• Title, Summary, Keyword: Palate

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Surgical Closure of Cleft Hard Palate in a Dog (개에서 경구개열의 외과적 교정례)

  • 권영삼;장환수;장광호
    • Journal of Veterinary Clinics
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    • v.21 no.3
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    • pp.326-328
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    • 2004
  • A 7-month-old, weak female dachshund dog which had signs of cough and sneezing while eating was admitted. This case was diagnosed as cleft hard palate by the physical and blood examination. After aseptic surgical preparation, a surgical method utilizing mucoperiosteal and buccal flap technique, in which accurate apposition and secure closure was very important, was used successfully. The defect of hard palate was healed completely on 10 days after surgery without any other complication.

The Thickness Measurement of Masticatory Mucosa on the Hard Palate and Maxillary Tuberosity in Healthy Korean Adults (건강한 한국 성인에서 경구개와 상악결절 부위 저작점막의 두께 측정)

  • Cho, Ik-Hyun;Park, Jung-Mi;Chang, Moon-Taek;Kim, Hyung-Seop;Kim, Hyun-Chul
    • Journal of Periodontal and Implant Science
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    • v.31 no.3
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    • pp.641-649
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    • 2001
  • The aim of present study was to assess the thickness of masticatory mucosa on the hard palate and tuberosity as a potential donor site for mucogingival surgery. Thickness measurement was performed in 30 dental college students who are periodontally healthy, with a recently developed, ultrasonic device(SDM). The mean age of study subjects was 23.7(range 21-29) years old and the subjects were composed of 18 males and 12 females. Eighteen standard measurement points were defined on the hard palate, located on 3 lines which ran at different distances parallel to the gingival margin. Six positions were designated on each of these 3 lines between the level of the canine and the second molar. On the tuberosity, 6 standard measurement points were defined, located on 2 lines running parallel to the gingival margin at different distances. Data were analyzed to determine differences in gender, between different positions, and between lines, by an analysis of variance. The results showed that the mucosa of the tuberosity was significantly thicker than that of the hard palate region. Gender did not influence the thickness of masticatory mucosa, either on the hard palate or the tuberosity. On the hard palate, mucosa thickness increased as the distance from the marginal gingiva increased. The mucosa over the palatal root of the maxillary first molar was significantly thinner than that at all other positions on the hard palate. Measurement error at palate was 0.25mm, at tuberosity 0.51mm. No difference in the thickness of masticatory mucosa on palate and tuberosity was found between men and women. On the hard palate, soft tissue thickness progressively increased in sites further from the gingival margin. Therefore, we may harvest more thicker graft on the tuberosity that has more masticatory mucosa thickness than hard palate, however the width may not be sufficient for using.

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Mesenchymal Smad4 mediated signaling is essential for palate development (구개 형성과정에서 간엽 내 Smad4 매개 신호전달의 역할)

  • Yoon, Chi-Young;Baek, Jin-A;Cho, Eui-Sic;Ko, Seung-O
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.460-465
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    • 2010
  • Introduction: A cleft palate is a common birth defect in humans with an incidence of 1/500 to 1/1,000 births. It appears to be caused by multiple genetic and environmental factors during palatogenesis. Many molecules are involved in palate formation but the biological mechanisms underlying the normal palate formation and cleft palate are unclear. Accumulating evidence suggests that transforming growth factor $\beta$/bone morphogenetic proteins (TGF-$\beta$/BMP) family members mediate the epithelial-mesenchymal interactions during palate formation. However, their roles in palatal morphogenesis are not completely understood. Materials and Methods: To understand the roles of TGF-$\beta$/BMP signaling in vivo during palatogenesis, mice with a palatal mesenchyme- specific deletion of Smad4, a key intracellular mediator of TGF-$\beta$/BMP signaling, were generated and analyzed using the Osr2Ires-Cre mice. Results: The mutant mice were alive at the time of birth with open eyelids and complete cleft palate but died within 24 hours after birth. In skeletal preparation, the horizontal processes of the palatine bones in mutants were not formed and resulted in a complete cleft palate. At E13.5, the palatal shelves of the mutants were growing as normally as those of theirwild type littermates. However, the palatal shelves of the mutants were not elevated at E14.5 in contrast to the elevated palatal shelves of the wild type mice. At E15.5, the palatal shelves of the mutants were elevated over the tongue but did not come in contact with each other, resulting in a cleft palate. Conclusion: These results suggest that mesenchymal Smad4 mediated signaling is essential for the growth of palatal processes and suggests that TGF-$\beta$/BMP family members are essential regulators during palate development.

Epidemiologic Study in Patients with Congenital Cleft Lip and Palate (선천성 구순 구개열 환자에 대한 역학적 연구)

  • Baek Jin-woo;Jung Sung-uk;Choi Sun-hyu;Yun Hyung-jin;Lee Eui-seok;Yun Jung-ju;Jang Hyun-seok;Rim Jae-suk
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.1
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    • pp.17-24
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    • 2004
  • Cleft lip and palate are most common congenital defomity to affect the orofacial region. Cleft lip and palate are caused by abnormal development of primary and secondary palate. Its causative mechanism is not completely understood, but genetic and environmental factors play important roles. Lots of epidemiologic surveys have been done extensively about incidence, racial influence, sex ratio, parent age, associated syndrome and genetic factors. These researches are useful to dissolve many problems in prevention and treatment of cleft lip and palate. We performed epidemiologic survey of cleft lip and palate who visited the department of Oral and Maxillofacial Surgery, Guro hospital of Korea University from 1995 to 2004.

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Spectral characteristics of resonance disorders in submucosal type cleft palate patients (점막하구개열 환자 공명장애의 스펙트럼 특성 연구)

  • Kim, Hyun-Chul;Lee, Jong-Seok;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keum;Kim, Hyun-Ki
    • Proceedings of the KSPS conference
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    • pp.152-154
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    • 2007
  • Submucosal type cleft palate is subdivision of cleft palate. Because of late detection, the treatment - for example, the operation or the speech therapy - for the submucosal type cleft palate patient usually late. In this study, we want to find the objective characteristics of submucosal type cleft palate patient, comparing with the normal and the complete cleft palate patient. Experimental groups are 10 submucosal type cleft palate patients who got the operation in our hospital, 10 complete cleft palate patients. And, 10 normals as control group. The sentence patterns using in this study is simple 5 vowels. Using CSL program we evaluate the Formant, Bandwidth. We analized the spectral characteristics of speech signals of 3 groups, before and after the operation.

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Improvement of phonetic function using modified two-flap palatoplasty and velar myoplasty : Report of a case (변형 피판 구개성형술 및 구개내 근육성형술의 언어기능의 개선 : 증례보고)

  • Yi, Ho;Myoung, Hoon;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pil-Hoon;Kim, Myung-Jin;Seo, Byoung-Moo
    • Korean Journal of Cleft Lip And Palate
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    • v.9 no.2
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    • pp.79-84
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    • 2006
  • Cleft palate is one of the most devastating congenital facial deformities frequently accompanied by cleft lip. In many cases, it causes phonetic and swallowing difficulties although surgical interventionwas applied. Among the surgical methods, Veau-Wardill-Kilner pushback palatoplasty (V-Y reposition) is widely used in the most cleft palate cases. It is designed to lengthen the palate posteriorly, hence to overcome the speech and swallowing problems, but broad postoperative palatal scar might interfere the normal maxillary growth. If the velar muscles were not reoriented, it could result in incomplete speech recovery. In this case report, the modified two-flap palatoplasty with minimal pushback was successfully applied to a 21 month-old girl who has had incomplete cleft palate extended to the posterior third of hard palate. The speech evaluation was confirmed as functional reconstruction of cleft palate was achieved.

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Dandy-Walker Syndrome with Submucous Cleft Palate: A Case Report (댄디워커증후군에 동반된 점막 밑 입천장갈림증 치험례)

  • Kwang, Bum Sik;Na, Young Cheon
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.54-56
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    • 2012
  • Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

Perceptual Speech Assessment after Maxillary Advancement Osteotomy in Patients with a Repaired Cleft Lip and Palate

  • Kim, Seok-Kwun;Kim, Ju-Chan;Moon, Ju-Bong;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.39 no.3
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    • pp.198-202
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    • 2012
  • Background : Maxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients. Methods : Eighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B. Results : No patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B. Conclusions : Repaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.

Postoperative Speech Improvement in the Patients of Velopharyngeal Dysfunction without Definite Cleft Palate (육안상 구개열이 없는 구개인두기능부전 환자의 술후 발음 개선)

  • Bae, Yong Chan;Kang, Cheol Uk;Nam, Su Bong;Herh, Jae Young;Kang, Young Seok
    • Archives of Plastic Surgery
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    • v.33 no.2
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    • pp.144-148
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    • 2006
  • The velopharyngeal dysfunction usually occurs in patients with previous operation of the cleft palate or with submucosal cleft palate. In case of velopharyngeal dysfunction without cleft palate, no study has been made when it comes to operative method and postoperative results. Here, we would like to present the operative methods and the postoperative results with the cases we've experienced. This study is based on seven cases of velopharyngeal dysfunction without cleft palate from 1999 to 2004. Analysis of age, sex, etiology, operative methods, satisfaction rate and speech evaluation was done. The patients were 3 males and 4 females, with an age ranged from 10 to 28 at the time of surgery. The follow-up period was more than six months. One case had bifid uvula, another had atypical anomaly in palate, and five cases had no anatomical abnormality. The palatal lengthening was done on one patient, the levator muscle repositioning on another patient and to the rest of them, the superiorly based posterior pharyngeal flap was done. It was difficult to determine the etiology of the velopharyngeal dysfunction without cleft palate. The speech improvement and the satisfaction rate of the patients and parents were diverse. Although the authors had a problem with statistical analysis between the operative age and the speech improvement, it was reasonable to perform a surgical operation because postoperative speech improvement was observed in most cases regardless of age. There is little statistical correlation, but significantly higher outcomes were observed in palatal lengthening and levator muscle repositioning than in pharyngeal flap.

Correction of Lower Eyelid Retraction with Autogenous Hard Palate Mucosa: 2 Case Report (자가 경구개점막 이식을 이용한 하안검 퇴축의 교정: 2례 보고)

  • Kim, Jino;Seul, Chul Hwan;Roh, Tae Suk;Yoo, Woon Min
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.499-502
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    • 2006
  • Purpose: Grave's disease is an autoimmune disease with chronic and systemic features. It affects the orbital fat and muscle bringing about defect in extrinsic eye motility, diplopia, optic nerve defect and lid retraction. In patients with lagopthalmos and resulting facial deformity, treatment can be done by rectus muscle recession or filling with various material. Autogenous auricular cartilage graft is often used and synthetic material such as synthetic acellular dermis, polyethylene meshs are also used for filling of the depressed area. Nevertheless, autogenous auricular cartilage grafts are difficult to utilize and synthetic materials sometimes result in protrusion or infection. Therefore, hard palate mucosa was considered as an alternative. We report two cases of patients with lower eyelid retraction corrected with autogenous hard palate mucosa. Methods: We performed this operation in two patients of Graves' ophthalmopathy. The capsulopalpebral fascia was incised and elevated through an incision on the conjunctiva. Then, the harvested hard palate mucosa was sutured to the inferior border of the tarsus and covered with the conjunctiva. Results: The lower eyelid retraction was corrected successfully. No hypertrophy or deformation of the transplanted hard palate mucosa was noted 6 months after the surgery. Conclusions: From the results above, we may conclude that the hard palate mucosa serves as an ideal spacer for the curvature and the inner lining in lower lid retraction. Hard palate mucosa is as sturdy as the autogenous cartilage but is much easier to utilize. It can be also used for lid retraction after lower lid aesthetic surgeries or traumas.