• 음성과학
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• 제5권1호
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• pp.105-119
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• 1999

Cleft palate patients have general speech problems with resonance disorders and articulation disorders. The aim of this study is to find the aerodynamic and acoustic characteristics of the nasalization in cleft palate speakers. Thirteen control groups and three cleft palate patients pre- and post operation were selected for these studies. The test words are composed by polysyllabic words: consonants between high vowel /i/ analysis. The cleft palate patients repeated test words pre- and post-operation from one, three and six month periods. The subjects repeated test words on Macquirer and on Nasometer Model 6200-3. The aerodynamic and acoustic results of nasalization show as follows: (1) The nasal rate in overall airflow of aspirated consonant for cleft palate patients shows higher levels than that of the control group. It had decreased since one month after operation. (2) The overall airflow of cleft palate patients is higher than in the control group, however oral air pressure is lower than control group. (3) The nasal airflow and the nasal rate in overall airflow of cleft palate patients has higher than the control group, however its decreased after operation. (4) The nasalance scores of cleft palate patients were 40% higher than that of the control group. The scores did not decrease after operation. The nasalance score of lateral and fricative sounds did not decrease after operation.

• 대한구순구개열학회지
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• 제13권2호
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• pp.77-84
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• 2010

Vomer flap is used to repair anterior hard palate in complete cleft lip and palate patients. As the midline structure located in between the two cleft segments of hard palate, the vomer flap is very useful because of its vicinity to cleft site and their ease of execution when it is done with primary cheiloplasty simultaneously. In addition, the quality of tissue is very similar to that of the nasal mucosa with good vascularity. In cases of simultaneous repair of cleft lip with anterior palate using vomer flap, the hard palate can be repaired at the same time with primary cheiloplasty which is earlier period than other techniques. With simultaneous close of cleft lip and cleft hard palate by vomer flap, subsequent palatoplasty does not require wide dissection, and consequently chance of oronasal fistula formation will be minimized. Additionally, surgical time will be reduced and, the harmful effects on mid-facial growth will be diminished. In this article, we will introduce the comprehensive vomer flap technique with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap.

• 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.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.43-49
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• 2022

Background Cleft lip and cleft palate are the most frequent congenital craniofacial deformities, with an incidence of approximately 1 per 700 people. Postoperative palatal fistula is one of the most significant long-term complications. This study investigated the incidence of postoperative palatal fistula and its predictive factors based on 25 years of experience at our hospital. Methods We retrospectively reviewed 636 consecutive palatal repairs performed between January 1996 and October 2020 by a single surgeon. Data from patients' medical records regarding cleft palate repair were analyzed. The preoperative extent of the cleft was evaluated using the Veau classification system, and the cleft palate repair technique was chosen according to the extent of the cleft. SPSS version 25.0 was used for all statistical analyses, and exploratory univariate associations were investigated using the t-test. Results Fistulas occurred in 20 of the 636 patients; thus, the incidence of palatal fistula was 3.1%. The most common fistula location was the hard palate (9/20, 45%), followed by the junction of the hard and soft palate (6/20, 30%) and the soft palate (5/20, 25%). The cleft palate repair technique significantly predicted the incidence of palatal fistula following cleft palate repair (P=0.042). Fistula incidence was significantly higher in patients who underwent surgery using the Furlow double-opposing Z-plasty technique (12.1%) than in cases where the Busan modification (3.0%) or two-flap technique (2.0%) was used. Conclusions The overall incidence of palatal fistulas was 3.1% in this study. Moreover, the technique of cleft palate repair predicted fistula incidence.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권1_2호
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• pp.1-21
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• 1992

In order to find the causes of velopharyngeal incompetency after primary palatorrhaphy in cleft patients, we analyzed the form and function of the velopharyngeal space of fifteen operated cleft palate patients and five normal subjects. The velopharyngeal function was evaluated by lateral cephalometric radiography, velopharyngography and hypernasality cul-de-sac test. The obtained results were as follows. 1. The rate of velopharyngeal incompetency was twenty percent, three of the fifteen operated patients. Two of them were complete cleft palate and the other was incomplete one. 2. The length of soft palate and levator eminence were longer in normal group than those of good speech group and complete cleft palate group during phonation of /i/ (P<0.05). The lengthening rate of soft palate was smaller in good and poor speech group than that of normal group(P<0.05), and, reduced in order, normal group, complete cleft palate group and incomplete palate group(P<0.05). 3. The nasopharyngeal distance had no significant difference between all groups at rest, but, smaller in normal group than that of both cleft palate group(P<0.05), good speech group and poor speech group(P<0.05) during phonation of /i/ The difference in nasopharyngeal distance between rest and /i/ phonation was greater in normal group than that of both cleft palate group, good speech group and poor speech group. 4. The moving distance of sop palate reduced in order, normal group, incomplete cleft palate group, complete cleft palate group(P<0.05). 5. The distance between lateral pharyngeal wall had no significant difference between all groups in rest, but, smaller than that of complete cleft palate group in normal group(P<0.01) and increased in order normal group, good speech group, poor speech group(P<0.01) during phonation of /a/. The mobility of lateral wall was reduced in order, normal group, good speech group poor speech group(P<0. 01). 6. There was low corelationship between the mobility of lateral pharyngeal wall and soft palate. Therfore, it suggest that the movements of lateral pharyngeal wall and soft palate occurs independently.

• 대한치과교정학회지
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• 제20권1호
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• pp.197-207
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• 1990

This comparative study was undertaken to investigate the position of the hyoid bone in unilateral cleft lip and palate individuals. The materials for this study consisted of 35 subjects with surgically repaired unilateral cleft lip and palate (25 males, 10 females) and 40 subjects with normal facial morphology (20 males, 20 females). Cephalometric measurements of unilateral cleft and palate individuals were compared with those of non-cleft individuals. The conclusions of this study were obtained as follows: 1. To the anterior cranial base, the hyoid bone in unilateral cleft lip and palate individuals was located downward as compared with non-cleft individuals. 2. To the mandible, the hyoid bone in unilateral cleft lip and palate individuals was located backward as compared with non-cleft individuals. 3. The distance between the dorsum of the tongue and the inferior border of the hard palate in unilateral cleft lip and palate individuals was longer than that in non-cleft individuals. 4. Unilateral cleft lip and palate individuals showed no significant difference in the distance between the hyoid bone and the dorum of the tongue as compared with non-cleft individuals.

• 대한두개안면성형외과학회지
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• 제9권2호
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• pp.72-76
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• 2008

Purpose: Authors evaluated results of palatoplasty by speech analysis in bilateral, unilateral complete, and unilateral incomplete and submucous cleft palate patients. Methods: The speech outcomes were studied in 15 bilateral, 28 unilateral complete, and 46 unilateral incomplete and submucous cleft palate patients who underwent push-back palatoplasties from January 1998 to July 2004. The patients were divided into 2 groups as 3 to 6, 7 to 10-year-old and compared with 20 normal children(control groups were divided into 10 children on each side). Nasal emission test, hypernasality test, and articulation test were done by speech evaluation table which was composed of 39 different words. Results: In all speech evaluation tests, the group of bilateral cleft palate patients got the worst score. And 7 to 10-year-old groups got better score when compared to the same type cleft palate. Conclusion: Bilateral cleft palate patients have many more speech problems than other patients. In cleft palate patients, the speech problem was improved with ages, postoperatively. And the speech therapy can improve the operative outcomes.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권1호
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• pp.13-20
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• 2017

Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.385-388
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• 2005

In cleft lip and/or palate patients with the complex congenital heart diseases, surgical repair of the cleft lip and/or palate has been postponed after the open heart surgery because the heart problem of the patient might cause more complications associated with anesthesia and surgery. There has been little report about experiences in the surgical management of these patients and optimal time of surgical intervention. Authors are introducing the experiences of performing corrective surgery of cleft lip and/or palate in the patients with congenital heart diseases before and after the open heart surgery. We managed five patients from May 1992 to March 2004. Two patients were male and the rest were female. One of them had cleft lip alone and others had cleft lip and palate. Two of them underwent delayed cleft lip and/or palate surgery after open heart surgery, and the rest had immediate intervention for cleft lip and/or palate. There was no complication during the operation and postoperative period. There would be no need to delay the corrective surgery of the cleft lip and/or palate after the open heart surgery, if solid medical team approach was available with the pediatric cardiologist and the anesthesiologist.