and more retrusive maxilla than the control subjects in both sexes. 3. In the cleft lip and palate subjects, they had more retrusive mandible than the control subjects in both sexes. 4. In the cleft lip and palate subjects, they had more concave profile than the control subjects.

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Early outcomes of cleft and palatal width following anterior palate repair (vomerine flap) in infants with wide cleft lip and palate

  • Saad, Arman Zaharil Mat;Chai, Koh Siang;Sulaiman, Wan Azman Wan;Johar, Siti Fatimah Noor Mat;Halim, Ahmad Sukari
    • 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.

Prenatal Diagnosis of Accompanying Alveolar Cleft and Cleft Palate in Fetuses with Cleft Lip Using Prenatal 3D Sonographic Identification and Antenatal Counseling (구순열 태아에서 3D 산전 초음파를 이용한 치조열 및 구개열의 동반 유무 진단 및 산전상담)

  • Koh, Kyung Suck;Kim, Hoon;Choi, Jong Woo;Won, Hye Sung;Kim, Sun Kwon
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.181-185
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    • 2007
  • Purpose: Cleft lip and/or palate is the most common congenital facial anomaly whose incidence is about 1 in 500~1000 live births. As this anomaly may be associated with the serious chromosomal anomalies or the multiple organ abnormalities resulting in the fetal loss or perinatal maternal morbidity and mortality, careful prenatal counseling with early and accurate detection is important. Although conventional prenatal ultrasound(US) examination in midterm pregnancy has been applied for screening of cleft lip, there are definite limitations in the diagnosis of accompanying cleft palate or alveolar cleft. We applied high-resolution 3D US along the serial axial, coronal and sagittal plane so that we could diagnose the cleft palate and/or alveolar cleft in fetuses with cleft lip. Methods: From May 2005 to September 2005, 20 fetuses with cleft lip were examined with prenatal 3D US. Average maternal age was 28.8 years old(24-35 years old), and average gestational age was 24.8 weeks(17.6 to 34.2 weeks). Consecutive axial, coronal and sagittal multislice view were obtained via prenatal 3D US examination and diagnosis of cleft palate and/or alveolar cleft in cleft lip fetuses was followed. Results: With noninvasive and safe prenatal 3D US examination, 17 of 20 cleft lip fetuses were demonstrated to have cleft palate and/or alveolar cleft. Prenatal counseling according to the result was made. Conclusion: Existing prenatal US examination is suitable for screening the cleft lip fetuses but has limitation in identifying the related existence of cleft palate and/ or alveolar cleft. Authors verify the presence of cleft palate and/or alveolar cleft acquiring the successive multislice axial, coronal, and sagittal view with prenatal 3D US examination. Therefore, prenatal 3D US examination could be regarded as a noninvasive and secure screening modality in fetuses with cleft lip for confirming whether cleft palate and/or alveolar cleft is accompanied.

Unilateral Segmental Palatal Distraction in Unilateral Cleft Lip and Palate Patient (편측성 구순구개열 환자에서의 편측성 분절 구개골 신장술)

  • Baek Seung-Hak;Kim Na-Young;Choi Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.43-51
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    • 2003
  • Patients with unilateral cleft lip and palate (UCLP) usually present unilateral cross bite due to collapse of the maxillary minor segment. Unequal expansion of the palate is needed to resolve this problem in UCLP patient. Unilateral segmental palatal distraction (USPD) after Le Fort I osteotomy and the oblique placed orthodontic expansion screw (Hyrax) can be used to correct the unilateral cross bite. 1his case report describes the effects of USPD of the collapsed maxillary minor segment on patient with unilateral cleft lip and palate.

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Tessier number 7 cleft with unilateral complete cleft lip and palate: a case report

  • Lee, Hyun Seung;Seo, Hyung Joon;Bae, Yong Chan
    • 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.