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At least 433 records · Page 24Linked to original sources
PubMed1993

Soft tissue response to orthognathic surgery in persons with unilateral cleft lip and palate.

Individuals with cleft lip and palate often require orthognathic surgery to establish facial harmony and optimal occlusal function. Surgery to the skeletal components of the face can accomplish predictable alterations in jaw relations. The soft tissue response to those skeletal movements, however, is difficult to predict, as it is also for the noncleft individual. In addition there is the variability of the repaired cleft lip. The study included 30 persons with complete unilateral cleft lip and palate, operated for midface deficiency using a Le Fort I maxillary advancement at a mean age of 18.0 years. Some relapse occurred in the immediate postoperative period, but after 1 year the mean advancement of the maxilla was 4.9 mm (best fit of anterior maxilla) and 5.6 mm (incisal edge). Both skeletal and soft tissue changes were negligible after that time. The ratio of upper lip advancement to underlying incisor advancement was 0.65 to 1. Although the lip response was highly correlated to the underlying bony movement, the variation was sufficient to preclude accurate prediction. The upper lip thinned with maxillary advancement, but this was not related to the original lip thickness. Coincident mandibular surgery had no appreciable effect on upper lip movement.

Adolescent↗
PubMed1998

Incidence of secondary lip surgeries as a function of cleft type and severity: one center's experience.

OBJECTIVE: This study was conducted to ascertain the frequency of surgeries typically required to adequately repair a cleft lip. MATERIAL: All operations performed on patients with clefts of the lip (alveolus and palate) from 1968 to 1990 in the Rostock Cleft Center were evaluated. METHODS: Procedures were classified as primary labioplasties versus secondary revisions. Patients were also classified according to cleft type, the anatomical segment revised, and the reason for lip revision. Two indices were calculated. The revision index related the number of revisions to the number of primary labioplasties. The index of indication related the number of patients with revisions to the number of primary labioplasties. RESULTS: During the period of study, 712 primary labioplasties and 771 secondary revisions were performed. The overall revision index was 1.10. The index of indication varied from 0.28 for unilateral complete clefts of the lip to 0.67 for bilateral complete clefts of the lip. Revision of the lip was the most common secondary procedure, followed by nostril and columella revision, and revision of the oral vestibule. CONCLUSIONS: The incidence of secondary surgery of the repaired cleft lip (index of indication) of about 35% is similar to previously reported data. However, the incidence varies with cleft type and is required more often with bilateral complete clefts of the lip.

Adolescent↗
PubMed1976

The lip profile after correction of retromaxillism in cleft and non-cleft patients.

Based on 25 cases with unilateral cleft of lip, alveolus and palate with retromaxillism (CLAP) and 25 cases with pure retromaxillism (RM), the effect on the lip of advancing the maxilla by Le Fort I osteotomy is analysed. It can be shown that on average the base of the upper lip follows the base of the maxilla in a ratio of 4:7. The free end of the upper lip is pushed forwards by the upper front teeth in a ratio of 5:9. This means that to achieve a specified lip advancement, the maxilla has to be brought forward about double the amount. No important between CLAP and RM could be seen. Leaving the nasal spine intact has a favourable influence on movements of the upper lip. The amount of maxillary advancement has no bearing on the ratios. It seems though that thin lips follow the movement of the maxilla better than voluminous lips. There is no satisfactory explanation why the extremes in all groups for all measurements are placed so very far apart. This leads to the conclusion that in spite of careful planning the result in the individual case can differ considerably from that expected.

Adult↗
PubMed2005

[Reconstruction of the lips after resection of malignant lesions].

This review deals with the presently used techniques for reconstruction of full thickness lip defects that occur as a result of resection of malignant lesions of the lips. Reconstruction of full thickness defects of the lip is not an easy task. Since the lips have such centrally important aesthetic and functional roles, successful maintenance of these roles after reconstruction is of paramount importance. Small defects of up to 1/3 of the lip are normally fairly easily reconstructed by means of primary closure, while extremely large defects of almost the entire lip will need to be reconstructed by means of distant free flaps with microsurgical techniques. We review a broad range of local flaps utilized for the reconstruction of full thickness defects greater than 1/3 of the lip up to the reconstruction of more than 1/2, but not the entire lip. The article presents the advantages and disadvantages of several techniques which are currently widely used.

Humans↗
PubMed1977

The influence of primary unilateral cleft lip repair on facila growth.

The lip pressure exerted by the repaired cleft lip was studied in 35 rabbits during a 20-week period. Animals were divided into four groups. Two of them were controls, and in the other two, two different surgical procedures were used for the lip repair. The results of this study indicate that there was reduction in lip pressure resulting from the surgically induced cleft lip, alveolus, and palate. Substantial increases in lip pressure were shown in both groups in which lip repair was completed. The influence of primary unilateral cleft lip repair on the facial growth of rabbits in this study will be presented in Part II of this report.

Animals↗
PubMed1978

Growth of the unilateral cleft lip.

Growth discrepancies have frequently been noted following surgery for the repair of clefts of the lip. A long lip is often noted months or years after LeMesurier, Tennison, or Asensio repair, whereas a short lip is noted after the Millard repair. We evaluated the problem by measuring 112 unrepaired unilateral completed cleft lips in a homogeneous population. Patients of all ages from newborn through adults were included. The study showed that a cleft lip has ten to twenty per cent greater growth in the transverse direction parallel with the orbicularis muscle than in the vertical direction perpendicular to the muscle. Thus, procedures such as those of LeMesurier and Asensio that transpose tissue from transverse to vertical will lead to excessive vertical growth. Lip growth is slightly decreased along the cleft margins but does not account for the short lip seen after the original Millard repair. Lip shortness occurs soon after repair because of scar contracture but tends to resolve with the passage of time.

Adolescent↗
PubMed1997

[Reconstruction of lip isocele].

The surgical treatment of labial carcinoma must allow the complete excision of the tumor. This must be performed by using an immediate reconstruction procedure with respect of the lip function and with a satisfying aesthetic result. To achieve this goal, we choose the isosceles lip reconstruction, according with Meyer's advancement flap technique, described in 1965. By using this method we can restore up to the 2/3 of the lower or upper lip and also the lip commissure, after malignant tumor surgery. For total lip reconstruction, we have to combine this method with an Abbe-Estlander flap. Our paper presents this original lip reconstruction technique and analyses the results obtained. We especially base our conclusions on functional tests, but also on aesthetical considerations. We underline the interest of this choice of surgical procedure, permitting its adaptation to all cases of lip reconstruction, with immediate possibility of reconstruction, usually in one stage, without compromising either the function or the aesthetic aspect of the reconstructed lip.

Humans↗
PubMed1996

[The Abbe-Estlander flap: anatomic basis, surgical technic and indications for lip repair].

The Abbe-Estlander flap is a full-thickness lip-switch flap rotated from mid lower lip to fill defects of the upper lip. In 1872, Estlander emphasized the importance of this flap. Abbe, in 1898, was the first to switch a lower lip flap into the upper lip for a cleft deformity. The lip-switch flap is an arterialized flap, based on the constant inferior labial artery. This flap is widely used to repair the defects from cancer and traumatism or in repair of the cleft lip deformities.

Cleft Lip↗
PubMed1975

[Lip prints--variability and genetics (author's transl)].

In a sample of 500 persons, including 76 families with 133 children, 22 mono- and 17 dizygote twins, lip prints were prepared for the study of variability and genetical basis of ridge-pattern in the region of mucous membrane lips. Taking 4 classes of pattern with different ridge-branching as a basis we observed more frequently branched pattern at the upper lip and mainly simple pattern at the lower lip. About 30% of the lip-prints showed whirling figures--at the upper lip simple and median, at the lower lip double and paramedian. Investigations during several months showed stability against environmental factors. The results of twins, families and mother(father)-child combinations proved a genetical basis of lip-prints. Applications of cheiloscopy to genetical investigations are reported.

Adolescent↗
PubMed2002

The soft-tissue facial profile of patients with unilateral clefts of the lip, alveolus, and palate compared with healthy adults.

PATIENTS AND METHOD: In this study the soft-tissue profile of 84 patients aged between 16 and 29 years after complete rehabilitation of a unilateral cleft of the lip, alveolus, and palate was compared on lateral cephalograms with that of 58 adult probands with no cleft formation. RESULTS AND CONCLUSION: In the patient group, the thickness at nasion, the subnasal thickness, the upper alveolabial sulcus thickness, the upper lip prominence, and the mental thickness were less pronounced than in the control group. In contrast, the patients showed significantly higher values in the prominence and thickness of the lower lip. These results indicate a less dominant development of the upper lip and a more voluminous lower lip in comparison to the control group. In contrast, the length of the upper lip did not differ significantly between patients and controls. In both groups the facial integument was thicker in males than in females. The soft-tissue anb-angle, the soft-tissue Holdaway II angle, and the nasolabial angle were significantly smaller in the patients than in the controls. Furthermore, the patients showed a distinctly more concave soft-tissue profile than the controls in measurements of the soft-tissue convexity angle. Thus, it is important for all surgeons involved in the rehabilitation of these patients to pay attention not only to an adequate length of the cleft-sided upper lip, but also to attaining a physiological alignment and reconstruction of the muscles, since the orbicularis oris muscle represents the most important component in the form and function of the lip. In addition, discontinuous muscular slings in the facial area may lead to severe midface growth disturbances.

Adolescent↗
PubMed2005

Perceptual distortion of face deletion by local anaesthesia of the human lips and teeth.

As visual guidance of facial movements is impossible, accurate movements for speech and mastication require an established body image that is formed via the information from mechanoreceptors in the skin, mucosa, periodontium, and proprioceptors in the facial and masticatory muscles and in the jaw joints. In this study we aimed to investigate how the acute deafferentation of lips and teeth alters the established image of lips, teeth and the thumb. We used a psychophysical method to determine whether the perceived sizes of the upper lip and front teeth change when the sensory input from the lips and front teeth is fully blocked. We also examined the perceived size of the thumb to test for acute interactions between the thumb and facial structures. Local anaesthetic blocking of upper lip and upper front teeth significantly increased the perceived size of the upper lip by as much as 100% (range 21-100%) in ten out of eleven subjects tested (overall mean 52%; p=0.001). The perceived size of the upper teeth also significantly increased by as much as 155% (range 30-155%) in eight of the eleven subjects during anaesthesia (overall mean 41%; p=0.035). When the region of anaesthesia was increased and both upper and lower teeth and lips were anaesthetised, the perceived size of the upper lip again increased, by 53% (p=0.040), but the change in perceived size of the upper front teeth (18%) was not significant (p=0.206). In both studies there was no change in perceived size of the thumb. The results illustrate the labile central interaction between sensory inputs and the importance of feedback from peripheral afferents in generating the subjective facial image. The timing, level, and area of anaesthesia may be important modifiers of these interactions.

Adolescent↗
PubMed1993

Role of substance P in neurogenic inflammation in the rat incisor pulp and the lower lip.

Vascular permeability was significantly increased in the incisor pulp and skin of the lower lip in the rat after antidromic electrical stimulation of the inferior alveolar nerve, and this response was significantly inhibited by a substance-P antagonist. The content of substance P in the pulp and lip was also increased after stimulation. The permeability response was reduced by aspirin and bradykinin antagonists (both B1- and B2-receptor types) in the pulp and lip, indicating that prostaglandins and bradykinin may be involved. Mepyramine and methysergide inhibited the vascular response in the lip but not the pulp; the roles of histamine and serotonin differ in the two tissues. Injection of substance P into the incisor pulp and the lip skin caused dye leakage. This response was inhibited by pretreatment with compound 48/80 in the lip but not the pulp. Lip histamine content was decreased significantly after antidromic stimulation of the inferior alveolar nerve and pretreatment with compound 48/80, but was not changed in the pulp. The results suggest that substance P in the lip, after being released from the peripheral sensory-nerve endings, may act on the vascular system via histamine release from mast cells; but in the pulp may cause vascular response directly because of the scarcity of mast cells.

Animals↗
PubMed2004

[Social adjustment in French adults from who had undergone standardised treatment of complete unilateral cleft lip and palate].

France has a population of about 60 million peoples and each ten years data about the standard of living are collected by the central bureau of statistics, we considered the collection of data on 5000 households in 1999 in our geographical area would afford a unique opportunity to compare the equivalent status of French adults with repaired cleft of the lip and palate (CLP). Aspects of social adjustment were investigated in a sample of 82 French adults 18-35 years old with repaired complete unilateral cleft of the lip and palate (CLP). All subjects received a standardized regimen of care from the Burgundy cleft palate team of Dijon. The investigation, based on response to a questionnaire, partly replicated a national survey of social and economic life in the population (Standard of living survey Burgundy, INSEE France 1999), so that adults with complete clefts could be compared with a large control sample of the same age. The control group was constituted by subjects between 18 and 35 years in the standard of living survey Burgundy 1999, INSEE France, they were taken from a regional probability sample of households. This report covers education, employment, and marriage. The significant difference between groups was assessed by: Student's t-test or analysis of variance for continuous variables and chi2 test for categorical variables. The results demonstrated that there are significant differences in educational attainment and employment between adults with cleft of the lip and palate and other people. Fewer with cleft of the lip and palate marry, and when they marry they do so later in life, scholarship history showed significant delay in the cleft of the lip and palate group, independence regarding housing was lower in the cleft of the lip and palate group. If cleft of the lip and palate adults functioned within normal limits with regard to employment. However, levels of income were substantively lower than control groups. It would appear that cleft subjects experience some limitation in their ability to secure vocational and economic rewards from society. As a conclusion we can say regarding our results that the cleft of the lip and palate group, even with the smallest degree of malformation (unilateral without associated malformation), showed a significant delay in the independence process.

Adaptation, Psychological↗
PubMed2006

Evaluation of speech intelligibility for children with cleft lip and palate by means of automatic speech recognition.

OBJECTIVE: Cleft lip and palate (CLP) may cause functional limitations even after adequate surgical and non-surgical treatment, speech disorders being one of them. Interindividually, they vary a lot, showing typical articulation specifics such as nasal emission and shift of articulation and therefore a diminished intelligibility. Until now, an objective means to determine and quantify the intelligibility does not exist. METHOD: An automatic speech recognition system, a new method, was applied on recordings of a standard test to evaluate articulation disorders (psycholinguistic analysis of speech disorders of children PLAKSS) of 31 children at the age of 10.1+/-3.8 years. Two had an isolated cleft lip, 20 a unilateral cleft lip and palate, 4 a bilateral cleft lip and palate, and 5 an isolated cleft palate. The speech recognition system was trained with adults and children without speech disorders and adapted to the speech of children with CLP. In this study, the automatic speech evaluation focussed on the word accuracy which represents the percentage of correctly recognized words. Results were confronted to a perceptive evaluation of intelligibility that was performed by a panel of three experts. RESULTS: The automatic speech recognition yielded word accuracies between 1.2 and 75.8% (mean 48.0+/-19.6%). The word accuracy was lowest for children with isolated cleft palate (36.9+/-23.3) and highest for children with isolated cleft lip (72.8+/-2.9). For children with unilateral cleft lip and palate it was 48.0+/-18.6 and for children with bilateral cleft lip and palate 49.3+/-9.4. The automatic evaluation complied with the experts' subjective evaluation of intelligibility (p<0.01). The multi-rater kappa of the experts alone differed only slightly from the multi-rater kappa of experts and recognizer. CONCLUSION: Automatic speech recognition may serve as a good means to objectify and quantify global speech outcome of children with cleft lip and palate.

Adolescent↗
PubMed2004

Comparing the effects of V-Y advancement versus simple closure on upper lip aesthetics after Le Fort I advancement.

PURPOSE: The aim of this study was to compare upper lip movement and its dimensional changes after maxillary advancement via Le Fort I osteotomy, using V-Y advancement versus simple continuous closure. The study investigates dimensional changes in the superior and inferior portions of the upper lip, as well as changes in lip length, resulting from the procedure. PATIENTS AND METHODS: The study group consisted of 35 patients who had undergone 1-piece Le Fort I osteotomy for maxillary advancement of 3 to 6 mm with less than 3 mm of vertical changes. Fixation was performed by rigid monocortical plating. Closure of soft tissue was achieved using V-Y advancement in 17 patients and simple continuous suturing in 18 patients. Lateral cephalometric radiographs were taken and measured preoperatively and then 6 months after surgery. RESULTS: The magnitude of upper lip movement was 88.89% of the maxillary advancement in the simple continuous suturing group and 90.77% in the V-Y advancement group. The superior portion of the upper lip thickened by 2.08 mm and 2.35 mm in the 2 groups, respectively. The inferior portion of the upper lip thickened by -1.94 mm and -1.14 mm, respectively. The upper lip shortened by 0.79 mm in the simple continuous suturing group and lengthened by 1.10 mm in the V-Y advancement group. CONCLUSIONS: Upper lip movement and dimensional changes differ when simple continuous suturing and V-Y advancement closure are used.

Adolescent↗
PubMed1999

Physiological characterization of lip and tentacle nerves in Lymnaea stagnalis.

The lip and tentacle nerves of the pond snail, Lymnaea stagnalis, were characterized using electrophysiological techniques. When the activity of those nerves was induced in lip-tentacle preparations, aversive taste signals were transmitted through all the lip and tentacle nerves, but appetitive signals could be recorded only through the superior lip nerve. In the CNS immersed in high Mg2+ -high Ca2+ saline, electrical stimuli applied to any of the nerves failed to induce action potentials in one of the regulatory neurons (cerebral giant cell: CGC) involved in feeding responses, implying that the signals are polysynaptically transmitted to the CGC. Intracellular recordings revealed that the CGCs in semi-intact half-body preparations received both appetitive and aversive taste signals not only through the superior lip nerve but also through the median lip nerve. In addition, an osphradium was ruled out as a candidate for appetitive reception. The present results, together with our preceding data arrived at by the histochemical analyses, indicate that the appetitive taste transduction responsible for generating feeding responses is performed through the superior lip nerve with some contribution of the median lip nerve. The data showing that the CGC can receive various taste signals suggests that it may play a crucial role in feeding behavior as demonstrated in the study of conditioned taste-aversion.

Animals↗
PubMed2005

Upper lip changes correlated to maxillary incisor retraction--a metallic implant study.

The soft tissue changes after the extraction of maxillary first premolars and subsequent anterior tooth retraction were evaluated for 16 Class II, division 1 patients. Pre- and posttreatment lateral head cephalograms were evaluated using superimpositions on Björk-type metallic implants in the maxilla. The patient sample was divided into group I patients, those who did exhibit lip seal at rest in the pretreatment cephalogram and group II patients, those who did not exhibit lip seal at rest in the pretreatment cephalogram. Upper incisor retraction was followed by a similar ratio of upper lip retraction in both the lip seal and nonsealed groups (1:0.75 and 1:0.70 mean ratios, respectively). However, those without lip seal did demonstrate more retraction at stomion (USt). The final upper lip position (Ls) was reasonably correlated with retraction of the cervical maxillary incisor point (cU1) with determination coefficients of 63.6% in the lip sealed and 68.5% in the lip incompetent groups. Although labial and nasolabial angles tended to open after incisor retraction, there was little predictability for this response.

Bicuspid↗
PubMed1996

Cosmetic surgery of the lips.

Lips are the central feature in the lower third of the face. When they are full and well defined, they impart a sense of youth, health, and attractiveness to the bearer. Thin, flat lips, on the other hand, imply fragility and senility. The characteristics of the lips responsible for these qualities are the shape of Cupid's bow, the relative length of the upper lip, and the projection or bulk of the lips. Esthetic guidelines are presented for each of these characteristics, which when understood help the surgeon formulate an operative plan. Lip augmentation techniques using autogenous and alloplastic materials are presented. For patients with a long upper lip, vermilion advancement and nasal base resection are discussed in detail. With a look to the future, a discussion of preliminary experience with carbon dioxide laser lip advancement concludes the article.

Adipose Tissue↗