[A case of cleft lip and palate patient with basilar impression]

Basilar impression is one of bony deformities occurred in the region of the foramen magnum, in which deformity, rim of the foramen magnum or a part of the vertebra impresses into the posterior cranial fossa. Major symptoms of this deformity are short neck, low hair line, torticollis, webbing of neck, pain and limitation of neck movement and various nerve symptoms, when nervous tissue is impressed by rim of the foramen magnum or dens of the second vertebra. This deformity has a characteristic to be found later as a congenital deformity, because nerve symptoms usually do not occur in earlier than 10 years old. The patient was 7 years and 8 months old at his initial visit, whose chief complaint was rotation of upper central incisors which created chewing disorder. When he became 12 years old, because he was taken palsy, walking disturbance, and neck pain in movement, neurosurgery was planned immediately. Edgewise appliance was, then, removed, and orthodontic treatment had to be discontinued until he left hospital. A case was reported of the problems in orthodontic treatment and characteristic of this deformity through our experience for this cleft lip and palate patient with basilar impression in addition to other reports about this deformity.