양측성 구순열 환자의 안모 변형에 대한 연구

윤보근,소병수,백진아,신효근 대한구순구개열학회 2001 대한구순구개열학회지 Vol.4 No.2

Midfacial hypoplasia in patients with clefts of the lip and palate is considered to be the result of congenital dysmorphogenesis. And cleft lip and palate developes facial deformity, jaw abnormality, speech problem, which is most frequent hereditary deformity in maxillofacial region. So cleft lip and palate is characterized by midface deformity which shaws maxillary anterior nasal septa) deviation and deformity. Our study describes congenital correlates of midfacial hypoplasia by examining the displacement of a normal complement of parts, a triangular tissue deficiency low on the lip border on the columellar side, and a linear deficiency and displacement in the line of the bilateral cleft lip. 15 patients with bilateral cleft lip and palate were taken impression before operation, but the patient who had other abnormalities and complications were excluded. Average age is 3.4 months and they were classified into both complete, both incomplete and complete & incomplete group. The obtained results were as follows 1. There were no differences on intercanthal width and canthal width between each of the groups. 2. Both complete group had longer lateral ala length than both incomplete group, but there were no differences between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 3. Columella length was greater in both incomplete group than in both complete group, but there was no difference between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 4. Both complete group had longer ala width & ala base width than both incomplete group had. But there were no differences between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 5. There were no differences between each of the groups on upper lip length, but nose/mouth width ratio was greater in both complete group than in both incomplete group. 6. Pronasale(pm), subnasle(sn), labrale superioris(ls), stomion(sto) points were located around the central vertical line of face but deviated to incomplete side in com. & incom. group. 7. Nasal tip protrusion was greater in both incomplete group and com. & incom. group than both complete group, but there was no difference between both incomplete group and com. & incom. group.

Cornelia de Lange syndrom 환아에서 발생한 Incomplete cleft palate의 치험례

윤보근,이환수,신효근 대한구순구개열학회 2000 대한구순구개열학회지 Vol.3 No.1

Cornelia de Lange syndrome is a disorder of unknown biochemical and genetic basis that is recognized on the basis of characteristic facies(low anterior hairline, synophrys, anteverted nares, maxillary prognathism, long philtrum, carp mouth) in association with prenatal and postnatal growth retardation, mental retardation and, in many cases, upper limb anomalies. We treated the patient with incomplete cleft palate related to Cornelia de Lange syndrome.

Palatal lift를 이용한 비인강폐쇄부전환자의 임상적 치험례

윤보근,고승오,신효근,Yoon, Bo-Keun,Ko, Seung-O,Shin, Hyo-Keun 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.1

Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, various muscles of palate & pharynx function as sphincter and occlude the oropharynx from the nasopharynx during the production of oral consonant sounds. Inadequate velopharyngeal function caused by neurologic disorder - cerebral apoplexy, regressive diseases - disseminated sclerosis, Parkinson's disease, congenital deformity - cleft palate, cerebral palsy and etc. may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. In our study, we constructed speech aids prosthesis - Palatal lift in acquired idiophathic VPI patient and assessed velopharyngeal function with various diagnostic instruments which can evaluate the speech characteristics objectively.

음성 폐쇄상을 이용한 구개열 환자의 언어치료의 증례 보고 - 장착 후 제거까지의 경과 -

임대호,윤보근,백진아,신효근,Leem, Dae-Ho,Yoon, Bo-Keun,Baik, Jin-A,Shin, Hyo-Keun 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.5

Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, various muscles of palate & pharynx function as sphincter and occlude the oropharynx from the nasopharynx during the production of oral consonant sounds. Inadequate velopharyngeal function caused by neurologic disorder - cerebral apoplexy, regressive diseases - disseminated sclerosis, Parkinson's disease, congenital deformity - cleft palate, cerebral palsy and etc. may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. In our study, we constructed speech aids prosthesis - Speech bulb in the incomplete cleft palate VPI patient with hypernasality and assessed velopharyngeal function with nasometer which can evaluate the speech characteristics objectively.

하악지 시상분할 절단술 후 감각 변화에 관한 연구

최준영,유준열,윤보근,임대호,신효근,고승오,Choi, Jun-Young,Yoo, Jun-Yeol,Yoon, Bo-Keun,Leem, Dae-Ho,Shin, Hyo-Keun,Ko, Seung-O 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.2

The bilateral sagittal split ramus osteotomy (BSSRO) is preferred method of surgical correction for mandibular prognathism, retrognathism and asymmetry. This technique performed from primarily an intraoral incision to avoid a scar. After forward movement of the distal segment of the mandible, healing of bone by primary or secondary intention is easily accomplished through large areas of cancellous bony overlap. When rigid fixation is used for the BSSRO, it is possible to open the mouth during the immediate post-operative period because it promotes the healing process. Although this surgical procedure has been well-documented, the incidence of postoperative trigeminal neurosensory disorder in the region of the inferior alveolar nerve and the mental nerve remains one of the major complication. However, evaluation of objective methods for sensory recovery patterns is insufficient although most patients find their sensory return. Neurometer electrodiagnostic device performs automated neuroselective sensory nerve conduction threshold evaluation by determining current perception threshold (CPT) measures. The purpose of this study was to evaluate the sensory recovery patterns of inferior alveolar and mental nerve over time. Nerve examination with a neurometer was performed in 30 patients undergoing the BSSRO at pre-operative, post-operative 1-, 2-, 4- week, and 2-, 3-, 4-, 5-, 6- month follow-up visits after the osteotomy to compare the differences of nerve injury and recovery patterns after the BSSRO with or without genioplasty and sensory recovery patterns associated with the kind of nerve fiber.

하악 전방부에 발생한 Stafne's cyst에 대한 증례보고

장학선,김은주,윤보근,임대호,고승오,신효근,Jang, Hak-Sun,Kim, Eun-Ju,Yoon, Bo-Keun,Leem, Dae-Ho,Ko, Seung-O,Shin, Hyo-Keun 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.2

In 1942, Stafne described 35 "bone cavities" at the angle of the mandible. They appeared as unilocular, well-circumscribed, round or elliptical radiolucencies located below the inferior dental canal and between the angle of the mandible and first molar tooth. Since 1942, these lesions have been frequently described under various terms: aberrant or ectopic salivary gland; static or latent or idiopathic defect, cavity or cyst; mandibular salivary gland inclusion; lingual mandibular cavity; and Stafne's cyst, defect or cavity. Usually they were asymptomatic, with a predilection for men between age 50 and 70 years, and almost unilateral. At surgical exploration, they appeared as concavities on the lingual cortex and contained salivary gland tissue, often in continuity with the submandibular gland. In 1957, Richard and Ziskind were the first to report the appearance of a Stafne's cyst in the premolar region. Contrary to posterior defects, the anterior defects are difficult to diagnose clinically because the mandibular canal is not present, and the unilocular radiolucency can be confused with other cysts (radicular, residual, odontogenic, lateral periodontal,etc). The purpose of the present report is to describe an unusual case of Stafne's cyst in the anterior region of the mandible in 58-years-old woman.

구개봉합술 후 발생한 구비강누공의 폐쇄 후 말소리 결과 : 증례보고

서민교,김다와,김은주,윤보근,김성일,임대호,고승오,문승영,김현기,신효근 대한구순구개열학회 2008 대한구순구개열학회지 Vol.12 No.1

Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter,had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in mm2 Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.