• Title/Summary/Keyword: Palate

Search Result 1,834, Processing Time 0.031 seconds

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
    • /
    • v.33 no.4
    • /
    • pp.499-502
    • /
    • 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.

Soft Palate Reconstruction Using Bilateral Palatal Mucomuscular Flap and Pharyngeal Flap after Resection of Squamous Cell Carcinoma

  • Kim, Jun Sik;Jo, Hyeon Jong;Kim, Nam Gyun;Lee, Kyung Suk
    • Archives of Plastic Surgery
    • /
    • v.39 no.6
    • /
    • pp.655-658
    • /
    • 2012
  • Squamous cell carcinoma infrequently occurs at the soft palate. Although various methods can be used for reconstruction of soft palate defects that occur after resecting squamous cell carcinoma, it is difficult to obtain satisfactory results from the perspective of the functional restoration of the soft palate. A combination of bilateral palatal mucomuscular flap for the oral side and superiorly based posterior pharyngeal flap for the nasal side were performed on two patients who were diagnosed with squamous cell carcinoma of the soft palate in order to reconstruct the soft palate defects after surgical resection. After surgery, the patients were followed-up for a mean period of 11 months. The flaps were well maintained in both patients. The donor site defects were epithelialized and completely recovered. Additionally, no recurrence of the primary sites was shown. Slight hyponasality was observed in the voice assessments that were conducted 6 months after surgery. No food regurgitation or aspiration was observed in the swallowing tests. We used a combination of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurred after resecting the squamous cell carcinomas. We reduced the donor site complications and achieved functionally satisfactory outcomes.

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
    • /
    • v.39 no.3
    • /
    • pp.198-202
    • /
    • 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.

A Study of Nasalance Change in Submucosal Type Cleft Palate Patients by Surgery (점막하 구개열 환자의 수술 전후 비음도 변화에 대한 연구)

  • Choi, Ju-Seok;Leem, Dae-Ho;Baek, Jin-A;Kim, Oh-Hwan;Kim, Hyun-Ki;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
    • /
    • v.8 no.2
    • /
    • pp.53-62
    • /
    • 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.

  • PDF

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
    • /
    • v.9 no.2
    • /
    • pp.79-84
    • /
    • 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.

  • PDF

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
    • /
    • v.13 no.1
    • /
    • pp.54-56
    • /
    • 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.

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
    • /
    • v.7 no.1
    • /
    • pp.17-24
    • /
    • 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.

  • PDF

Frequency of anemia and micronutrient deficiency among children with cleft lip and palate: a single-center cross-sectional study from Uttarakhand, India

  • Chattopadhyay, Debarati;Vathulya, Madhubari;Naithani, Manisha;Jayaprakash, Praveen A;Palepu, Sarika;Bandyopadhyay, Arkapal;Kapoor, Akshay;Nath, Uttam Kumar
    • Archives of Craniofacial Surgery
    • /
    • v.22 no.1
    • /
    • pp.33-37
    • /
    • 2021
  • Background: Children with cleft lip and/or palate can be undernourished due to feeding difficulties after birth. A vicious cycle ensues where malnutrition and low body weight precludes the child from having the corrective surgery, in the absence of which the child fails to gain weight. This study aimed to identify the proportion of malnutrition, including the deficiency of major micronutrients, namely iron, folate and vitamin B12, in children with cleft lip and/or palate and thus help in finding out what nutritional interventions can improve the scenario for these children. Methods: All children less than 5 years with cleft lip and/or cleft palate attending our institute were included. On their first visit, following were recorded: demographic data, assessment of malnutrition, investigations: complete blood count and peripheral blood film examination; serum albumin, ferritin, iron, folate, and vitamin B12 levels. Results: Eighty-one children with cleft lip and/or palate were included. Mean age was 25.37±21.49 months (range, 3-60 months). In 53% of children suffered from moderate to severe wasting, according to World Health Organization (WHO) classification. Iron deficiency state was found in 91.6% of children. In 35.80% of children had vitamin B12 deficiency and 23.45% had folate deficiency. No correlation was found between iron deficiency and the type of deformity. Conclusion: Iron deficiency state is almost universally present in children with cleft lip and palate. Thus, iron and folic acid supplementation should be given at first contact to improve iron reserve and hematological parameters for optimum and safe surgery.

Acquired Palatal Fistula in Patients with Submucous and Incomplete Cleft Palate before Surgery

  • Park, Ie Hyon;Chung, Jee Hyeok;Choi, Tae Hyun;Han, Jihyeon;Kim, Suk Wha
    • Archives of Plastic Surgery
    • /
    • v.43 no.6
    • /
    • pp.582-585
    • /
    • 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.

Incomplete cleft palate related to Cornelia de Lange syndrome -A case report- (Cornelia de Lange syndrom 환아에서 발생한 Incomplete cleft palate의 치험례)

  • Yoon, Bo-Keun;Lee, Hwan-Soo;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
    • /
    • v.3 no.1
    • /
    • pp.33-36
    • /
    • 2000
  • Cornelia de Lange syndrome is a disorder of unknown biochemical and geneic basis that is recognized on the basis of characteristic facies(low anterior hairline, synophrys, anteverted nares, maxillary prognathism, long philtrum, carp mouth) in association with prenatal and postnatal growth retardation, mental retardation and, in many cases, upper limb anomalies. We treated the patient with incomplete cleft palate related to Cornelia de Lange syndrome.

  • PDF