Objective: To present the case of a midline Tessier 30 cleft in a baby boy who initially underwent a glossoplasty, cheiloplasty and mentoplasty. Methods: Design: Case Report. Setting: Tertiary Government Training Hospital. Patient: One. Result: A 4-month-old boy with a complete midline cleft of the lower lip, alveolus and mandible, and bifid distal tongue that was fused with the floor of the mouth, underwent glossoplasty, cheiloplasty and mentoplasty with subsequent excellent aesthetic outcome and normal oral competency. Conclusion Tessier 30 is a rare congenital midline mandibular cleft. Prompt glossoplasty, cheiloplasty and mentoplasty can correct the gross deformity, restore oral competency, and address functional needs such as feeding, swallowing and early speech development. Future bony repair will hopefully complete the reconstruction.
Mandible ; Cleft Lip ; Tongue Diseases ; Jaw Abnormalities ; Plastic Surgery Procedures

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

Squamous cell carcinoma of the lower lip can be developec by a number of underlying etiologic factors, the most outstanding of which is solar irracdiation, and is considerably more aggresive and has a much higher incidence of metastatic spread. Its early detection and effective treatment afford a high cure rate. Cryosurgery is a simple, efficient and effective method of treatment of skin cancer and is now a widely accepted modality for the treatment of these lesions. Two patients(67-year-old male and 57-year-old female) were presented with solitary or two masses on the lower lip without regional lymphadenopathy. These two cases showed clinical and histopathologic findings of squamous cell carcinoma. They were successfully treated by cryotherapy with liquid nitrogen without any significant side effects.
Carcinoma, Squamous Cell ; Cryosurgery ; Cryotherapy ; Humans ; Incidence ; Lip* ; Lymphatic Diseases ; Male ; Middle Aged ; Nitrogen* ; Skin Neoplasms

BACKGROUND: Cheilitis is a common problem, the cause of which is often obscure. OBJECTIVE: We evaluated the frequency of allergic contact cheilitis and irritant contact cheilitis among 23 eczematous cheilitis patients via patch testing and assessment of past medical history. METHODS: This study consisted of 23 patients with eczematous cheilitis who had visited the Department of Dermatology, two University Hospital in Incheon, between January 2005 and August 2006. Of the 23 patients, 20 were female, and the age range was 15 to 70 years. We analyzed the clinical characteristics (age, gender, duration, atopic or allergic disease, lip licking) of the patients. All patients were patch-tested with the Korean standard series, 9 patients with the Cosmetic series and 5 patients with as is test. We then analyzed the results of the patch tests and evaluated the relevance of any positive results. RESULTS: Of the cases, 34.78% were identified as irritant contact dermatitis (ICD), and 30.43% as allergic contact dermatitis (ACD). Furthermore, of the 23 patients, 11 were positive to one or more antigen and 7 of these had a clinical relevance for positive antigen. The substances causing a positive reaction, triggering ACD were identified as medicaments applied to the lip, lipstick ingredients and toothpaste. CONCLUSION: The most common cause of cheilitis was irritation, frequently caused by lip licking. But, almost one third was caused by ACD. Patients with chronic eczematous cheilitis should be patch-tested to identify the materials causing ACD.
Cheilitis* ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Dermatology ; Female ; Humans ; Incheon ; Lip ; Lip Diseases ; Patch Tests* ; Toothpastes

OBJECTIVETo explore the effect of myringotomy with insertion of tube and tympanocentesis on alleviating secretory otitis media (SOM) and hearing loss in cleft palate infants.

METHODSNineteen cleft lip and palate infants with SOM and hearing loss (38 ears) were treated with myringotomy with insertion of ventilation tube at the same time of repair of the cleft lip, who were performed averagely at 6.9 months of age. Fifteen cleft lip and palate infants with SOM (30 ears) were treated with tympanocentesis at the same time of repair of the cleft lip averagely at 6.6 months of age. All cases were followed up from 1 week to 12 months and estimated by auditory brainstem response (ABR) and acoustic immitance audiometry.

RESULTSThe average wave V reacting thresholds of ABR were separately 55.41 dBnHL and 28.48 dBnHL, and 79.17% tympanogram B changed to tympanogram A in cleft palate infants with insertion of tube before and after operation. The average wave V reacting thresholds of ABR were separately 40.63 dBnHL and 26.50 dBnHL, and 40.91% tympanogram B changed to tympanogram A in cleft palate infants with tympanocentesis preoperatively and in 1 week postoperatively, in whom the average hearing thresholds and tympanograms had no significant difference preoperatively and in 1 or 3 months postoperatively (P>0.05).

CONCLUSIONThe early myringotomy with insertion of tube is effective to restore the function of the middle ear in cleft palate infants with SOM, so to suggest to be performed at the same time of the repair of cleft lip within the first 1-year of life. The tympanocentesis should not be used as a regular management in the cleft palate infants with SOM.

Alveolar synechia or syngnathia is a rare anomaly showing soft tissue or bony adhesions between the alveolar ridges of maxilla and mandible. In our review of the world literature, we have identified 68 reports of alvelolar synechia. Most cases describe cleft palate and the term cleft palate and congenital alveolar synechia syndrome was coined by Verdi and 0'neal(1983). Additional anomalies such as cleft lip, micrognathia, microglossia, lower lip pits, ankyloblepharon, and limb anomalies are associated. Related syndromes may include popliteal pterygium syndrome, van der Woude syndrome, and orofaciodigital syndrome. We present a child with congenital alveolar synechia and left unilateral complete cleft lip and palate. The child had difficulty in mouth opening with a maximal anterior jaw opening of 4 mm. The fibrous synechia was resected at the age of 4 months. On dividing the fibrous band, the jaws were distracted to an opening of only 7 mm using finger dilatation. However, the maximal anterior jaw opening by passive dilatation had increased to 19.0 mm after 2 months and up to 23.1 mm after 6 months by stretching exercise of the mandible, so the child could open his mouth successfully.
Child ; Cleft Lip ; Cleft Palate* ; Dilatation ; Extremities ; Fingers ; Humans ; Jaw ; Lip ; Mandible ; Maxilla ; Mouth ; Numismatics ; Orofaciodigital Syndromes ; Palate ; Pterygium ; Tongue Diseases

Alveolar synechia or syngnathia is a rare anomaly showing soft tissue or bony adhesions between the alveolar ridges of maxilla and mandible. In our review of the world literature, we have identified 68 reports of alvelolar synechia. Most cases describe cleft palate and the term cleft palate and congenital alveolar synechia syndrome was coined by Verdi and 0'neal(1983). Additional anomalies such as cleft lip, micrognathia, microglossia, lower lip pits, ankyloblepharon, and limb anomalies are associated. Related syndromes may include popliteal pterygium syndrome, van der Woude syndrome, and orofaciodigital syndrome. We present a child with congenital alveolar synechia and left unilateral complete cleft lip and palate. The child had difficulty in mouth opening with a maximal anterior jaw opening of 4 mm. The fibrous synechia was resected at the age of 4 months. On dividing the fibrous band, the jaws were distracted to an opening of only 7 mm using finger dilatation. However, the maximal anterior jaw opening by passive dilatation had increased to 19.0 mm after 2 months and up to 23.1 mm after 6 months by stretching exercise of the mandible, so the child could open his mouth successfully.
Child ; Cleft Lip ; Cleft Palate* ; Dilatation ; Extremities ; Fingers ; Humans ; Jaw ; Lip ; Mandible ; Maxilla ; Mouth ; Numismatics ; Orofaciodigital Syndromes ; Palate ; Pterygium ; Tongue Diseases

The Dandy-Wlaker syndrome is a developmental disoeder characterized by cystic dilatation of the fourth ventricle and agenesis or hypoplasia of the cerebellar vermis and is usually associated with hydrocephalus. This syndrome is also associated with intracranial malformations such as agenesis of corpus callosum, and extracranial malformations such as facial anormalies (cleft palate, cleft lip, and ocular anomalies), polycystic kidney, and cardiac anormalies. Reported associated ophthalmic anomalies are microphthalmos, coloboma, and congenital cataract.We experienced a case of infantile esotropia in abnormal insertion and direction of lateral rectus muscle as a variant of the Dandy-Walker syndrome accompanied by cleft palate and cleft lip in a 19-month-old male infant. Subsequent treatment of the 30delta esodeviation and left inferior oblique muscle overaction, including resection of the lateral rectus muscle in both eyes and the myectomy of the inferior oblique muscle in the left eye, yielded satisfactory results, so we report this case, with a review of the pertinent literature, as the first case of Dandy-Walker syndrome associated with esotropia with abnormal course of lateral rectus muscle in Korea.
Agenesis of Corpus Callosum ; Cleft Lip ; Cleft Palate ; Coloboma ; Dandy-Walker Syndrome* ; Dilatation ; Esotropia* ; Fourth Ventricle ; Humans ; Hydrocephalus ; Infant ; Korea ; Lip ; Male ; Microphthalmos ; Polycystic Kidney Diseases

OBJECTIVE: Clinical examination and molecular genetic analysis were carried out for one case with special facial features with developmental retardation, hearing impairment and cleft lip and palate. METHODS: The intelligence test, hearing test, and MRI test were performed. At the same time, the blood were collected to detect the copy number variation of the whole genome with the chromosomal karyotype analysis and the chromosomal microarray analysis (CMA). And the whole exome sequencing (WES) was used to analyze the pathogenic variant. RESULTS: The children had mild mental retardation and the IQ was 61. There was moderate hearing loss in both ears(left ear 60 dB, right ear 65 dB). And bilateral horizontal hypoplasia of semicircular canal was found by cranial MRI test. No copy number abnormality was found by chromosome karyotype analysis and chromosome microarray analysis in peripheral blood. And whole exome sequencing suggested that there was heterozygous pathogenic variants in KMT2D gene (p.Leu545Argfs*385). CONCLUSION The patient has a peculiar face and multiple system defects, and was diagnosed as Niikawa-Kuroki syndrome type I by KMT2D gene variant. The whole exome sequencing is helpful for the diagnosis of complex genetic diseases.
Abnormalities, Multiple ; Child ; Cleft Lip ; Cleft Palate ; DNA Copy Number Variations ; Face/abnormalities* ; Hematologic Diseases ; Humans ; Vestibular Diseases

The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I–III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.
Aged ; Carcinoma, Squamous Cell ; Humans ; Lip Neoplasms* ; Lip* ; Lung Neoplasms ; Lymph Nodes ; Lymphoma ; Mouth ; Neck ; Neck Dissection ; Neoplasm Metastasis* ; Neoplasm Recurrence, Local ; Prognosis ; Rare Diseases ; Recurrence* ; Soft Tissue Neoplasms ; Treatment Failure