• 대한후두음성언어의학회지
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• 제13권2호
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• pp.180-187
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• 2002

Background and Objectives : The operation Double Opposing Z-Plasty, has been used for improving VPI function in the submucous cleft palate. However, few reports on the effects of the speech change were presented. The purpose of this study is to compare the difference of nasality and nasalance, parents satisfaction between before and after this operation and to consider how much improvement in speech. Materials and Methods : Ten submucous cleft palate children who underwent double opposing Z-plasty were analyzed. We retrospectively studied nasalance, auditory perception (nasality) with hypernasality, patients satisfaction, speech evaluation by using charts review, video tape, telephone interview. Results : In 8 patients of 10 submucous cleft palate, hypernasality reduced and speech intelligibility was higher and mean 0.35 point was increased in the velum length after operation. After operation, nasality was improved (2.0 point) and level of nasal emission decreased. Regarding satisfaction of this operation, scale was mean 2.8 (5 point-scale) : 8 parents were satisfied in the resonance, 3 parents were satisfied articulation. The reason of dissatisfaction was mostly compensatory articulation. Conclusion : To improve of speech in the submucous cleft palate, speech therapy afterthis operation as well as successful surgery should be considered.

• 대한소아치과학회지
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• 제23권3호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권1호
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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.

• 한국식품조리과학회지
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• 제29권5호
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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.

• 대한두경부종양학회지
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• 제35권1호
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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.

• 대한두개안면성형외과학회지
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• 제22권4호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권4호
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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.

• Archives of Plastic Surgery
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• 제34권2호
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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.

• 대한치과보철학회지
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• 제51권4호
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• pp.353-360
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• 2013

구순 구개열은 구강 악안면 부위에 발생하는 선천적 기형이다. 정상적인 연구개는 휴식 시에는 구강과 비강을 연결해 주고, 연하나 특정 발음 시에는 상방으로 이동하여, 구강과 비강을 분리하는 구개인두 폐쇄 운동을 한다. 구개인두 기능부전을 갖는 구개열 환자에서는 이 운동이 불완전하여 저작, 연하, 발음 시에 어려움을 겪는다. 이때, 구개 결손부를 폐쇄하기 위해 사용하는 보철물을 구개 폐쇄장치라고 한다. 구개 폐쇄장치는 구강과 비강을 분리하여 발음, 저작, 연하, 심미적 기능을 회복한다. 본 증례의 환자는 구개인두 기능부전을 갖는 선천적 구개열 환자로 구개인두 폐쇄를 이루기 위하여 모델링 콤파운드와 점막 조정재를 이용한 기능인상 과정을 시행하여 제작한 구개 폐쇄장치를 장착하여 기능적인 면과 심미적인 면에서 만족할만한 결과를 얻었기에 이를 보고하는 바이다.