• Title/Summary/Keyword: Palate

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EARLY ORTHOPEDIC TREATMENT IN CLEFT LIP AND PALATE PATIENT: A CASE REPORT (구순구개열 환아의 조기 악정형치료에 관한 증례)

  • Yoon, Tae-Won;Lim, Kwang-Ho;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.729-735
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    • 1996
  • Cleft lip and palate is the most common malformation in the craniofacial region. The patients with cleft lip and palate have functional problem such as, speech, feeding and respiratory as well as esthetic problem. So, treatment should be done by multidiciplinary team approach. The role of pediatric dentist in the team is advicement for feeding method, guidance of normal growth, caries control and preventive orthodontics. In cleft lip and palate patients, maxillary arch after cheiloplasty is usually collapsed by excessive tension of the scar. This collapse increase the difficulty of later orthodontic treatment. Therefore, the maxillary arch segments should be moved and retaind to normal position as soon as cheiloplasty is done to reduce the need and difficulty of orthodontic treatment. This concept is called by the early orthopedic treatment in cleft lip and palate. Also, this orthopedic appliance works as feeding applince to normal feeding and weight gain We reported two cases of early orthopedic treatment with favorable result in complete bilateral cleft lip and palate patients after cheiloplasty. Patients showed normal weight and their maxillary arch widths were increased.

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Prenatal ultrasonographic diagnosis of cleft lip with or without cleft palate; pitfalls and considerations

  • Kim, Dong Wook;Chung, Seung-Won;Jung, Hwi-Dong;Jung, Young-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.24.1-24.5
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    • 2015
  • Ultrasonographic examination is widely used for screening of abnormal findings on prenatal screening. Cleft lip with or without cleft palate of the fetus can also be screened by using ultrasonography. Presence of abnormal findings of the fetal lip or palate can be detected by the imaging professionals. However, such findings may not be familiar to oral and maxillofacial surgeons. Oral and maxillofacial surgeons can use ultrasonographic imaging of fetal cleft lip with or without cleft palate to provide information regarding treatment protocols and outcomes to the parent. Therefore, surgeons should also be able to identify the abnormal details from the images, in order to setup proper treatment planning after the birth of the fetus. We report two cases of cleft lip with or without cleft palate that the official readings of prenatal ultrasonography were inconsistent with the actual facial structure identified after birth. Also, critical and practical points in fetal ultrasonographic diagnosis are to be discussed.

Epithelial Cyst of the Uvula with Unilateral Complete Cleft Lip and Palate

  • Kim, Young-Bin;Yang, Jae-Young;Leem, Dae-Ho;Baek, Jin-A;Ko, Seung-O;Shin, Hyo-Keun
    • 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.

Developing descriptive analysis protocol for gochujang: establishing optimal palate cleanser (고추장 묘사분석을 위한 프로토콜 개발: 입가심물질 중심으로)

  • Lee, Eun-Hye;Chung, Seo-Jin;Yu, Seon-Mi;Han, Kui-Jeong
    • Korean journal of food and cookery science
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    • v.29 no.5
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    • pp.489-500
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    • 2013
  • This study was conducted to establish an effective palate cleanser when conducting descriptive analysis for gochujang products. In addition, descriptive analysis procedure for gochujang products was optimized. A generic descriptive analysis was performed on 4 types of gochujang samples varying in hot and spicy levels. The sensory attributes developed were 9 odors, 13 flavors, 4 texture and mouth feel attributes, and 4 appearance attributes. In order to select an effective palate cleanser for gochujang, 5 types of cleansers were tested (water, water+bread, water+cucumber, water+milk, water+cracker). Correct answering rate, significant numbers of product effect on sensory attributes, and the mean hot and spicy intensity values were considered to select the optimal palate cleanser. Results showed that as the hot & spicy level increased, red pepper odor and flavor significantly increased whereas umami taste intensity decreased. When comparing the efficiencies of various palate cleanser, the correct answer rates were the highest when warm water was used with either cucumber or cracker. Additionally, the attribute intensities were better differentiated between gochujang samples when cracker, white wheat bread, or cucumber were used. Overall, warm water with cucumber or cracker were shown to be the most effective cleansers.

Use of Acellular Allogenic Dermal Matrix in Soft Palate Reconstruction after Excision the Pleomorphic Adenoma (다형샘종 제거 후 발생한 연구개 점막 결손의 무세포 동종 진피기질을 이용한 재건 1례)

  • Lee, Jae Seong;Lim, Gil Chae;Kim, Jeong Hong;Kang, Jae Kyoung;Shin, Myoung Soo;Yun, Byung-Min
    • Korean Journal of Head & Neck Oncology
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    • v.35 no.1
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    • pp.21-23
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    • 2019
  • Recent studies have reported on the reconstruction of oral mucosal defects using acellular dermal matrix (ADM). This case report describes the reconstruction of a soft-palate mucosal defect using ADM. A 43-year-old man developed a $2.5cm{\times}3cm$ soft-palate mucosal defect after the removal of a lump on the soft palate andreconstructed the defect using ADM without further complications. Reconstruction of the soft palate with ADM could be more convenient than traditional methods including primary closure, skin graft, and local or free flap without complications.

Use of a buccinator myomucosal flap and bilateral pedicled buccal fat pad transfer in wide palatal fistula repair: a case report

  • Choi, Jin Mi;Park, Hojin;Oh, Tae Suk
    • Archives of Craniofacial Surgery
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    • v.22 no.4
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    • pp.209-213
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    • 2021
  • Primary palatoplasty for cleft palate places patients at high risk for scarring, altered vascularity, and persistent tension. Palatal fistulas are a challenging complication of primary palatoplasty that typically form around the hard palate-soft palate junction. Repairing palatal fistulas, particularly wide fistulas, is extremely difficult because there are not many choices for closure. However, a few techniques are commonly used to close the remaining fistula after primary palatoplasty. Herein, we report the revision of a palatal fistula using a pedicled buccal fat pad and palatal lengthening with a buccinator myomucosal flap and sphincter pharyngoplasty to treat a patient with a wide palatal fistula. Tension-free closure of the palatal fistula was achieved, as well as velopharyngeal insufficiency (VPI) correction. This surgical method enhanced healing, minimized palatal contracture and shortening, and reduced the risk of infection. The palate healed with mucosalization at 2 weeks, and no complications were noted after 4 years of follow-up. Therefore, these flaps should be considered as an option for closure of large oronasal fistulas and VPI correction in young patients with wide palatal defects and VPI.

COMPREHENSIVE TREATMENT OF UNILATERAL COMPLETE CLEFT LIP AND PALATE (편측성 완전 구순구개열 환자의 포괄적 치료)

  • Lee, Jeong-Keun;Hwang, Byung-Nam;Choi, Eun-Zoo;Kim, Yong-Been
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.4
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    • pp.430-435
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    • 2000
  • Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.

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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.

Palatal obturator restoration of a cleft palate patient with velopharyngeal insufficiency: a clinical report (구개인두 기능부전을 갖는 구개열 환자에서 폐쇄장치를 이용한 보철 치료 증례)

  • Heo, Yu-Ri;Kim, Jong-Wook;Lee, Gyeong-Je;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.353-360
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    • 2013
  • Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.

An epidemiologic study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Pusan National University Hospital (부산대학교병원 교정과에 내원한 구순구개열 환자들에 대한 역학조사)

  • Son Woo-Sung;Baek Jae-Ho;Lee Won-Chul
    • Korean Journal of Cleft Lip And Palate
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    • v.5 no.1
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    • pp.43-58
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    • 2002
  • A General survey on the cleft lip and/or palate patients in Pusan National University Hospital was done. The conclusions were as follow. 1. In gender ratio, male was higher than female. 2. In the cleft type, unilateral cleft lip and palate, cleft lip and alveolus, and bilateral cleft lip and palate in higher ratio order. Left unilateral cleft lip and palate was higher than right in ratio. 3. In first hospital visiting age for dental treatment, the group from 6 years old to 12 years old was most and in that the age group for attending elementary school (about 7-8 years old) showed especially higher ratio. The large majority of patient were born in 1980's and lived in Pusan metropolitan city, KyungSangNamDo. Especially, most of them lived in the neighboring Held of Pusan National University Hospital. 4. Class III skeletal pattern and Angle's Class III molar relationship was most prevalent. Angle's Class II molar relationship showed relative higher ratio because tooth loss and malposition. 5. Primary lip closure in 3 months, secondary lip closure in 6-7 years old, palatal closure in 12-16 months and bone graft in 8-10 years old were operated mostly. Rhinoplasty and scar revision were operated in too early age so the need of infantile orthopedics must be considered. 6. Maxillary expansion and protraction were operated mostly in 8-11 years old but operating in primary dentition must be considered. 7. Tooth alignment were started mostly in mixed dentition and consideration about prosthodontic treatment and retention will be need. 8. In tooth anomaly, tooth malformation and missing were most prevalent.

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