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김석화,반준섭 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.1
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.
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반준섭,이윤호 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.7
Deficiencies of the tubercle, philtral ridges and philtral dimple are common secondary deformities after cleft lip repair, and the reconstruction of these three elements are important for an aesthetically pleasing upper lip. Although various techniques have been described to deal with tubercle deficiency, absence of phitral ridges and phitral dimple, a technique which is simple and can create the tubercle, phitral ridges and philtral dimple in a single operation is rare. We present a technique which contains (1) V-Y mucosal advancement flap, (2) vertical rearrangement of the central portion of the orbicularis oris muscle, (3) adhesion of skin to the created dimple in orbicularis oris muscle for reconstruction of the philtral dimple and (4) in some cases, submucosal graft for reconstruction of the philtral ridge. This technique was performed in eighteen patients who had mild to moderate deficiency of the tubercle and produced satisfactory results.
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