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At least 307 records · Page 17Linked to original sources
PubMed2000

Lip rejuvenation.

BACKGROUND: The management of the senile lip remains a dilemma. Allogenic fillers often feel unnatural, lip resurfacing is not adequate, and fat transfers may disappear. OBJECTIVE: To develop a more reliable step-by-step approach to lip augmentation. METHOD: Lips were divided into types: (1) the simple senile lip that had lost its fullness-treated with fat augmentation; (2) the lip with rhagades-treated with fat augmentation and laser resurfacing; and (3) the duckbill lip-treated with lip advancement, fat augmentation, and laser resurfacing. Tattooing to increase the degree of redness was performed on all types of lips. RESULT: If there had been a previously full lip, it was possible to rejuvenate the lip by simple augmentation with autologous fat transfer. The average number of fat transfer sessions to generate this pleasing lip was two to three. The lip with rhagades required fat filling, with laser resurfacing to achieve a new contour. The duckbill lip required a lip advancement along with lipofilling and laser resurfacing. All types benefited from lip tattooing. CONCLUSIONS: It was possible with fat augmentation and/or laser resurfacing to generate a pleasing lip in type 1 and 2 lips. Lip type 3 required a lip advancement along with fat augmentation and laser resurfacing. Lip tattooing accentuated all the lip types.

Adipose Tissue↗
PubMed1999

A long-term, controlled-outcome analysis of in utero versus neonatal cleft lip repair using an ovine model.

Successful open repair of a cleft lip in utero has the advantage of scarless wound healing in the fetus. Unfortunately, no long-term outcome studies have been performed to evaluate the efficacy of these repairs. Moreover, no study to date has compared the long-term results of an in utero cleft lip repair to a similar, control-matched, newborn cleft repair. This study was performed to evaluate the 9-month outcome of in utero cleft lip surgery compared with an identical cleft lip repair performed on infant lambs. In utero epithelialized cleft lips were created through an open hysterotomy in sixteen 65-day-old fetal lambs (term = 140 days) using methods described by Longaker et al. Eight of 16 animals underwent subsequent in utero repair of these clefts at 90 days gestational age. The repair of the remaining eight animals was delayed until 1 week postpartum. At 9 months, the animals were analyzed for changes in lip contour and for the degree of scarring by hematoxylin and eosin and Masson's trichrome collagen staining. Two animals in each group died from preterm labor. Of the animals that survived to term, all repaired lips had some degree of abnormality postoperatively. One of six lips repaired in utero dehisced before delivery. Three of six neonatal repairs dehisced in the first postoperative month. In the remaining animals with intact lip repairs, the vertical lip height on the repaired side was an average of 9 to 12 mm shorter than the normal lip in both the in utero and neonatally repaired animals. Phenotypically, the postnatally repaired animals had more lip distortion and visible notching. Histologically, the in utero repair was scarless and the neonatal repairs had scar throughout the entire vertical height of the lip with an associated loss of hair in this region. Maxillary growth was also evaluated. There was no inhibition of maxillary growth in the animals that underwent in utero cleft lip repair. However, in the neonatal repair group, significant maxillary retrusion was evident. Compared with the cleft side of the maxilla, horizontal growth was decreased by 11 percent (p = 0.01). Compared with the intrauterine repair group, there was a 17-percent decrease in horizontal maxillary width (p = 0.01). Straight-line in utero repair of a cleft lip produces a better long-term result in terms of maxillary growth than a similar repair performed postnatally in the ovine model. There was no diminution in maxillary growth in the animals treated in utero. Histologically, in utero repair of clefts was indeed scarless. However, both lip repairs produced lips that were significantly shorter than their contralateral noncleft sides. This degree of lip shortening would require a secondary lip revision, thereby defeating the purpose of performing an intrauterine repair. Comparisons now need to be made between in utero and neonatal repairs using a Millard-type rotation advancement technique before intrauterine treatment can be considered to be more beneficial than our current treatment modalities.

Animals↗
PubMed1989

Gain and spatial characteristics of human lip-muscle reflexes.

Mechanically evoked early and late excitatory reflexes (E1 and E2) and suppression responses (S) were studied in human lip muscle. Acceleration pulses were applied at 30-150 m/s2 independently to the upper and lower lips during lip rounding and lower-lip depression postures, and to both lips during a lip-press posture. E1 responses were prevalent during lip rounding and press gestures and S responses during lip depression. Reflex magnitudes were well correlated with stimulus acceleration for the 3 response components, with E1 responses showing the strongest association. The slopes of linear equations relating reflex and stimulus magnitudes, i.e. reflex gains, for E1 and E2 responses were highly variable across subjects. This variability was partially related to subject gender, females showing larger reflex gains. Two novel findings on the spatial aspects of lip-muscle reflexes are that: (1) S responses in lower-lip muscle are more prevalent to upper-lip versus lower-lip stimulation, and (2) E1 and E2 gains in lower-lip muscle are larger for stimulation of the lower lip compared to stimulation of the upper lip. Further testing suggested that this latter pattern differs with form of stimulation, with a laterally directed sliding stimulus on the upper lip producing predominant effects in both the upper- and lower-lip muscle, and an indenting stimulus producing the largest reflexes in muscle of the stimulated lip.

Adult↗
PubMed2003

Quantitative evaluation of lip symmetry in functional asymmetry.

The objectives of this study were to quantitate lip symmetry/asymmetry from clinical photographs; to demonstrate that asymmetry due to functional side shifts (functional asymmetry) leading to unilateral crossbites including the canines, results from measurable thinning of the upper lip and thickening of the lower lip on the side of the crossbite when viewed in the intercuspal contact position; and to show that orthodontic treatment aimed at eliminating the functional shift and crossbite would achieve lip symmetry, both visually and quantitatively. The study consisted of 26 patients, who were divided into two groups: a study group of 13 patients (eight females, five males, aged 8-17 years) with a functional asymmetry, and a control group of 13 age- and gender-matched subjects with other forms of malocclusion without functional asymmetry. All patients in the study group exhibited unilateral crossbites including the canines in intercuspal contact position. Digitized images of frontal facial photographs were analysed for upper and lower lip symmetry pre- and post-orthodontic treatment. The upper and lower lips were subdivided into four quadrants and the surface area and length of each quadrant were measured and expressed as a percentage of the total surface area/length of the relevant lip. The degree of asymmetry was obtained by calculating the difference in percentage area or length between the two quadrants of each lip. In the study group, the lower lip quadrant on the shift side was enlarged while the contralateral side was reduced (mean area ratio 59.9 to 40.1 per cent, mean length ratio 53.0 to 47.0 per cent). The upper lip demonstrated differences that were smaller and inverse. The controls showed a small difference between the right and left sides (less than 1 per cent). After treatment, both groups displayed visual and quantitative lower and upper lip symmetry, i.e. an area or length of approximately 50 per cent of each quadrant. In absolute values, the control patients had up to 3 per cent asymmetry in area regardless of treatment. The patients in the study group exhibited mean absolute asymmetry of 9.2 per cent in the upper lip and 19.8 per cent in the lower lip. Asymmetry values in the study group were reduced to approximately 3 per cent post-treatment. The absolute values of asymmetry in length of all patients were up to 2 per cent in the control group regardless of treatment. The subjects in the study group exhibited mean absolute asymmetry of 6.3 per cent in the upper lip and 8.6 per cent in the lower lip. Asymmetry values in the study group were reduced post-treatment to approximately 2 per cent. Although asymmetry in the study group could be quantitated using both parameters (lip surface area and lip length), the surface area parameter proved to be a more sensitive tool for measuring lip asymmetry.

Adolescent↗
PubMed1989

[The changes of the orofacial muscle activity induced by the lip forces in subjects with normal occlusion].

This study was intended to investigate whether lip exercise affect the activities of the lips, tongue, digastric and masseter muscles and to understand the functional interrelationship between them. As the forces of maximum lip grimace was reduced to slight lip seal gradually, the electromyograph was taken from 9 conscious human adults with normal occlusion in the upper and lower lips, tongue, digastric and masseter muscle using surface electrodes, especially, newly designed subminiature surface electrodes which was attached directly to the tongue. The results were as follows. 1. During induced maximum lip grimace in the mandibular rest position, there're prominent increase of EMG activity in the upper and lower lips, tongue and digastric muscle 1714 mu v, 2787 mu v, 2142 mu v and 623 mu v, respectively, but there was little activity in the masseter muscle, 129 mu v. The force level induced by maximum grimace of the lips was about 110g when the force transducer was positioned between upper and lower lips in the incisor area. 2. As the lip forces were reduced gradually, EMG activities of the lips, tongue and digastric muscles were decreased definitely with certain tendency, but there was no change in the masseteric EMG activity. Above mentioned results suggest that (1) lip exercise can promote the activities of the lips, tongue and digastric muscles but cannot change the activity of the masseter muscle and (2) masseteric muscle activity seems to be independent of the lips and the tongue but digastric muscle activity is related more closely to them through lip exercise in the subjects with normal occlusion.

Adult↗
PubMed1997

Lip and jaw kinematics in bilabial stop consonant production.

This paper reports two experiments, each designed to clarify different aspects of bilabial stop consonant production. The first one examined events during the labial closure using kinematic recordings in combination with records of oral air pressure and force of labial contact. The results of this experiment suggested that the lips were moving at a high velocity when the oral closure occurred. They also indicated mechanical interactions between the lips during the closure, including tissue compression and the lower lip moving the upper lip upward. The second experiment studied patterns of upper and lower lip interactions, movement variability within and across speakers, and the effects on lip and jaw kinematics of stop consonant voicing and vowel context. Again, the results showed that the lips were moving at a high velocity at the onset of the oral closure. No consistent influences of stop consonant voicing were observed on lip and jaw kinematics in five subjects, nor on a derived measure of lip aperture. The overall results are compatible with the hypothesis that one target for the lips in bilabial stop production is a region of negative lip aperture. A negative lip aperture implies that to reach their virtual target, the lips would have to move beyond each other. Such a control strategy would ensure that the lips will form an air light seal irrespective of any contextual variability in the onset positions of their closing movements.

Female↗
PubMed2004

Functional properties of the surface of the vermilion border of the lips are distinct from those of the facial skin.

BACKGROUND: The vermilion border of the lips (lip for short) is the only part on the face where the oral mucosa is persistently exposed to the outside. Despite its prominent presence on the face, constituting not only the target of cosmetics but also the site for various skin diseases, its functional properties remain almost unknown. OBJECTIVES: To elucidate the functional properties of the vermilion border of the lips. METHODS: We studied the biophysical properties of the lip by comparing them with those of the cheek skin in 303 healthy Japanese females aged 21-80 years, in winter. We used a closed-chamber system to measure transepithelial water loss (TEWL) of the lip to avoid the effect of breathing. Moreover, we examined the effects of oral etretinate, a drug that definitely produces dry, scaly lips, on the lips of seven male patients aged 49-89 (average 67) years. RESULTS: TEWL was significantly almost three times as high on the lips as that on the cheek which is a site that shows far higher levels than do other body areas. TEWL decreased with age more remarkably on the lip than on the cheek. High-frequency conductance, a parameter for surface hydration state, was significantly lower on the lip than on the cheek. The mean values obtained were about one-third of those on the cheek, and no age-related changes were observed either on the lip or on the cheek. The superficial epithelial cells on the lip were parakeratotic and larger than those of the cheek skin. Furthermore, we detected a significant increase in TEWL on the lip as well as on the cheek of patients treated with oral etretinate. CONCLUSIONS: It appears that the incomplete corneocyte formation of the lip surface is responsible for the poor barrier function and water-holding capacity.

Administration, Oral↗
PubMed2006

Discriminative analysis of lip motion features for speaker identification and speech-reading.

There have been several studies that jointly use audio, lip intensity, and lip geometry information for speaker identification and speech-reading applications. This paper proposes using explicit lip motion information, instead of or in addition to lip intensity and/or geometry information, for speaker identification and speech-reading within a unified feature selection and discrimination analysis framework, and addresses two important issues: 1) Is using explicit lip motion information useful, and, 2) if so, what are the best lip motion features for these two applications? The best lip motion features for speaker identification are considered to be those that result in the highest discrimination of individual speakers in a population, whereas for speech-reading, the best features are those providing the highest phoneme/word/phrase recognition rate. Several lip motion feature candidates have been considered including dense motion features within a bounding box about the lip, lip contour motion features, and combination of these with lip shape features. Furthermore, a novel two-stage, spatial, and temporal discrimination analysis is introduced to select the best lip motion features for speaker identification and speech-reading applications. Experimental results using an hidden-Markov-model-based recognition system indicate that using explicit lip motion information provides additional performance gains in both applications, and lip motion features prove more valuable in the case of speech-reading application.

Algorithms↗
PubMed2004

Total lower lip reconstruction with a composite radial forearm-palmaris longus tendon flap: a clinical series.

Large, full-thickness lip defects after head and neck surgery continue to be a challenge for reconstructive surgeons. The reconstructive aims are to restore the oral lining, the external cheek, oral competence, and function (i.e., articulation, speech, and mastication). The authors' refinement of the composite radial forearm-palmaris longus free flap technique meets these criteria and allows a functional reconstruction of extensive lip and cheek defects in one stage. A composite radial forearm flap including the palmaris longus tendon was designed. The skin flap for the reconstruction of the intraoral lining and the skin defect was folded over the palmaris longus tendon. Both ends of the vascularized tendon were laid through the bilateral modiolus and anchored with adequate tension to the intact orbicularis muscle of the upper lip. This procedure was used in 12 patients. Six patients had cancer of the lower lip, five patients had a buccal cancer involving the lip, and one patient had a primary gum cancer that extended to the lower lip. Total to near-total resection (more than 80 percent) of the lower lip was indicated in six patients. In two other patients, the cancer ablation included more than 80 percent of the lower lip and up to 40 percent of the upper lip. A radial forearm palmaris longus free flap was used in all cases for reconstruction of the defect. Free flap survival was 100 percent. At the time of final evaluation, which was 1 year after the operation, all patients had good oral continence at rest (static suspension) and had achieved sufficient oral competence when eating. Ten patients were able to resume a regular diet, and two patients could eat a soft diet. All patients regained normal or near-normal speech and had an acceptable appearance. The described refinement of the composite radial palmaris longus free flap technique allows the reconstruction of the lower lip with a functioning oral sphincter; the technique can be recommended for patients who need large lower lip resection. It provides functional recovery of the reconstructed lower lip synchronizing with the remaining upper lip.

Adult↗
PubMed2004

A comparison of the effects of the Latham-Millard procedure with those of a conservative treatment approach for dental occlusion and facial aesthetics in unilateral and bilateral complete cleft lip and palate: part I. Dental occlusion.

The purpose of this study was to compare the effect of the Latham-Millard presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion protocol with conservative treatment (nonpresurgical orthopedics without gingivoperiosteoplasty) for palatal and dental occlusion in complete bilateral and complete unilateral cleft lip and palate. All patients were from the South Florida Cleft Palate Clinic. A retrospective dental occlusal study was conducted using serial dental casts that had been taken of patients from birth to 12 years of age. All surgical procedures, except for the secondary alveolar bone grafts in the conservative, nonpresurgical orthopedics group, were performed by D. Ralph Millard, Jr. Ralph Latham supervised the presurgical orthopedics cases. Samuel Berkowitz collected and analyzed all the serial records from 1960 to 1996. Among the patients with complete unilateral cleft lip and palate, 30 patients were treated with presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (the Latham-Millard protocol) and 51 patients were treated conservatively (i.e., nonpresurgical orthopedics without gingivoperiosteoplasty). Among the patients with complete bilateral cleft lip and palate, 21 patients were treated with the Latham-Millard protocol and 49 patients were treated conservatively. Conservative treatment was performed between 1960 and 1980. In patients with bilateral cleft lip and palate, a head bonnet with an elastic strip was used to ventroflex the protruding premaxilla. In all patients (unilateral and bilateral cleft), lip adhesion was performed at 3 months followed by definitive lip surgery at 6 to 8 months and palatal cleft closure between 18 and 24 months of age, in most cases. The Latham-Millard procedure was performed from 1980 to 1996; in bilateral cleft patients, it involved the use of a fixed palatal orthopedic appliance to bodily retract the protruding premaxilla and align it within the alveolar segments soon after birth. In all patients (unilateral and bilateral cleft), palatal alignment was also followed by gingivoperiosteoplasty and lip adhesion. Definitive lip surgery was performed between 6 and 8 months of age, and palatal closure was performed between 8 and 24 months of age using the von Langenbeck procedure with a modified vomer flap. All of the study participants had cleft lips and palates of either the unilateral or bilateral type; the unilateral and bilateral groups were further subdivided based on whether they had received the Latham-Millard protocol or the conservative treatment. It was then determined how many in each of these four basic groups had either anterior or buccal crossbites at four different age levels, when they were approximately 3, 6, 9, and 12 years of age. Although several children entered the study at or just before age 6, every patient in the 9-year-old and 12-year-old sample groups had been in the 6-year-old group and all of the 12-year-olds had been included in the immediate preceding age sample. Two-by-two chi-square tests were carried out within each cleft type (unilateral or bilateral) at each of the four age levels separately, to test whether the treatment groups (protocol versus conservative) differed in the frequency of cases with a given kind of crossbite (rather than not having that kind of crossbite). At every age level, a greater percentage of patients treated with the Latham-Millard protocol developed crossbites than did those treated more conservatively. This difference existed for both the anterior and buccal crossbites and for both unilateral and bilateral clefts. Chi-square tests of the treatment differences in crossbite frequency showed that in three quarters of the Latham-Millard protocol versus conservative treatment comparisons (12 out of 16), a significantly greater frequency of crossbite cases occurred after the Latham-Millard protocol treatment as compared with after the conservative procedure. The chi-square values for the differences in outcome between the two kinds of treatment procedures were greater for the anterior crossbites than for the buccal crossbites, suggesting that the Latham-Millard protocol, relative to the conservative method, was more likely to have an adverse effect on the anterior crossbites than on the buccal crossbites. For those patients born with a bilateral cleft, the differences in crossbite frequency between the protocol and the conservative treatment were statistically significant for patients with an anterior crossbite but not for patients with a buccal crossbite. The analysis shows that in complete bilateral and unilateral cleft lip and palate, the frequency of the anterior crossbite and (except for ages 3 and 12) the buccal crossbite is significantly higher with the Latham-Millard presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion protocol compared with the conservative, nonpresurgical orthopedics without gingivoperiosteoplasty treatment. The exception in the bilateral buccal case may be attributed to the small experimental sample size, which brings down the confidence level.

Alveolar Process↗
PubMedDate not supplied

Rejuvenation of the aging lip with an injectable acellular dermal graft (Cymetra).

OBJECTIVE: To evaluate the effects of Cymetra (micronized AlloDerm tissue) in rejuvenating the aging and atrophic lip. PATIENTS: Forty-four patients aged 32 to 80 years who reported age-related changes in the size and contour of the upper lip. METHODS: Patients were randomized to treatment with either Cymetra or glutaraldehyde cross-linked bovine collagen (Zyplast). Standardized photographs of each subject were taken before and after treatment initially and 3, 6, 9, and 12 months after initial treatment. Patients were monitored for signs of hypersensitivity, infection, and inflammation. MAIN OUTCOME MEASURES: Digital photographs were analyzed for changes in the nasolabial angle, percentage of the total lip accounted for by the exposed red lip in the midline and on the lateral view, the visible red upper and lower lip surface areas, and the anterior projection of the upper and lower lips. RESULTS: All patients tolerated treatment well without any significant local or systemic complications. Nineteen patients were treated with Cymetra and 25 with Zyplast. Cymetra-treated patients were more likely than Zyplast-treated patients at 12 months (3 months after the previous treatment) to have increased the percentage of red lip in the midline (84.6% vs 38.9%; P =.01), the vermilion height in the upper lip midline (84.6% vs 38.9%; P =.01), and the exposed red lower lip on the lateral view (69.2% vs 33.3%; P =.048) by at least 20%; increased the lower lip projection by 0.5 mm or more (69.2% vs 27.8%; P =.02); and decreased the nasolabial angle by at least 10 degrees (46.2% vs 16.7%; P =.07). CONCLUSIONS: Cymetra is a suspension of particulate dermal matrix that seems to increase the upper lip bulk, vermilion, and lower lip projection after a threshold of Cymetra has been administered. There are few differences in any measured long-term (3 months after treatment) variables until the 12-month visit, when there were statistically significantly more Cymetra-treated patients with improved lip aesthetics than those treated with Zyplast. With repeated treatments, Cymetra seems to accumulate, producing a long-term effect superior to Zyplast in many patients.

Adult↗
PubMed1982

Mitotic index in mouse embryos with 6-aminonicotinamide-induced and inherited cleft lip.

Three types of cleft lip were studied histologically before and during lip formation in mouse embryos. C57BL/6 embryos observed near term following treatment with 6-aminonicotinamide (6AN) at gestation D9/12 (vp day = day 0) had 18% median cleft lip. Treated embryos observed at D10 and D11 showed retarded somite and nasal placode development. Sections at lip closure time showed marked reduction of medial and some reduction of lateral nasal processes, and the mitotic index was significantly reduced in the nasal area on D10 and D11 but less consistently in the neural area. 6AN-treatment on D10/8, caused 22% lateral cleft lip. Treated embryos showed initial retardation of somite and nasal placode development that became normal by D11/14. Sections showed reduction of the medial and lateral nasal processes, and less organized denser nasal ectoderm. The mitotic index was significantly reduced in the nasal and neural areas on D10 and D11. In crosses having the major gene mutation dancer (Dc) 20% of embryos had lateral cleft lip and potential cleft lip mutant embryos showed reduced lateral and medial nasal processes. Mitotic index was not reduced in the nasal area but it was in the neural area. The CL/Fr strain, with a predisposing face shape in which 26% of the embryos have cleft lip of multifactorial origin, had a mitotic index similar to that of C57BL/6 (0% cleft lip) at lip closure time, D11/14, and prominent medial nasal processes. It is postulated that 6AN-induced median cleft lip is due to reduced cell proliferation in and size of the medial nasal processes; 6AN-induced lateral cleft lip to reduced cell proliferation and reduced medial and lateral nasal processes and dancer lateral cleft lip to reduction of the medial nasals.

6-Aminonicotinamide↗
PubMed1981

The value of clinical lip strength measurements.

The strength of the lips was measured with a dynamometer in fifty children, aged 7 to 13 years, with varying types of malocclusion. The lip strength was related to the electromyographically recorded activity of the lips during the lip strength measurements and to bite and facial morphology. The morphology was recorded on dental casts and profile radiographs. The lip strength measurements were found, in duplicate determinations, to have limited reproducibility. There was no correlation between lip strength and the EMG activity of the lips during the recordings. Lip strength was not correlated to dentoalveolar cephalometric variables, including relationship and inclination of the incisors. Nor was there any correlation between lip strength and lip morphology. The value of lip strength measurements seems to be limited, due either to difficulties in recording lip strength or to a small influence of lip muscle forces on the dentition.

Adolescent↗
PubMed1995

Cumulative operative procedures in patients aged 14 years and older with unilateral or bilateral cleft lip and palate.

Sixty-seven consecutive patients over the age of 14 with either unilateral (n = 38) cleft lip and palate or bilateral (n = 29) cleft lip and palate seen over a 15-month period at the University of Michigan Craniofacial Program were reviewed to determine the total number of surgical procedures performed over the course of treatment. The demographics of the two groups differed: There were 25 males and 13 females who were a mean age of 17 years and 9 months with unilateral cleft lip and palate and 23 males and 6 females who were a mean age of 18 years and 5 months with bilateral cleft lip and palate. Lip and palate repairs were carried out on all patients. Lip adhesions were performed in 29 and 62 percent; pharyngoplasties (either pharyngeal flap or modified Ortichochea) in 39 and 38 percent; alveolar bone grafts in 82 and 79 percent; Abbé flaps in 0 and 10 percent; and orthognathic surgery was done in 10.5 and 13.8 percent and recommended and/or done in 26 and 24 percent of patients with unilateral cleft lip and palate and bilateral cleft lip and palate, respectively. Lip revisions averaged 1.13 and 2.17 per patient and secondary nasal surgeries averaged 1.13 and 1.18 per patient in the unilateral cleft lip and palate and bilateral cleft lip and palate, respectively. All totaled, the average number of operations was 6.12 per patient (range 3 to 12) in the unilateral cleft lip and palate and 8.04 per patient (range 5 to 15) in the bilateral cleft lip and palate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

Unilateral cleft lip repair: an anatomical subunit approximation technique.

BACKGROUND: A technique of unilateral cleft lip repair is described. The repair draws from a variety of previously described repairs and adheres to a concept of anatomical subunits of the lip. Cases from within the spectrum of the deformity have been chosen from a series of 144 consecutive cases to demonstrate the applicability of the technique in all forms of unilateral cleft lip. METHODS: Incisions cross the lip perpendicular to the cutaneous roll at the cleft side peak of Cupid's bow of the medial lip and at the base of the philtral column of the lateral lip. Above this level, incisions ascend the lip to allow for approximation along a line symmetrical with the non-cleft-side philtral column. Incisions then ascend superolaterally bordering the lip columellar crease to the point of closure in the nostril sill. A Rose-Thompson lengthening effect occurs just above the level of the cutaneous roll. If necessary, a small triangle positioned just above the cutaneous roll is often used. Any central vermilion deficiency is augmented by a laterally based triangular vermilion flap from the lateral lip element. RESULTS: Since January of 2000, this technique has been used in 144 consecutive unilateral cleft lip repairs. The inferior triangle is small (average, 1.24 mm; range, 0 to 2 mm). The technique can be applied to all degrees of unilateral cleft lip. CONCLUSIONS: A technique of unilateral cleft lip repair is described. The repair allows for a repair line that ascends the lip at the seams of anatomical subunits.

Cleft Lip↗
PubMed1995

Outcome analysis for lip carcinoma.

Carcinoma of the lip is a relatively common malignancy of the head and neck region, accounting for approximately one quarter of oral cavity cancers. Although this form of cancer is generally readily curable compared with malignancies at other head and neck sites, regional metastases, local recurrence, and even death from this disease may occasionally occur. A review of 1252 patients who were diagnosed with lip cancer from 1940 to 1987 was undertaken to identify and rank prognostic variables, clarify differential incidences of site predilection between male and female patients, and examine the correlation between tumor site and histopathologic diagnoses. Large tumor size, high tumor grade, the presence of adenopathy, a subsite other than the lower lip, and inadequate surgical margins were found to have a negative impact on determinate survival of patients with lip carcinoma. Twenty-one percent of lip cancers in female patients arose on the upper lip, whereas only 3% of lip cancers in male patients developed on the upper lip. Basal cell carcinomas comprised 13% of upper lip cancers and only less than 1% of lower lip cancers. Recurrence developed in 15.1% of the patients reviewed and was strongly associated with large tumor size and poor differentiation. Local recurrence was associated with a determinate survival of 78%, whereas patients having regional recurrences had a survival rate of 52%. These data support aggressive treatment of lip cancers greater than 3 cm in diameter, high-grade tumors, tumors associated with cervical lymphadenopathy, and upper lip and commissure tumors. Lip cancer in women seems to be slightly more aggressive than in men.

Adult↗
PubMed2005

Maxillary and sella turcica morphology in newborns with cleft lip and palate.

OBJECTIVE: The first aim was to examine maxillary developmental fields by analyzing bone size parameters within the maxillary bone complex in newborns with unilateral cleft lip (UCL) and unilateral cleft lip and palate (UCLP). The second aim was to evaluate sella turcica morphology in unilateral cleft lip and unilateral cleft lip and palate. SUBJECTS AND METHODS: Axial and profile radiographs from 40 newborns (boy-girl, 1:1) in each group (20 unilateral cleft lip and 20 unilateral cleft lip and palate) were randomly selected among radiographs taken for optimizing treatment planning. Analysis of maxillary bone size was performed on axial radiographs and size parameters were measured. Furthermore, analysis of sella turcica morphology was performed on profile radiographs. The results were divided into groups with normal morphology and severe deviations in the morphology. RESULTS: The maxillary areas were significantly shorter and broader in unilateral cleft lip and palate than in unilateral cleft lip. A profound asymmetry in the maxillary areas was seen in unilateral cleft lip and palate, but not in unilateral cleft lip. In both cleft types, approximately half of the individuals had deviations in sella turcica morphology. The most severe deviations occurred in newborns with unilateral cleft lip and palate. CONCLUSIONS: In newborns with unilateral cleft lip and palate, the maxillary areas are significantly shorter, broader, and more asymmetric than in newborns with unilateral cleft lip. The present study showed that bone structures are a suitable parameter for characterizing the craniofacial developmental fields. Additionally, a high incidence of deviations in sella turcica morphology might indicate that this area is affected in individuals with clefts.

Cephalometry↗
PubMed2000

A three-dimensional quantitative analysis of lips in normal young adults.

OBJECTIVE: To supply information about (1) sex-related dimensions (linear distances and ratios, vermilion area, volume) of normal adult lips, (2) presence of sexual dimorphism, and (3) correlations between anthropometric characteristics of the lip and nose. METHODS: The three-dimensional coordinates of soft tissue landmarks on the lips and nose were obtained using an optoelectronic instrument in 90 healthy young adult women and 90 healthy young adult men. From the landmarks, several linear distances (mouth width, total vermilion height, nose height, anatomic nose width, total lip height, upper lip height), the ratio of vermilion height to mouth width, and some areas (vermilion of the upper lip, vermilion of the lower lip, total vermilion) and volumes (upper lip volume, lower lip volume, total lip volume) were calculated. Linear correlation analyses between pairs of variables were also conducted within each sex. RESULTS: All lip dimensions (distances, areas, and volumes) were significantly larger in men than in women (p<.005), but no sex differences were found in the vermilion height to mouth width ratio. Overall, mouth and nose dimensions were not significantly correlated, with the exceptions of the upper and lower lip volumes in both sexes and of the mouth and nose widths in the female sample, in which a modest part of the variance in one measurement could be explained by the other. CONCLUSION: The dimensions of the mouth and the nose did not seem to be strictly related. Data collected in the present investigation could represent a database for the quantitative description of human lip morphology in adult subjects.

Adult↗