OBJECTIVETo study the application of extraoral distraction devices in correction of various maxillo-mandibular deformities.

METHODSFrom 1997, 11 cases with various maxillo-mandibular deformities were corrected by distraction devices of designed by myself. 7 cases of then were the patients with cleft palate who have severe secondary maxillary hypoplasia. 1 case with micrognathia, 1 case with partial mandibular mentum defect, 1 case with lateral deviation of micrognathia and 1 case with hemimandibular hypertrophy. The mandibles were elongated, from 12 mm to 20 mm, the maxillae were elongated from 7 mm to 22 mm, the vertical mandibular distraction was 15 mm.

RESULTSAll cases were corrected satisfactorily and haven't any complications. In 1 cases the 1 Kischners pin had been pull out by loosen during distration. 4 Kischners pin were curved during vertical mandibular distration. Another case the maxillary hypoplasia appeared edge-to-edge and mild open occlusion after 4 weeks fixation.

CONCLUSIONThe extraoral distration osteogenesis provides a new method with many advantages for those maxillo-mandibular deformities that are difficulty corrected by ordinary orthognathic surgery.

Cleft Palate ; therapy ; Humans ; Jaw Abnormalities ; therapy ; Mandible ; abnormalities ; Maxilla ; abnormalities ; Micrognathism ; therapy ; Osteogenesis, Distraction ; instrumentation ; Treatment Outcome

Dysphasia related to oral anomaly is a common situation in oral and maxillofacial surgery. The etiology of oral anomalies causing dysphasia can be divided into congenital and acquired disease. Congenital diseases include teratoma or benign tumors and congenital defects such as cleft lip and palate. Benign tumors include cystic hygroma in the neck and hemangioma in the tongue. Certain syndromes with macroglossia and micrognathia are also related to difficulty in swallowing. The three common syndromes are Pierre-Robin syndrome, Beckwith-Widermann syndrome and ectodermal dysplasia. Taken together, these congenital diseases require a multi-discipline approach to obtain optimal results. Representative disease of acquired dysphasia is the oral cavity cancer. Cancer ablation results in tissue defect and decreased motor function. Free flap reconstruction is the choice of treatment following oral cavity caner operation; however, dysphasia after cancer operation is inevitable. In this review article, the full scopes of oral anomaly associated with dysphasia were classified and treatment was suggested.
Aphasia ; Cleft Lip ; Congenital Abnormalities ; Deglutition ; Ectodermal Dysplasia ; Free Tissue Flaps ; Hemangioma ; Lymphangioma, Cystic ; Macroglossia ; Micrognathism ; Mouth ; Mouth Neoplasms ; Neck ; Palate ; Pierre Robin Syndrome ; Surgery, Oral ; Teratoma ; Tongue

Management of infants born with cleft lip and palate entails an interdisciplinary team effort that begins from infancy to adulthood. The goal of pre-surgical infant orthopedics is to reduce the severity of the cleft deformity before surgery. However, traditional methods do not address the deformity of the nasal cartilages and alveolar ridges simultaneously. The Nasoalveolar Molding (NAM) technique takes advantage of the malleability of immature nasal cartilage and its ability to maintain a permanent correction of its form. The NAM device is used to actively mold the alar dome, nasal cartilages, premaxilla, and alveolar ridges into a more normal anatomic form and position. It permits non-surgical elongation of the columella through application of tissue expansion principles. This results in better facial aesthetics and may help reduce the extent, number and cost of surgeries. The three cases presented illustrate the application of the NAM device for the pre-surgical infant orthopedics in unilateral and bilateral cleft lip and palate patients treated at the Philippine Children's Medical Center-Pediatric Dentistry Division (PCMC-PDD).
Human ; Male ; Infant Newborn ; CLEFT LIP ; CLEFT PALATE ; MUSCULOSKELETAL DISEASES ; JAW DISEASES ; JAW ABNORMALITIES

Pierre Robin sequence (PRS) describes the clinical triad of micro- and/or retrognathia, glossoptosis and cleft soft palate. Glossopexy has been demonstrated to be an effective treatment in selected cases of obstruction caused by glossoptosis (generally 6 to 10 months of glossopexy period). If radiofrequency therapy (RF) can reduce tongue volume in PRS, it will be helpful in early releasing of the glossopexy. Two-day-old patient showed a PRS triad. Intermittent cyanosis, respiratory difficulty and feeding problems were also observed. The respiration was not improved and prolonged intubation increased the possibility of respiratory complications like pneumonia. The surgical intervention-glossopexy and RF was done 20 days after birth. We applied RF combined with conventional glossopexy and could get successful results while reducing the overall treatment time to 6 weeks. The follow-up until 12 months after birth was uneventful. Considering that early recovery is highly beneficial to PRS patients by reducing risks associated with glossopexy and low energy RF application is very simple and low risk to patient, our combination therapy should be considered for the treatment of airway problem related to PRS.]]>
Cleft Palate ; Cyanosis ; Follow-Up Studies ; Humans ; Intubation ; Palate, Soft ; Parturition ; Pierre Robin Syndrome ; Pneumonia ; Respiration ; Retrognathia ; Tongue

Cleft lip and palate is one of the most frequent hereditary deformities of the maxillofacial region which can arise in facial and jaw abnormalities as well as malocclusion and speech problems. In particular, unilateral cleft lip and palate is characterized by midface deformity resulting in maxillary anterior nasal septal deviation and nasal deformity. The aim of this study is to analyze the facial deformity of untreated unilateral cleft lip patients for contribution to primary cheiloplasty.METHODS: Thirty-three patients with unilateral cleft lip and palate were impressioned before operation and facial casts were made. The casts were classified into complete cleft lip and incomplete cleft lip groups and each group were classified into affected side and normal side. Anthropometric reference points and lines were setted up and analysis between points and lines were made.RESULTS AND CONCLUSION: The obtained results were as follows:1.The intercanthal width had no significant difference between the incomplete and complete cleft lip groups.2.Cleft width and alar base width were greater in the complete group, and nasal tip protrusion was greater in the incomplete group.3.Involved alar width and nostril width were greater in the complete group and in both complete and incomplete groups, involved alar width and nostril width were greater than the non-involved side.4.The lateral deviation of the subnasale was greater in the complete group in both involved and non-involved sides.5.The nasal laterale was placed inferiorly in both cleft groups.6.The subnasale was deviated to the non-involved side in both cleft groups.7.The nose tip was deviated to the non-involved side in both cleft groups and had greater lateral deviation in the complete cleft group.8.The midpoint of cupid's bow had no vertical difference between complete and incomplete groups, but had a greater lateral deviation in the complete group.9.In the complete cleft group, correlation between differences in cleft width and nostril width and columella height difference were obtained.]]>
Cleft Lip ; Congenital Abnormalities ; Humans ; Jaw Abnormalities ; Malocclusion ; Nose ; Palate ; Rhinoplasty ; Succinates

No abstract available.
Congenital Abnormalities* ; Humans ; Jaw*

Pierre Robin sequence (PRS) is characterized by the triad of micrognathia, glossoptosis, and airway obstruction. PRS does not have a single pathogenesis, but rather is associated with multiple syndromes. This report presents the case of a 35-year-old woman with PRS and scoliosis. Among the syndromes related to PRS, cerebro-costo-mandibular syndrome (CCMS), which is characterized by posterior rib gap defects and vertebral anomalies, was suspected in this patient. However, no posterior rib gap defect was detected on radiological examinations. Although over 80 cases of CCMS have been reported to date, few cases of PRS with scoliosis alone have been reported. Therefore, this report demonstrated the clinical, radiological, and cephalometric characteristics of an adult patient with PRS and scoliosis, but without rib anomalies.
Adult ; Airway Obstruction ; Female ; Glossoptosis ; Humans ; Micrognathism ; Pierre Robin Syndrome ; Ribs ; Scoliosis

Pierre Robin sequence (PRS), also called Robin sequence, is a congenital anomaly characterized by a triad of micrognathia, glossoptosis, and upper airway obstruction. Infants with PRS can present with varying degrees of respiratory difficulty secondary to upper airway obstruction. There has been no consensus for the treatment of upper airway obstruction in infants with PRS, but recent studies recommend attempting non-surgical interventions before surgical treatment. In this case report, we present 3 cases of infants diagnosed with PRS who showed persistent respiratory difficulties after birth. Before considering surgical intervention, insertion of a nasopharyngeal airway was attempted in these infants. Following this procedure, symptoms of upper airway obstruction were relieved, and all infants were discharged without surgical interventions; the nasopharyngeal airway was removed 1 to 2 months later. To date, no infant has shown signs of upper airway obstruction. Nasopharyngeal airway insertion is a highly effective and less invasive treatment option for infants with PRS. However, it is not widely known and used in Korea. Nasopharyngeal airway insertion can be preferentially considered before surgical intervention for upper airway obstruction in such infants.
Airway Obstruction ; Consensus ; Glossoptosis ; Humans ; Infant ; Korea ; Micrognathism ; Parturition ; Pierre Robin Syndrome

A case of Crouzon's disease, in spite of the relatively small number of cases reported until recently. The patient was 3years old male and hospitalized Woo-Sok University hospital 5 May, 1970. the appearance of the patient was striking type of facial deformity. There is a marked frontal boss forming a prominent bregmatic tumour, hooked nose, a small receding maxilla and a pronounced prognathism in wthich the teeth of the lower jaw protrude several centimetres beyond those of the upper. Proptosis and subnormal mentality was present, Cerebral decompression had been performed to the patient for his exophthalmos, it was aggreviated after the operation and thus enucleation was done finally.
Congenital Abnormalities ; Craniofacial Dysostosis* ; Decompression ; Exophthalmos ; Humans ; Jaw ; Male ; Maxilla ; Nose ; Prognathism ; Strikes, Employee ; Tooth

prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.]]>
Congenital Abnormalities ; Esthetics ; Humans ; Jaw ; Lip ; Malocclusion ; Maxilla ; Nose ; Orthognathic Surgery ; Prognathism ; Spine