• Archives of Plastic Surgery
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• v.32 no.3
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.4
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• pp.310-319
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• 2006

Submucosal type cleft palate is subdivision of the cleft palate. It is very difficult to find submucosal cleft, because when we exam submucosal type cleft palate patients, it seems to be normal. But in fact, there are abnormal union of palatal muscles of submucosal type cleft palate patients. Because of late detection, the treatment - for example, the operation or the speech therapy - for the submucosal type cleft palate patient usually becomes late. Some patients visited our hospital due to speech disorder nevertheless normal intraoral appearance. After precise intraoral examination, we found out submucosal cleft palate. We evaluated the speech before and after surgery of these patients. In this study, we want to find the objective characteristics of submucosal type cleft palate patients, comparing with the normal and the complete cleft palate patients. Experimental groups were 10 submucosal type cleft palate patients and 10 complete cleft palate patients who got the operation in our hospital. And, the controls were 10 normal person. The sentence patterns using in this study were simple 5 vowels. Using CSL program we evaluated the Formant, Bandwidth. We analized the spectral characteristics of speech signals of 3 groups, before and after the operation. In most cases, the formant scores were higher in experimental groups (complete cleft palate group and submucosal type cleft palate group) than controls. There were small differences when speeching /a/, /i/, /e/ between experimental groups and control groups, large differences when speeching /o/, /u/. After surgery the formant scores were decreased in experimental groups (complete cleft palate group and submucosal type cleft palate group). In bandwidth scores, there were no significant differences between experimental groups and controls.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.600-603
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• 2010

Oblique facial cleft is extremely rare. The frequency was reported 1/1300 cases of facial cleft. The cleft appears to be bilateral in approximately 20% and more often on the right when unilateral. Oblique facial cleft is nearly always associated with cleft lip and palate. Thus, the case that is unilateral on the left and not associated with cleft lip or palate is very rare. We experienced a case of 2 years 6 months old Philippine girl who had oblique facial cleft that is not associated with cleft lip or palate. The probable cause and treatment is discussed with a review of literatures.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.630-634
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• 2021

To date, there have been no reports of patients showing a Tessier number 7 cleft with unilateral complete cleft lip and palate. Furthermore, no studies have established the sequence, plan, or timing of surgical methods for treating patients presenting the above anomalies simultaneously. We report a case of a Tessier number 7 cleft with unilateral complete cleft lip and palate. Two months after birth, lip adhesion was performed on the unilateral complete cleft lip and total excision was performed on the skin tag. At 4 months of age, Tessier number 7 cleft was corrected. At 6 months of age, surgery involving two small triangular flaps was performed on the unilateral incomplete cleft lip after performing lip adhesion. At 13 months of age, two-flap palatoplasty with a vomer flap was performed on the complete cleft palate. At 6 years of age, open rhinoplasty was performed on the unilateral cleft lip nose deformity. At 9 years of age, bone grafting was performed for the alveolar cleft. At follow-up appointments up to 13 years of age, there were no major complications. Here, we present this patient, surgical procedures and timelines, and show our results demonstrating good postoperative outcomes.

• The Journal of the Korean dental association
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• v.9 no.9
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• pp.557-560
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• 1971

The authors had treated 27 cleft lip and cleft palate patients including 16 male patients and 11 female patients. There were 17 cases of unilateral cleft lip patients, 4 cases of bilateral cleft lip patients, and 6 cases with cleft lip and cleft palate patients. We had accomplished that the surgical plastic closures of cleft lips and cleft palates had been performed by using of Millard's, Hagedorn's, Meyer's, LeMesurier's, Wunderer's, Lindemann's methods and Veau's Method with Z-plasty.

• Korean Journal of Cleft Lip And Palate
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• v.3 no.2
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• pp.67-73
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• 2000

The purpose of this survey was to obtain an overall view of the status of cleft lip and palate management in Oral and Maxillofacial Surgery(OMFS) in Korea. Korea Cleft lip and Palate Association conducted mailed survey which was composed of 29 questions conceming pre-operative and post-operative management in CLP surgery and completed by 58 training hospital. Of 58 questionnaires sent, 23 were returned(response rate of 40%). Authors compared this results with those of other similar surneys, which reveal much difference between OMFS and Plastic Surgery(PS) in CLP treatment. In OMFS, many surgeons were in favor of presugical orthopaedics than lip adhesion to manage protruded premaxilla. It reflects interdisciplinary team approach between OMFS and orthodontic department reduces the need of lip adhesion through presurgical orthopaedics. Timing of palatal surgery was later than that of PS, which reflects concern for an impediment of maxillaty growth. To our knowledge, this survey may be the first on organization and management for cleft patient in OMFS in Korea.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.53-62
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• 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.

• Archives of Plastic Surgery
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• v.33 no.1
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• pp.75-79
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• 2006

The upper and lower lateral cartilages provide the key to the lower cartilaginous portion of the nose. Lifting the cartilages is essential procedure for correction of unilateral cleft lip nose deformity. After correction of cleft lip nose deformity, authors used acoustic rhinometry (AR) to compare the lower nasal cavity of cleft side with non-cleft side. AR is a well known new, non-invasive diagnostic technique in which nasal geometry is assessed by means of acoustic reflection. From June 1996 to January 2004, we performed acoustic rhinometric analysis after correction of unilateral cleft lip nose deformity. This study involved 40 children of age ranged from 3 months to 8 years. Subjects were divided into the group of incomplete unilateral cleft lip nose deformity(20 subjects), and the group of complete unilateral cleft lip nose deformity(20 subjects). Results show that lower nasal cavity volume between non-cleft side and cleft side has no difference, and better results were obtained when nasal molding prong was applied at cleft side nostril. The results between incomplete type and complete type have no significant difference. In conclusion, AR is an effective method to calibrate cross sectional area and nasal cavity volume of unilateral cleft lip nose deformity, and furthermore effective in comparing the volume of cleft side with non-cleft side after unilateral cleft lip nose deformity correction with lifting the lower lateral cartilages to the upper lateral cartilages.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.3
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• pp.260-264
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• 1997

The congenital deformities of cleft lip and cleft palate have been known to afflict man since prehistoric time. Efforts to correct these abnormities have evolved over the centuries as scientific knowledge has advanced. Although there is no agreement as to when the surgery should be performed, most surgeons adhere to "rule of 10" : the infant must be 10 week old weigh 10 Ibs, have a hemoglobin value 10gm/dl and have a white blood cell count no greater than 10 $thousands/mm^3$. Consensus favors performing initial palatal surgery in the child when he is between 18 and 24 months old. The timing of cleft alveolus surgery is usually between 10 and 11 years old. In the period from 1992 to 1996, 38 patients with cleft lip and cleft palate treated at the department of oral and maxillofacial surgery, Chosun university, dental hospital were analysed clinically. The obtained results were as follows. 1. The ratio of male to female was 1.92 : 1 (25/23) 2. The ratio of cleft lip, cleft palate and cleft lip & palate was 1.5 : 1 : 2.5 (12/8/18) 3. The ratio of unilateral to bilateral cleft lip was 5 : 1 (25/5) 4. The ratio of left to right side in unilateral cleft lip was 1.5 : 1 (15/10)

• Archives of Plastic Surgery
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• v.47 no.3
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• pp.263-266
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• 2020

Infantile hemangiomas have a growth phase and an involution phase. For this reason, serial observation has generally been recommended as the treatment for uncomplicated infantile hemangiomas. Recently, however, individualized approaches have been emphasized. Although cleft lip and infantile hemangioma are common congenital diseases, infantile hemangiomas on the cleft side (i.e., in the operative field of the cleft lip) are extremely rare, and no clear guidelines have been established for their treatment. We experienced a case in which a patient with a cleft lip had an infantile hemangioma on the cleft side. In accordance with general treatment guidelines, cleft repair was performed 3 months after birth. The Millard rotation-advancement technique, which involves the use of a lower small triangular flap, was used for the repair. No intraoperative complications, such as massive bleeding, or postoperative complications were noted. The patient has received regular follow-up for the past 18 years, and other than a reddish scar on the lower lip, he currently has no related issues. Therefore, this case demonstrates that cleft lip repair performed according to cleft lip treatment guidelines produces good outcomes, even in cases involving a hemangioma on the cleft side.