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Secondary RhinoCheiloplasty In Unilateral Cleft Lip And Palate Patient

Secondary RhinoCheiloplasty In Unilateral Cleft Lip And Palate Patient . Dept. of Oral & Maxillofacial Surgery Gachon Medical School, Gil Medical Center 최세훈* , 정종철 , 송민석 , 전창훈 , 김현민. Introduction. Primary surgery If needed, but almost needed Secondary surgery. Review of Literatures.

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Secondary RhinoCheiloplasty In Unilateral Cleft Lip And Palate Patient

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  1. Secondary RhinoCheiloplasty In Unilateral Cleft Lip And Palate Patient Dept. of Oral & Maxillofacial Surgery Gachon Medical School, Gil Medical Center 최세훈*,정종철,송민석,전창훈,김현민

  2. Introduction • Primary surgery If needed, but almost needed • Secondary surgery

  3. Review of Literatures • The correction of secondary cleft lip nasal deformity YK Kim, HH Yeo(1995) • Nasal sill augmentation in adult incomplete cleft lip nose deformity using superiorly based turn over orbicularis oris muscle flap R Agarwal(1998) • Correction of secondary deformity of cleft lip nose S Samuel(2001) • Levator septi nasi muscle and its clinical significance T Harashina(2003)

  4. Timing • Intermediate surgery • Definitive surgery • Millard-6 years • Ahuja- after growth completed • Dutton & Bumsted-after puberty

  5. Considerations • Corrective anatomy • Motional deficiency • Asymmetry • Etc.

  6. Anatomy

  7. Anatomy

  8. General Findings • Nostril asymmetry • Lip scar • Alar base depression • Columella shortening • Discrepancy of muscle continuity • Etc.

  9. Nostril Asymmetry &Alar Base Depression • Primary surgery • Philtrum asymmetry • Cartilage disposition • Incomplete rotation • Alveolus cleft

  10. Alar unit rotation Correction of alar base

  11. Cartilage Deformity • Severe depression of lateral cartilage • Deficiency of cartilage

  12. Reposition of cartilage Graft augmentation

  13. Discrepancy of Muscle Continuity • Orbicularis oris disposition

  14. Prognosis • Follow up • Esthetic evaluation • Functional evaluation

  15. Case Report

  16. Case 1 • 8 years /F • Unilateral cleft lip and palate • After primary surgery, • fall down accident C/C: severe deviated nostril • Treatment plan 1. rhinocheiloplasty

  17. Pre Op

  18. Intra Op

  19. Intra Op

  20. Post Op(4 months)

  21. Comparison

  22. Case 2 • F/ 10 years • Unilateral cleft lip and palate • C/C: nostril asymmetry • Treatment plan 1. Rhinoplasty 2. Cleft alveolus correction 3. Bone graft

  23. Preop

  24. Intra Op

  25. Intra Op

  26. Post Op

  27. Comparison

  28. Case 3 • 27 years/F • Unilateral cleft lip and alveolus • Treatment plan 1. Rhinocheiloplasty 2. Cleft alveolus – bone graft

  29. Pre Op

  30. Intra Op

  31. Intra Op

  32. Post Op

  33. Comparison

  34. Summary • Correction of deviated septal cartilage • Repositioning of depressed lower lateral cartilage

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