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At least 397 records · Page 22Linked to original sources
PubMed2006

[Use of the modified Fries technique in the reconstruction of the lower lip after the removal of a malignant tumor].

BACKGROUND/AIM: Lip carcinoma makes about 1/4 of all oral carcinomas. Primary treatment of the lower lip carcinoma means radical excision of the full thickness of the lower lip tissue together with the tumor. The reconstruction of the defect accomplished after the removal of the lower lip tumor is a challenge for the surgeon and requires a detailed preoperative planning, the right choice of the method for reconstruction and the knowledge of the adequate surgical techniques needed. The aim of this study was to presenta ten-year clinical results and experience concerning the reconstruction of lower lip defects longer than 4 cm by means of the modified Fries method in patients treated for the lower lip carcinoma. METHODS: The reconstruction of the lower lip by means of the modified Fries method was performed in 37 patients. The following parameters were analyzed: sex, age, the time elapsed from the occurrence of the first symptoms until the first consultation with the doctor, the size of tumors, the size of the postexcision defect, TNM classification, the application of side diagnostic procedures, pathohistological diagnosis of postoperative complications. The sensibility of the lower lip region was monitored, as well as the obtained esthetic effects. RESULTS: The results classified according to the mentioned parameters were processed, analyzed and displayed in detail. Clinical experience concerning the application of this reconstruction technique was presented and analyzed. CONCLUSION: The modified Fries technique can successfully be applied in the reconstruction of the lower lip defects longer than 4 cm because its application leads to satisfactory functional and acceptable esthetic results.

Aged↗
PubMed1980

The influence of simultaneous cleft lip and palate repair on facial growth in rabbits.

This study was designed to test the influence of simultaneous cleft lip and palate repair on facial growth in rabbits. Three groups of rabbits were used. Group I consisted of control rabbits who had no surgery; Group II had surgically created, but unrepaired, clefts of the lip, alveolus, and palate; and Group III had surgically created clefts of the lip, alveolus, and palate followed by immediate simultaneous lip and palate repair. In Group III, the lip was repaired using the Millare technique and the palate using two-flap palatoplasty, leaving no bare bone exposed. All animals were sacrificed after twenty weeks. Results of the direct cephalometry of the skulls confirmed that simultaneous lip and palate repair results in inhibition of anterior-posterior and transverse maxillary growth. Some significant changes were also found in mandibular length and nasal deflection. All 15 rabbits with simultaneous cleft lip and palate repair developed anterior crossbites and functional shifts to the left or cleft side. Further analysis comparing the results of facial growth inhibition in this study with inhibition following lip repair only or palate repair only will be necessary to assess the severity of secondary maxillo-facial deformities resulting from lip and palate repair.

Animals↗
PubMed2000

Position, shape, and dimension of the maxilla in unoperated cleft lip and palate patients: review of the literature.

The inhibition of growth and development resulting from surgical treatment of the cleft lip and palate is a widely discussed topic. Various studies have been conducted in search of answers as to how the untreated upper jaw develops, focusing on individuals with untreated cleft lip and palate as found in so-called Third World countries. This study offers the opportunity to compile literature dealing with the research and description of untreated unilateral cleft lip and palate. The focus was to take a closer look at groups of individuals with complete unilateral cleft lip and palate, who had received no surgical treatment at all, as well as groups who had received surgical treatment of only the cleft lip. The upper jaw of untreated cleft lip and palate patients most often adopts a protruded position without enlarging the maxilla itself. The horizontal dimension tends to be reduced, whereas the vertical dimension is normal. The upper jaw of patients with unilateral cleft lip and palate who received surgical treatment of the lip more often adopted a retruded position. The model analysis showed no clear-cut tendencies. There seemed to be a degree of regional variation. Considering the relatively small number of recruitable individuals with untreated cleft lip and palate, the introduction of a standard method of evaluation is desirable. This would significantly facilitate the comparison of different studies with each other in the future. The first steps in this direction have already been initiated.

Child↗
PubMed1993

Direct upper-lip lifting: a safe procedure.

Thin lips and an aging lower third of the face are increasingly the focus for surgical improvement. Thin and tightly pursed lips imply a certain resignation or even bitterness, especially in older women. Excessive application of lipstick to enhance the shape and color of thin lips was a solution but a poor camouflage. The desire for well-defined and full lips, as seen today on many models and actresses, is the motivation behind the increasing demand of women with relatively normal looking lips to turn to cosmetic surgery. They often present the surgeon with photographs of the shape and fullness of lips they desire to achieve. In this article the author recommends the use of the direct upper-lip lifting method as a more effective and successful approach to enhancing the shape of the upper lip. For plumping the lower and upper lip, the author recommends using autologous collagen augmentation.

Adipose Tissue↗
PubMed2003

Low-level static lip force control does not alter vibrotactile detection thresholds in the human orofacial system.

Mechanosensation associated with precise orofacial force regulation may contribute considerably to processes associated with perception, proprioception and sensorimotor control due to the direct coupling between orofacial skin and the underlying musculature. Recent investigations have demonstrated that dynamic, low-level lip force control is capable of modulating vibrotactile detection thresholds of the lips in a frequency-dependent manner. What is not known is whether the mode of motor control (static versus dynamic) may represent an important control variable in the expression of these perceptual threshold changes. The purpose of this study was to assess lower-lip (LL) vibratory detection thresholds from adult subjects during the simultaneous performance of a visually regulated, static lip motor control task. Vibrotactile inputs were delivered to the right LL vermilion at test frequencies of 5, 10, 50 and 150 Hz. Psychophysical detection was performed simultaneously during a no-force baseline condition and an active static force control task performed with the lip musculature. Subjects used their analog lip force signal to maintain a static lip force posture by visually tracking a steady-state force target calibrated to a 0.1 N load. Both signals were displayed in real time on a monitor. Results suggest that, unlike dynamic lip motor control, low-level, static lip force regulation is not effective in altering LL vibrotactile detection thresholds to any test frequency. These findings are discussed in relation to published reports of movement-related sensory gating in orofacial and limb systems and the possible significance this phenomenon may have for perception and proprioception in the orofacial system.

Adult↗
PubMedDate not supplied

Lip augmentation with AlloDerm acellular allogenic dermal graft and fat autograft: A comparison with autologous fat injection alone.

Many surgical options exist for lip augmentation, none of which consistently provide safe, lasting, and predictable volume gains. We describe and evaluate the use of AlloDerm acellular allogenic dermal graft in combination with fat autograft and compare the postoperative results with those of autologous fat injection alone. Analysis of the preoperative and 1- and 3-month postoperative photographs was done using digital imaging software. Outcome measures included vermilion show and horizontal lip projection from the soft tissue pogonion-subnasale plane. A 61% mean increase in vermilion show was observed in lips augmented with AlloDerm/fat injection, in comparison to a mean increase of 13% in lips augmented with fat injection alone. Lip projection demonstrated a mean increase of 1 mm in AlloDerm/fat lips at 3 months. Postoperatively, no evidence of resorption was seen in lips augmented with AlloDerm/fat between the 1- and the 3-month follow-ups, however, a 9% decrease in vermilion show occurred in lips augmented with fat injection over the same period. No complications occurred in either group. We conclude that AlloDerm in conjunction with autologous fat injection constitutes a safe, reliable, and lasting method of lip augmentation providing increased vermilion show compared to that with autologous fat injection alone.

Adipose Tissue↗
PubMed2001

Unravelling the complex genetics of cleft lip in the mouse model.

Nonsyndromic cleft lip in "A" strain mice and humans is genetically complex and is distinct from isolated cleft palate. Cleft lip embryos recovered in 2.4% of 1485 first backcross (BC1) segregants from a cross of A/WySnJ (24% cleft lip) and C57BL/6J (no cleft lip) in A/WySnJ mothers, and in testcrosses of 10 recombinant inbred (RI) strains (AXB/Pgn or BXA/Pgn), were used for gene mapping and for inference of genetic architecture. The A/WySnJ maternal genotype increased cleft lip risk in reciprocal crosses; the relevant genetic difference between AXB-6/Pgn (8%) and A/WySnJ (24%) is entirely maternal. A combination of new mapping panels (325 meioses), new markers, and a recombinant cleft lip embryo redefined the location of a recessive factor essential to cleft lip risk, clf1, and candidate genes Itgb3 and Crhr, to between D11Mit146/360 and D11Mit166/147. A screen of 54 YACs for 46 genes and SSLP loci located Wnt15, Wnt3, Crhr, Mtapt, Itgb3, Dlx3, and Dlx7 within the clf1 candidate region. The clf2 locus was newly mapped to Chromosome (Chr) 13 by a genome screen of BC1 segregants, and further defined to a 4-cM region between D13Mit13/54 and D13Mit231 by strain distribution patterns of cleft lip liability and markers in testcrossed RI strains. Specific combinations of marker genotypes associated with cleft lip risk indicated that high risk in A/WySnJ mice is caused by epistatic interaction between clf1 and clf2 in the context of a genetic maternal effect. Human homologs of clf1 and clf2 are expected to be on 17q and 5q/9q.

Animals↗
PubMed1984

Morphologic analysis of upper lip area following maxillary osteotomy via the tunneling approach.

Preservation of favorable upper lip morphology is a critical factor in assessing the success of maxillary osteotomy surgery. Unesthetic postsurgical lips often appear thin and tight, with the vermilion border shortened and rolled inward. Clinical observation of patients who had undergone total maxillary alveolar process osteotomies by means of vertical buccal incisions and a tunneling approach suggests that presurgical lip morphology is minimally changed. This study investigates the presence and degree of change in upper lip morphology following this technique. Pre- and postoperative cephalometric radiographs of ten patients were compared by superimposition of acetate tracings on cranial base landmarks. Cross-sectional lip area was calculated by compensating polar planimetry presurgically and at four intervals following intervention: 1 to 3 days, 1 to 3.5 months, 6 to 9 months, and more than 10 months. Analysis showed the cross-sectional upper lip area, compared to the presurgical baseline, to be as follows: Immediately following surgery, the area increased by a mean of 27.8% (range, 15.0% to 36.9%; SE = 4.72). At 1 to 3.5 months postsurgery, the increase was reduced to 3.3% (range, 0 to 7.7%; SE = 0.82). At 6 to 9 months, lip area remained minimally increased, at + 0.78% (range, -5.0% to 7.6%; SE = 1.68). At 10 months or longer, the mean increase from preoperative values was 0.61% (range, -6% to 6.4%; SE = 1.38). The results of this study indicate that the upper lip cross-sectional area returns to its presurgical value at 6 months following surgery and remains constant at subsequent measurements. The performance of maxillary surgery with this flap design appears to preserve presurgical lip morphology.

Adult↗
PubMed1999

Histological characterization of lip and tentacle nerves in Lymnaea stagnalis.

The lip and tentacle nerves of the pond snail, Lymnaea stagnalis, were characterized using histological techniques. Anatomical drawings showed the detailed distributions of the superior lip, median lip, and tentacle nerves in the lip and tentacle; in particular it was found that the mouth is mainly innervated by the superior lip nerve. The tentacle nerve was clarified to form a zigzag structure along the extension direction in a shrinking tentacle. By backfilling of the superior lip nerve and/or the median lip nerve with fluorescent dyes, the neurons in the CNS made some clusters, whereas those stained from the tentacle nerve made other clusters. These stained neurons were not part of the central pattern generator or its regulatory neurons for feeding. The present results, therefore, suggest that the superior lip nerve may be employed as a principal factor in the chemosensory transduction from the mouth, and that no direct inputs occur through the lip and tentacle nerves to the central pattern generator or its regulatory neurons for feeding.

Animals↗
PubMed1997

Forces produced by lip bumpers on mandibular molars.

The purpose of this study was to measure the forces produced by a lip bumper on the mandibular permanent first molars. The forces in a sample of 38 patients were measured bilaterally with specially designed gauges at rest but with their lips lightly touching, speaking the words church, phone, and pop, and swallowing water. Forces were compared between two types of lip bumpers, i.e., wire or shield, and between various anteroposterior and vertical positions of the lip bumper. The resting forces produced by the wire lip bumper 2 mm anterior to the incisors and vertically positioned at the middle of the incisor crown were 5.93 +/- 4.84 gm for the left side and 4.66 +/- 4.8 gm for the right. The forces were found to be significantly higher when the wire lip bumper was placed 4 mm anterior to the incisors and at a more gingival position, measuring 16.68 +/- 8.7 gm for the left side and 13.88 +/- 8.28 gm for the right. The shield lip bumper had higher forces both at the center of the incisor as well as when it was positioned gingivally. A large individual variation was observed. There were no statistically significant differences in force levels between male and female subjects. Speaking the words church, pop, and phone, produced forces between 11 and 23 gm, using a wire lip bumper. Swallowing produced the highest forces, between 32 and 36 gm. Lip thickness and height did not appear to affect the force levels.

Acrylic Resins↗
PubMed1999

EMG activity of the orbicularis oris and mentalis muscles in children with malocclusion, incompetent lips and atypical swallowing--part II.

The EMG activity of the orbicularis oris (upper and lower), and of the mentalis muscles was verified during several movements of the lips, in 18 children ageing from 8 to 12 years, divided into three groups: one with normal occlusion, and two with class II division 1, with atypical swallowing and/or incompetent lips and who had received no orthodontic treatment. In blowing through a straw the muscular activity of the orbicularis oris and the mentalis was significantly greater in the incompetent lips group. The mentalis presented moderate activity in the competent lips group and negligible in normal occlusion. In puffing out of the cheeks, the malocclusion groups developed marked activity of the orbicularis oris and very marked activity of the mentalis, while the normal occlusion presented moderate and negligible activities, respectively. In pursing of the lips, only the incompetent lips group presented a very marked activity of the lower segment. The compression of the lips against the teeth revealed a marked activity of the upper segment of the orbicularis oris in the groups of malocclusion and the mentalis presented greater activity in the competent lips group. The reciprocal compression of the lips presented a hyperactivity of the three muscles.

Action Potentials↗
PubMed2003

Lower lip repair in Van der Woude syndrome.

Van der Woude syndrome is an unusual congenital malformation. It combines lower lip sinuses with a cleft lip and/or palate. The asymmetry appears more pronounced due to lower lip hypotonia and procheilia, which are more unaesthetic than the fistulae themselves. The malformation of the orbicularis oris muscle in its medial part induces the hypotonic aspect of the lower lip, which contrasts with the retracted scarred upper lip after the cleft has been repaired. It is also responsible for a real bilabial asymmetry. For many years, the most common surgical treatment was simple excision of the sinuses. Bad functional repair results prompted the authors to try another surgical procedure, the split-lip advancement technique as described by Mutaf. The authors report here on 8 operated children out of 25 patients followed up for Van der Woude syndrome. They evaluated the results according to the appearance of the lip when relaxed, its functional aspect, and the satisfaction of the parents or the child. Our results point to the importance of early surgical treatment, radical excision of dysplastic tissue and the repair of lip muscles to restore good lip functionality and satisfactory bilabial symmetry. The technique now used in our department has made it possible for us to achieve these goals.

Child↗
PubMed1989

Congenital double lip: a review of seven cases.

Congenital double-lip deformity is an infrequent developmental abnormality affecting the lips, more commonly the upper lip. We report seven cases of double lip, all in males, of which six were in the upper lip and one in the lower lip. It was quite interesting to observe that in the upper lip, the buccal portion of the double lip appeared on either side with a midline constriction; in the lower lip, it was prominent in the midline without any central constriction. Surgical excision under regional nerve block anesthesia gives good results. The embryology, clinical appearances, and histopathology are discussed with a review of the literature.

Adolescent↗
PubMed1994

Relationship between the sequence of lip and palate repair and maxillary growth: an experimental study in beagles.

The present study was designed to evaluate the relationship between varying sequences of lip and palate repair and maxillary growth. To investigate this problem, an experimental study using beagles was conducted to assess the influence of three different sequences of lip and palate repair. The first sequence constitutes the commonly accepted approach of lip repair first, palate repair second. The second sequence was reversed: palate repair first, lip repair second. The third sequence consisted of simultaneous lip and palate repair. Using 70 eight-week-old beagles, we tested the following hypothesis: The sequence of lip repair first and palate repair second is less detrimental to maxillary growth than the other two sequences. The animals were assigned to two control groups (unoperated and unrepaired animals) and three experimental groups, in which three different sequences of repair were executed. Upon sacrifice, 11 maxillary variables were measured directly from cleaned skulls and analyzed by univariate and multivariate techniques. The most important finding from this analysis is that the commonly accepted sequence of cleft lip and palate repair (lip first, palate second) is less detrimental to maxillary growth than repairing the palate first and the lip second or simultaneous closure of both defects.

Analysis of Variance↗
PubMed1997

Vascular lip enlargement: Part I. Hemangiomas--tenets of therapy.

Vascular lesions involving the lips pose a difficult problem for both the surgeon and patient. Their removal by surgery may result in greater disfigurement and impairment than the original lesion. When nonsurgical modalities fail, using a well-planned strategy of sequential procedures can provide excellent results. Many hemangioma patients require judicious serial debulking of excess tissue mass, whereas enlargement from port-wine lesions may require direct aggressive surgery. Over a 10-year period, 38 patients underwent surgery for treatment of vascular lip enlargement. In 27 patients, the lip deformities were caused by hemangiomas. The remaining 11 patients had macrocheilia associated with port-wine vascular malformations. This paper specifically addresses hemangiomas of the lips, tenets for their removal, and reduction strategies. Of the 27 patients with hemangiomas involving the lips, 12 had had some form of previous treatment including corticosteroids (4 patients), embolization (3 patients), laser (3 patients), and interferon (2 patients). All 12 of these patients had unsatisfactory results. Specific tenets for the surgical management of these patients are presented. The distribution of the facial hemangiomas was as follows: 15 patients had isolated involvement of the upper lip, 7 lesions involved the lower lip alone and 5 involved both upper and lower lips. Additionally, 10 of these lesions involved the cheek(s), nose, or chin to some degree. Six patients experienced some form of functional impairment before our evaluation including difficulty with eating or drinking, visual obstruction, and psychosocial problems. All operations were performed following several principles established by the senior surgeon (B.M.Z.). By following the tenets presented in this report, he has achieved near-normal lip form, giving the patient marked improvement in appearance and function.

Adolescent↗
PubMed1999

Computer-assisted anthropometry for outcome assessment of cleft lip.

Anthropometry and clinical examination best evaluate the morphology of repaired cleft lip and nose. An original, accurate, and practical image analysis of the lip and nose, which takes advantage of the mathematic, geometric, and organizational capabilities of public domain NIH-Image software (http://rsb.info.nih.gov/nih-image/), has been developed and tested over the past 6 years. A modified structured physical examination form that complements this analysis is under study. Accuracy of NIH-Image-based anthropometry was compared with direct measurements of 22 linear distances on the lip and nose. Twenty-five sets of direct measurements were taken, prospectively, on 15 children with repaired cleft lip over a 6-year period. The results were submitted to regression analysis. Then, relevant lip and nasal tip aesthetics were evaluated by the measuring capabilities of NIH-Image to create a quantitative assessment tool. For each episode, 15 possible faults were weighted, according to aesthetics and deformity, to provide an adverse score. The sum of the 5 lip scores, 10 nose scores, and combination gave respective grades. The analysis was modified to stratify congenital deformity to relate severity of disease to outcome. This analysis was applied to digitized images of 19 consecutive children, immediately prior to repair of complete unilateral cleft lip and nose, at the time of palate repair, and annually from the age of 3 to 6 years. There were 19 NIH-Image-based measurements of the congenital deformity and 35 measurements of surgical results; four children had three sets of records, eight had two sets, and seven had one set Descriptive statistics were applied. Following 556 paired direct and computer-assisted measurements, exceptional linear correlation was shown with a Pearson R coefficient of 0.96. The best correlation was lines within the plane of the camera lens, with the average difference ranging between 0.025 and 0.997 mm. Visual inspection of frontal and submental photographs of excellent, good, and poor results substantiates the ability of this analysis to quantify and grade a spectrum of relevant cleft lip and nasal anatomy. For these 19 patients, there was a broad range of performance scores, approximating a normal distribution. The mean of the NIH-Image-based analysis scores, 16.91, was a (very) good grade. A single standard deviation of 6.88 extended up into excellent and down to fair. The congenital analysis indicated a range of deformity. Comparing deformity with outcome, simple regression analysis had a coefficient of determination (R2) of 0.223, indicative of a weak positive relationship. An accurate and practical morphologic computer-assisted outcome assessment of repaired cleft lip and nasal deformity has been developed. There is a weak direct correlation between severity of deformity and outcome. Testing in multiple clinics is warranted.

Anthropometry↗
PubMed1999

Primary reconstruction of complex midfacial defects with combined lip-switch procedures and free flaps.

Free flaps are generally the preferred method for reconstructing large defects of the midface, orbit, and maxilla that include the lip and oral commissure; commissuroplasty is traditionally performed at a second stage. Functional results of the oral sphincter using this reconstructive approach are, however, limited. This article presents a new approach to the reconstruction of massive defects of the lip and midface using a free flap in combination with a lip-switch flap. This was used in 10 patients. One-third to one-half of the upper lip was excised in seven patients, one-third of the lower lip was excised in one patient, and both the upper and lower lips were excised (one-third each) in two patients. All patients had maxillectomies, with or without mandibulectomies, in addition to full-thickness resections of the cheek. A switch flap from the opposite lip was used for reconstruction of the oral commissure and oral sphincter, and a rectus abdominis myocutaneous flap with two or three skin islands was used for reconstruction of the through-and-through defect in the midface. Free flap survival was 100 percent. All patients had good-to-excellent oral competence, and they were discharged without feeding tubes. A majority (80 percent) of the patients had an adequate oral stoma and could eat a soft diet. All patients have a satisfactory postoperative result. Immediate reconstruction of defects using a lip-switch procedure creates an oral sphincter that has excellent function, with good mobility and competence. This is a simple procedure that adds minimal operative time to the free-flap reconstruction and provides the patient with a functional stoma and acceptable appearance. The free flap can be used to reconstruct the soft tissue of the intraoral lining and external skin deficits, but it should not be used to reconstruct the lip.

Adult↗
PubMed2006

V-Y in V-Y procedure: new technique for augmentation and protrusion of the upper lip.

A new surgical technique for upper lip augmentation is presented. In this technique, 2 vertically parallel V-shaped incisions placed in a "V in V" fashion are used. Remarkable augmentation of the lip is provided by V-to-Y closure of the incisions. Over 7 years, this new technique, namely, V-Y in V-Y procedure, was used in 46 female patients for upper lip augmentation. The mean age of patients was 23 years, ranging from 16 to 47 years. The average follow-up was 2 years. In all patients, a satisfactory upper lip augmentation was obtained. Except a moderate edema subsiding within 2-3 weeks postoperatively, there was no complication in our patients. Despite that no filling material was used, the results were found to be long lasting at late term. The "V-Y in V-Y" procedure is a very easygoing and adjustable technique which allows the surgeon to augment the lip tubercle and the lateral segments separately, as required by the individual needs of each patient. Besides an anatomic lip augmentation by preserving and accentuating the natural contours of the lip, this new procedure provides a remarkable protrusion of the entire upper lip as an additional contribution for rejuvenation of the upper lip.

Adolescent↗