Rhinoplasy and Orthognathic Surgery
on the Patients with Cleft Lip and Palate 高戶毅(Tsuyoshi TAKATO) University of Tokyo Hospital, JAPAN |
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However, the deformity of nose and maxillomandibular discrepancy in cleft lip/palate patients, has not
been solved completely. Our group reported that one of the reasons of the nasal deformity was caused by the
deviation of both the septal cartilage and perpendicular plate. Septoplasty and turbinectomy are performed to
relieve the obstructed nasal breathing. An adequate-sized piece is cut from the removed cartilage to enforce
the columella, which acts as a strut to keep both lower lateral cartilages symmetrical and to create a nasal tip.
A common additional request from our Oriental patients is for a narrower nose with a more prominent profile.
We prefer the cantilever bone grafting for that purpose. The graft material is the iliac bone. Although the
satisfactory results are obtained, the nose that is reconstructed with iliac bone is too hard and some patients
experienced the fracture of the grafted bone. Until now, we developed regenerative cartilage for the nose
with auricular chondrocytes. The clinical trial has been finished with satisfactory results. Although the poly-L
lactic acid scaffold enables auricular chondrocytes to attach and generate cartilage matrix, it has simple shape,
limiting the application of this technique to the cartilage defects in other regions. To solve these problems,
now we are promoting a project to develop a 3D bioprinter with which cells and growth factors can be injected
in addition to scaffold materials. In this project, we will regenerate bone, skin, meniscus, cartilage and knee
joint by mimicking both outer shapes and inner structures of native tissues. We are also engaged in research
on ear reconstruction using induced pluripotent stem cells (iPS cells). Conventionally, one-stage 2-jaw surgery
combining Le Fort I osteotomy and mandibular setback surgery has been used to treat severe maxillomandibular
discrepancy in cleft lip/palate patients. In some patients, stable occlusion and a good aesthetic outcome of
this method are precluded by the presence of severely contracted soft tissue. Recently, maxillary distraction
has been used for midface advancement in such patients. This technique allows the overlying midface to be
advanced, because distraction osteogenesis gradually lengthens both the bones and the soft tissues. However,
the control of maxillary movement is difficult and the long wearing of outstanding distractors causes psychosocial problems. To overcome these problems, we had developed the two-stage surgery consists of maxillary distraction and mandibular osteotomies.
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Curriculum Vitae Career
2017- Present
2011-2017
2001-2017
1996-2017
1992-1996 1989-1992 1987-1989 1985-1987 1983-1984 1979-1983 Education 1973-1979
Director of Hospital of JR Tokyo General Hospital
Director of 22nd Century Medical and Research Center Chief of Division of Tissue Engineering Professor of Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, University of Tokyo Associate Professor of Department of Oral and Maxillofacial Surgery, University of Tokyo Assistant Professor of Department of Oral and Maxillofacial Surgery, University of Tokyo (1990 July - 1991 May Toronto Sick Children's Hospital, Plastic Surgery Division) Chief of Plastic Surgery Division, Shizuoka Sick Children's Hospital Chief of Plastic Surgery Division, Bokuto Metropolitan Hospital Staff of National Cancer Center, Head and Neck Division Residency-Plastic Surgery Division, Tokyo University Hospital and Hyogo Sick Children's Hospital
University of Tokyo, Faculty of Medicine (Graduate School)
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