• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.4
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• pp.295-309
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• 2006

The present study was aimed to evaluate the incidence, etiological factors, and management of cleft lip and palate. Two hundred and twenty patients with cleft lip and/or cleft palate who were treated at Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, during the period between January 1994 and December 2003 were reviewed. The ratios of cleft lip : cleft lip with cleft palate : and cleft palate were 0.4:1.1:1. Males were more common than females in cleft lip (1.3:1) and cleft lip and palate (2.5:1), while females were more common than males in cleft palate (1:1.3). In the cleft side, left clefts were more prevalent than right clefts (cleft lip 1.3:1, cleft lip and palate 1.6:1). Unilateral clefts were more common than bilateral clefts in cleft lip (79:21). Cleft lip and cleft palate were more common in those with blood type A (34.5%) than those with other types. There was no significant relationship between birth season and frequency of clefts. The clefts were common in the first-born (48.8%), and in mothers aged between 25 and 29 (51.7%). Medication (24.7%) and stress (16.7%) during the first trimester were noted. Positive familial history was noted in 13 cases (5.9%). Thirty-two cases (15%) were associated with other congenital anomalies, in which tonguetie (40.6%) and congenital heart disease (21.9%) were most common. Among 100 patients with cleft palate, 77 patients had middle ear disease (77%), which occurred predominently in the incomplete cleft palate. Seventy-six among the 77 patients received myringotomy and ventilation tube insertion, and the remaining one received antibiotic medication only. Cleft lips were treated primarily at 3 to 6 months, and cleft palates were at 1 to 2 years. Treatment regimens included modified Millard method mainly in the cleft lip, and Wardill V-Y, Dorrance method, and Furlow method in the cleft palate. The percentage of palatal lengthening as type of cleft palate was greater in the incomplete cleft palate group (11.2%) than in the complete cleft palate group (9.6%). The percentage of palatal lengthening as operating method was no difference between the Furlow method (10.9%) and the push back method (10.7%). As postoperative complications, hypertrophic scar was most frequent in the cleft lip, and oronasal fistula in the cleft palate. In summary, it was shown that medication and stress during the first trimester of pregnancy were frequently associated with cleft lip and cleft palate, adequate timing and selection of method of operation are important factors to obtain morphologically and functionally good results. Furthermore prevention and treatment of middle ear disease are important in cleft palate patients because of its high co-occurrence.

• Proceedings of The Korean Cleft Lip And Palate Association
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• 1998.06a
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• pp.45-45
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• 1998

• Korean Journal of Cleft Lip And Palate
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• v.9 no.2
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• pp.85-92
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• 2006

Korean Cleft Lip and Palate Association (KCLPA) was founded in 1996. The first overseas charity operation was in Karachi, Pakistan, 2002 and our association has visited fourteen times in six countries for the free cleft surgery: Pakistan, Egypt, Kenya, Morocco, Jordan and Vietnam. The cumulated number of operated patients reaches to 280. Before our association, many Korean oral and maxillofacial surgeons have performed charity operations individually since 1964. It was started from Vietnam but the activity is now carried on in Africa, middle-east Asia, south-east Asia, China, and Korea as an official team. LG electronics, a Korean company helped to propagate our team's activity to middle-east Asia to Africa. This paper is a report concerning about the results of our association's charity activities especially in Kenya, east Africa. We provided free cleft surgery for 30 patients in 2004 and 27 patients in 2005, in Nairobi. As the blood test for HIV of the cleft patients was not allowed before and during surgery, our surgeons and nurses were cautious about every movement during the surgeries. Thus the operation time for each patient was longer than any other time. The attitude of the local hospital and the doctors seemed to be accustomed to this situation. They helped us in case of needle injuries. Safety of medical staff and patients is more important than the number of the patients operated in charity operation. This belief should be approached being parallel and multidisciplinary as an international cooperation, focusing on international funding for medical support and continuous education for local doctors who are willing to devote to their people.

• The Journal of the Korean dental association
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• v.13 no.2
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• pp.169-173
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• 1975

The author had treated 35 caseds of cleft lips and cleft palate patients including 26 male patients and 8 female patients. There were 29 cases of unilateral cleft lip patients and 4 cases of bilateral cleft lip patients, 5 cases with together cleft lips and cleft palates among 35 cases were observed. I had accomplished that "Plastic Cheiloplasty", surgical plastic closure of cleft lips and cleft palates had been performed by using Millard's, Hagedorn's, Meyer's and LeMesurier's method.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.529-545
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• 1996

In order to find the distribution, causes and treatments of cleft lip and/or palate, I analyzed 113 patients of cleft lip and/or palate who were treated in the Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Iksan, Chunbuk, KOREA from September 1984 to August 1995. The obtained results were as follows. 1. In total 113 patients of cleft lip and/or palate, male patients were 63 cases (56%) and female patients were 50 cases (44%). 2. In distribution of cleft lip and/or palate, cleft lip patients were 30 cases (27%), cleft palate patient were 23 cases (20%) and cleft lip and palate patients were 60 cases (53%). 3. Unilateral cleft lip patients (78 cases: 87%) were larger than bilateral cleft lip. In unilateral cleft lip patients, lip side cleft lip patients (45 cases: 50%) were larger than right side cleft lip patients (33 cases: 37%). 4. Possible causes of cleft lip and/or palate were related with familial tendency, drug intoxication, malnutrition, old maternal age, stress and hypoxia during 4-8 weeks of pregnancy period. 5. The favorite treated method of cleft lip was Millard rotation-advancement method. Probably the most popular operated period was 3 months. 6. The useful operating technique of cleft palate was Wardill V-Y flap method. The most popular period has been 18 to 24 months. 7. In 11 patients with velopharyngeal insufficiency, hypernasality decreased by superior based pharyngeal flap pharyngoplasty. 8. Cleft alveolus was treated with autogenous and allogeneic bone graft. The most appropriate operation period was 9 to 11 years.

• 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.

• Korean Journal of Cleft Lip And Palate
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• v.10 no.1
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• pp.39-56
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• 2007

The bilateral cleft lip, a more severe form of clefting than unilateral cleft lip, involves separation of the lip along philtral lines, isolating the central segment (prolabium). Bilateral cleft lip may be either symmetrical or asymmetrical, in which case the cleft lip is split more on one side than on the other. The cleft affects the obvious facial form as an anatomic deformity and has functional consequences, affecting the child's ability to eat, speak, hear, and breathe. Although there would seem to be quite a variance in reported figures, ratios of cleft lip with or without cleft palate have gone as high as 1:500 and as low as 1:1000. It is known that less than 10% of cleft lips are bilateral. Although bilateral cleft lip is less common than unilateral cleft lip, the deformity is more severe, and the reconstructive technique is more complex. Surgery is the only treatment necessary for patients with bilateral cleft lip. Accompanying the evolution of surgical repair is the increasingly important role of orthodontic support with early presurgical alveolar and nasal molding. Repositioning the maxillary and alveolar segments into a more anatomic position allows the surgeon to repair the lip and associated nasal deformity under more optimal conditions. The purpose of this article is to review the related anatomy, presurgical management, and surgical management of bilateral cleft lip.

• 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.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.15 no.1
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• pp.51-57
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• 1985

The purpose of this study is to investigate possible correlation between the dental anomalies and site of cleft in cleft lip and palate. In this study, 142 patients who had cleft lip and/or cleft palate were examined. The results are as follows. 1. The incidence of missing tooth was high in the permanent dentition as compared to the incidence in the deciduous dentition. 2. There was not much difference of incidence of supernumerary tooth between deciduous and permanent dentition in the group of patients who had cleft lip and jaw with or without cleft palate. 3. In the group of patients who had cleft lip and jaw with or without cleft palate, the frequency of incidence of cleft sides was higer in unilateral than bilateral cases. And, incidence of left sides was higher than right sides. 4. The type of cleft between central incisor and canine with missing lateral incisor was most frequent in permanent dentition and the type of cleft between central and lateral incisor was most frequent in deciduous dentition. 5. The type of cleft associated with tooth position in deciduous dentition was not almost the same in the succeeding permanent dentition.

• 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.