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PubMed1999

Augmentation of the nasal floor with Surgicel in primary lip repair: a prospective study showing no efficacy.

The symmetry of the alar base and the nasal floor is very important in achieving a satisfactory result in primary lip and nasal reconstruction during cleft lip repair. The skeletal base of the nasal pyramid is usually hypoplastic even in incomplete clefts. A periosteal pocket filled with Surgicel can facilitate blood clot formation and can theoretically stimulate bone formation, thereby improving the asymmetry of the bone base. To test this hypothesis, a prospective study was performed in 64 primary lip repairs by comparing the effect of subperiosteal nasal floor augmentation with Surgicel. From February 1989 to June 1993, 64 patients with incomplete cleft lips (excluding occult cleft lip and complete clefts with Simonart's band) were operated by the same surgeon. The patients were divided randomly into two groups. One group had subperiosteal nasal floor augmentation with Surgicel and the other group did not. The lip repair was a rotation-advancement cheiloplasty with primary closed rhinoplasty of the tip and ala. In the first group, a subperiosteal pocket was created under the cleft alar base and the nasal floor. The pocket was filled with Surgicel up the point where the level of the alar base and the nasal floor was symmetrical with the noncleft side. The control group underwent a similar procedure, less the creation of the subperiosteal pocket and the use of Surgicel. All patients were followed for at least 3 years and their photographs were used to compare and analyze the results of their nasal correction. Critical attention was paid to the symmetry of their nasal floor and alar base. The results were evaluated by at least two plastic surgeons for consistency. The data indicate that the control group showed a higher number of subjects with asymmetry (10 of 32) compared with the study group (8 of 32). However, there was no statistical significance to the findings. Two patients in the study group who received Surgicel developed hypertrophic lip scars. This study, although unable to determine statistically the contributory affect of Surgicel in primary nasal reconstruction, does show a possible benefit from the use of osteogenic materials in the primary management of the deficient nasal floor. Hypertrophic scars developed by 2 patients in the study group may point to a possible soft-tissue reaction to the use of Surgicel in primary lip and nasal repair.

Cellulose, Oxidized↗
PubMed2000

The temporal and spatial epidemiology of lip cancer in England and Wales.

OBJECTIVE: To examine trends in lip cancer mortality and incidence during the 20th century, and its geographical distribution, in England and Wales as a prerequisite to establishing any essential differences in the aetiology of lip and intra-oral cancer. METHOD: Age-standardised rates for lip cancer mortality by gender from 1901 to 1991 were derived from archived OPCS data. Standardised incidence rates from 1962 to 1986 were also calculated. Registrations of lip cancer between 1979 and 1983 in the 15 RHAs covering England and Wales were obtained from the same source and standardised incidence ratios (SIR) computed. RESULTS: Progressive and sustained falls in lip cancer mortality and incidence were recorded in the period covered. In males, these related particularly to cohorts born after 1856. In addition, the incidence of lip cancer in both genders was found to be raised in a band stretching from East Anglia to the South West and also in the Trent and Wales RHAs. CONCLUSIONS: The findings support an hypothesis that employment in the agriculture, forestry and fishing industries, and also pipe smoking, were the major risk factors for lip cancer in the 20th century. Further research is required to differentiate between the aetiological risk factors for lip and intra-oral cancer.

Adult↗
PubMed2002

[A study of the feasibility and efficacy of fetal surgical closure of spontaneous cleft lip in CL/fraser mice].

Cleft lip with or without cleft palate is one of the most common human craniofacial congenital malformations. Failure to form a continuous tissue in the upper lip during the early embryonic period results in cleft lip. There has been an increasing interest in the possibility of in-utero correction of life threatening fetal abnormalities. In the present study, the feasibility and efficacy of surgical suturing of the fetal mouse lip was examined by using CL/Fraser mouse fetuses (spontaneous of cleft lip) at embryonic 15, 16 or 17 days. The obtained results were as follows. #1. Abortion rate of pregnant dam applied inhalation of Ethrane was less than that of intraperitoneal injection of Nembutal. #2. Successful delivery rate of fetal mouse surgically treated at the embryonic 16 day or 17 day is higher than that on the embryonic 15 day. #3. Fusion rate of mouse fetal lip surgically treated on the embryonic 16 day was higher after 60 hours in dam's uteri than that after 36 hours. These results suggest that inhalation of Ethrane is more recommendable, and that the optimal timing of fetal surgery of spontaneous cleft lip in CL/Fr. mouse fetus is an embryonic 16 day, and that the average time of 60 hours after surgical operation is enough for sutured lip to fuse in dam's uteri.

Anesthesia↗
PubMed1993

[Vestibuloplasty in patients with cleft lip and palate].

After cleft lip repair the upper lip is sometimes attached at the premaxilla. The scar bands and contractures may occur deleterious effects on: the growth, the facial expression, the speech, problems during orthodontic treatment and in prosthetic dental care, regression of the attached gingiva, resorption of the transplanted bone and the aspect of the upper lip. In nine edentulous patients with cleft lip palate, in six patients with cleft lip palate and with a mutilated dentition and in ten younger patients with cleft lip palate the buccal sulcus was successfully restored. The importance of a free upper lip and adequate sulcus has been under-emphasized in treatment of the patient with cleft lip palate.

Adult↗
PubMed2002

[Lip carcinoma. A review].

Lip cancer develops in the vermilion border of the lip. The great majority of these malignancies are squamous cell carcinomas. Lip cancer predominantly affects the lower lip and particularly occurs in males. The main risk factors involved are cumulative lifetime exposure to sunlight and the use of tobacco. It usually presents at an early stage. In the Netherlands (16 million inhabitants), approximately 190 new cases are registered annually. Since lip cancers in most instances are easily recognized, they may be diagnosed at an early stage. Lip cancer is best cured when it is diagnosed early. Dental examination should routinely include clinical examination of the lips and, on indication, palpation. This article reviews the clinical presentation, diagnosis and management of lip cancer.

Carcinoma, Squamous Cell↗
PubMed2003

[Surgical treatment of malignant lip tumors. Personal experience].

The malignant tumours of the lip account for nearly 1-2% of the cervicofacial neoplasms. These lesions are frequently spinous cell carcinomas and basal cell carcinomas (25% of all oral cancers). The spinous cell carcinoma is mainly located in the lower lip, the basal cell carcinoma is more common in the upper lip. The incidence of lip cancer in males is much high than in females. The etiopathogenesis of these lesions is connected with exposure to sun, smoking, genetics predisposition (mutation of the p53 suppressor factor) and with the evolution of precancerous lesions (radiodermatitis, chronic cheilitis, xeroderma pigmentosum). Some Authors emphasized the viral etiopathogenesis: HPV16, HPV24, HSV1, HSV2. The treatment of lip carcinoma is surgical: excision and reconstruction. The numerous reconstructive techniques are mostly the cutaneous local sliding flaps and the rotation flaps. The lip reconstruction require a remarkable diligence for preserve, as much possible, the shape and functions of lip. The Authors report their experience about the surgical treatment of 19 patients with lip carcinoma (16 spinous cell carcinomas, 3 basal cell carcinomas) and describe the main surgical reconstructive techniques to preserve the feeding, phonation and mimic expression.

Aged↗
PubMed2006

Effect of upper premolar extractions on the position of the upper lip.

BACKGROUND: It has been suggested that Class II division 1 malocclusions treated with extractions result in detrimental changes in the facial profile. This study investigates changes in the position of the upper lip following upper arch extractions only. OBJECTIVE: To investigate changes in the position of the upper lip following extraction of the upper first premolars and retraction of the upper incisors. METHODS: The sample consisted of 35 Class II division 1 patients with overjets of least 5 mm whose malocclusions were corrected with upper first premolar extractions and full fixed appliances. Twelve patients in the sample had overjets > or = 9 mm. There were no extractions in the lower arch. Pre- and post-treatment lateral cephalograms were used to determine the changes in the position of the upper lip. RESULTS: At the end of treatment the upper lip was 0.46 mm less protrusive than at the start of treatment. In patients with overjets > or = 9 mm the upper lip was approximately 1 mm less protrusive at the end of treatment (Mean pre- and post-treatment difference: 0.92 mm). There were no significant gender differences in the positions of the upper lip. CONCLUSION: Minimal changes occur in the position of the upper lip following extraction of the upper premolars and retraction of the upper incisors. Factors other than the position of the upper incisors may determine the post-treatment position of the upper lip.

Adolescent↗
PubMedDate not supplied

[Carcinoma of the lip: a retrospective study of 86 cases].

Carcinoma of the lip is a common lesion which is not always acknowledged as as a potentially lethal disease. The risk of cancer occurs most commonly among aging white men. The risk factors normally associated with lip cancer are rural residence and outdoor occupation. In addition, both actinic radiation and tobacco smoking have been considered casually related to lip cancer. The present study is based on a retrospective review of 86 patients (82 males, 4 females, mean age 65) affected by carcinoma of the lip, treated in Florence from 1970 to 1988. The most frequent site for carcinoma of the lip proved to be the lower lip (71 cases); other sites included the upper lip (7) and the commissure (8). The lip tumor was a squamous cell carcinoma in 82 patients and a basal cell carcinoma in the remaining four. Good prognosis was found for all those with relatively small lesions (T1-T2). On the contrary, the prognosis proved quite poor for those who exhibited tumor fixation to the mandible or erosion of the mandible (23.5%, 5 year survival). Primary radiotherapy may be used for the smaller lesions as cure rates proved equivalent to those achieved surgically although the authors found surgery is always preferable as a primary method of treatment. Surgical excision of the tumor is a relatively minor procedure with a minimum of morbidity as compared with radiation therapy which may lead to local tissue reaction and may disturb function. Surgical management is also recommended as it bears the advantage of being to give a histologically accurate tumor margin assessment. Moreover, with surgery, functional results are good.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Detection of cleft lip by early second-trimester transvaginal sonography.

OBJECTIVE: To describe the detection of cleft lip in the early second trimester using transvaginal sonography. METHODS: We analyzed retrospectively 14,988 ultrasound examinations conducted for fetal malformations between 12-16 weeks' gestation. Seventy-five percent of the patients were at low risk for fetal anomalies and 25% were at high risk. RESULTS: Eleven cases of fetal cleft lip with or without cleft palate were detected by transvaginal sonography among 14,988 fetuses (0.07%). In nine cases, no risk factors for cleft lip or palate existed. In six cases, the cleft lip represented an isolated malformation, with no other associated anomaly; in five of these six cases, the pregnancy was terminated. One additional case of a small cleft lip was not detected, for a false-negative rate of 8%. CONCLUSIONS: The fetal lips can be scanned by transvaginal sonography in the early second trimester, and fetal cleft lip can be detected in most cases. Early second-trimester detection of cleft lip by transvaginal sonography allows informed parental choice regarding continuing or terminating the affected pregnancy.

Abnormalities, Multiple↗
PubMedDate not supplied

Deficient and delayed primary palatal fusion and mesenchymal bridge formation in cleft lip-liable strains of mice.

During mammalian primary palate formation, the facial prominences enlarge around the nasal pit, fuse and then merge to give rise to the tissue of the upper lip and premaxillary region. The mechanisms involved in successful primary palate formation and how they are affected in the cleft lip genotype remain poorly understood. The purpose of this study was to compare morphometrically internal development and growth of the primary palate in five different strains of mice. Two of the strains, BALB/cByJ, and C57BL/6J, have normal primary palate development, and three of the strains, A/J, A/WySn, and CL/Fr, have stable frequencies of cleft lip associated with genotype. In the present study, frequencies of 4, 23, and 24%, respectively, were observed on day 13. For palatal growth analysis, embryos were collected on days 10 and 11, staged by number of tail somites (TS), and the heads were photographed and serially sectioned for measurement of primary palate components. The heights of the epithelial seam and the mesenchyme bridge between the facial prominences were measured on serial sections and areas of contact were calculated. The position or depth of the maxillary prominence was determined from the number of frontal sections from its tip to the rostral end of the nasal fin. Analysis of measurements showed that in cleft lip strains enlargement of the epithelial seam and replacement of epithelia by a mesenchymal bridge were both delayed relative to somite stages. Measurements from day 11 embryos with complete failure of contact were excluded from the growth analyses. The mesenchymal bridge formed at 12--13 TS in noncleft strains, 14 TS in the A/J strains with higher cleft lip frequency, and 15--17 TS in A/WySn and CL/Fr strains with higher cleft lip frequency. Forward growth of the maxillary prominence was highly correlated with the primary palate measurements and mesenchymal bridge formation in all strains. In both cleft and noncleft strains, the primitive choanae open at 18--20 TS and the medial nasal region narrows with advancing embryonic development. As a result, cleft lip-liable strains have a narrower window in development in which a robust mesenchymal bridge must form, thus increasing the liability to cleft lip.

Animals↗
PubMed2006

New modification of the mandibulotomy approach without lip splitting.

BACKGROUND: A lower lip-splitting incision has traditionally been performed with different types of mandibulotomy approaches for obtaining wide access to oral and oropharyngeal cancers. However, lip splitting can be associated with unfavorable aesthetic results. We describe our new modification of a traditional mandibulotomy approach without lip splitting to avoid these morbidities. This is a case series in a tertiary referral center. METHODS: The primary tumor site was the oropharynx in four cases, the oral cavity in two cases, and the parapharynx in one case. Each case was assessed for TNM staging, perioperative complications, status of the resection margins, tumor recurrence, and the aesthetic and functional results of the lower lip. RESULTS: All the tumors were safely removed by means of our modified non-lip-splitting mandibulotomy approach through the combined intraoral and transcervical routes with adequate resection margins. There were no troublesome difficulties in reconstruction of the surgical defects with various major flaps. The cosmetic results were excellent with intact lip function. CONCLUSION: We believe this new modified non-lip-splitting mandibulotomy approach could replace the conventional mandibulotomy approach for some selected malignant lesions, with excellent cosmetic and functional results of the lower lip.

Adolescent↗
PubMed2005

Expression on wood, molecular cloning and characterization of three lignin peroxidase (LiP) encoding genes of the white rot fungus Phlebia radiata.

Lignin peroxidase (LiP) is the first enzyme connected to oxidative breakdown of the aromatic plant heteropolymer lignin and related xenobiotics. However, this extracellular enzyme has been described in only a few species of wood-decaying basidiomycetous fungi. The white rot basidiomycete Phlebia radiata 79 readily produces a versatile set of lignin-oxidizing enzymes including lignin and manganese peroxidases (LiPs and MnPs) and laccases. Here we describe genomic and primary structure of two new LiP-encoding genes, Pr-lip1 and Pr-lip4, and genomic characterization for isozyme LiP3/LIII of P. radiata, encoded by the gene depicted Pr-lip3. Pr-lip1 and Pr-lip4 code for 370- and 361-amino-acid long proteins beginning with 26- and 24-amino-acid secretion pre-propeptides, respectively. Translated LiP1 and LiP4 share the highest protein sequence identity (74 and 86%) with P. radiata LiP3, and 70% identity with the one deduced LiP from Bjerkandera adusta. The three P. radiata LiP sequences form a coherent phylogenetic cluster, which is further supported by similarities within gene organization interrupted by 11-introns. To find out the significance of LiP upon fungal growth on natural lignocellulose, such as wood, we studied ligninolytic gene expression on hardwood (milled alder) and softwood (spruce chips). All the LiP-encoding genes were expressed on wood with predominance of Pr-lip3 transcript abundance, in particular on spruce wood chips, where also time-dependent expression of the multiple lip genes was observed.

Amino Acid Sequence↗
PubMed1994

Corneal lip tunnel incision.

To evaluate whether the corneal lip tunnel incision or the sutureless closure causes any refractive problems, we performed a retrospective study on 387 cataract surgery patients who were divided into four groups based on type of wound closure and whether the corneal lip was made. The four groups consisted of patients who received an X-stitch closure without the corneal lip, a horizontal mattress stitch without the lip, a horizontal mattress stitch with the lip, and a sutureless closure with the lip. All patients had phacoemulsification in situ; implantation of a foldable silicone lens was performed through a scleral tunnel incision. Clinical evaluations included preoperative characteristics and postoperative Snellen visual acuity, intraocular pressure, and vector analysis of cylinder. In all four groups, a 4.0 mm wide incision was used. Entrance into the clear cornea during the corneal lip tunnel incision did not induce additional cylinder, and the sutureless closure did not decrease induced cylinder or increase the against-the-rule shift. The results of this study indicate that the combination of a 4.0 mm incision with 1.5 mm corneal lip, phacoemulsification in situ, foldable lens implantation, and sutureless closure is a safe and effective procedure for cataract surgery.

Aged↗
PubMed2000

Lip-reading ability and patterns of cortical activation studied using fMRI.

Lip-reading is a complex cognitive skill with large individual differences in performance. The basis of these individual differences remains poorly understood. Functional magnetic resonance imaging (fMRI) techniques allows brain activation accompanying complex cognitive activities to be studied noninvasively. In the present paper, fMRI was used to study the patterns of cortical activation that occur during the silent lip-reading of connected speech and to investigate whether there are detectable differences in activation between subjects with widely differing lip-reading abilities. From a cohort of 26 volunteers, nine subjects who fell into three distinct lip-reading ability groups were selected. Brain activation was measured in two conditions: an experimental condition where subjects attempted to lip-read sentences; and a baseline condition where subjects passively viewed a static image of a talker's face. Relative to the baseline condition, lip-reading induced activation in several cortical areas, including the auditory cortices, despite the lack of an auditory component to the task. In comparison to the better two groups of lip-readers, subjects in the poorest group displayed significantly less activation in superior and middle temporal gyrus, but not inferior temporal gyrus. These preliminary results justify more extensive investigations of the cortical basis of individual differences in lip-reading.

Adult↗
PubMed1989

Teaching lip-reading: the efficacy of lessons on video.

Studies of the efficacy of filmed and videotaped materials for lip-reading self instruction have provided encouraging results. The recent increase in private ownership of VCRs allows widespread home use of video lessons for improving lip-reading skills. Such an approach is particularly, useful for hearing-impaired adults who have no access to lip-reading classes. To fill this need in Australia a 3-hour video cassette of nine lip-reading lessons was produced. The video lessons were tested over a period of 5 weeks. The study showed a significant improvement in the lip-reading skill of students who studied the video cassette compared to a control group who did not. The extent of improvement did not differ for students who studied the video in a class, at home, or as supplementary teaching material. While the age and sex of the subjects did not influence improvement of lip-reading skills, the study showed greater improvement for the relatively poorer lip-readers. More detailed testing of one group of students showed generalization of lip-reading skills to unfamiliar speakers and materials.

Adult↗
PubMed2002

[Intra-uterine model of cleft lip and scarless wound healing of fetal rats].

OBJECTIVE: To properly evaluate the benefits of in utero repair of cleft lip, an animal model of cleft lip was developed and the fetal scarless wound healing was observed in SD rat fetus. METHODS: Through a maternal celiotomy and hysterotomy, twenty excisional cleft was created in the upper lip of rat fetus. Another group of 20 rat fetus were given full-thickness incisional wounds in the upper lips. The fetus with cleft lip were returned into utero for further development till birth.Wound specimens from the incisional wounds in the other group were removed successively 12, 24, 48, 72h postwounding for histological examination. RESULTS: The fetus with excisional wound demonstrated a complete cleft lip after birth. In contrast, the wound in the fetus with incisional wounds regenerated with normal architecture histologically, indistinguishable from the surrounding normal skin. CONCLUSION: The results of this preliminary study indicates that the fetal rat cleft lip is technically feasible with an excellent survival rate. Healing occurs without scar formation. This model will be used to document facial growth following in utero repair of a cleft lip.

English Abstract↗
PubMed2003

[RT--PCR analysis of Phanerochaete chrysosporium lip genes in colonized fir wood].

Expression of Phanerochaete chrysosporium lip A2 (GLG3) lip C1 (GLG2) lip C2 (GLGS) lipD2( GLG1), lipE (LP0811) genes were analyzed by RT-PCR method. It was showed that some genes were expressed in special colonized period. Only lip A2 (GLG3) transcription occured in the 2nd week and the 8th week, both lip C1 (GLG2) and lip D2 (GLG1) gene transcription was checked out in the period of 6 weeks. However, no lip genes were expressed in the time of 4 weeks. These results indicated that lip gene expression is relied on the colonized period and transcript patterns are re dramatically different from those in previous studies with defined media.

Abies↗
PubMed1975

Intraoral closure of subcutaneous clefts of lip.

A new method for the closure of subcutaneous clefts of lip has been presented. The operation was achieved from an incision in the oral mucosa, without skin incision in the white portion of the lip. The muscle stumps of the orbicularis oris are freed from their false insertion and re-united. In addition, the musculature is separated from the skin In this manner, the shortness of the white portion of the lip, which is due to the elevation of the musculature, is largely eliminated. The lip on the cleft side thus attains the same length as that of the healthy side. The muscular pull gives rise to a conspicuous philtrum pit and ridge, without external scar on the lip. This principle of separating the musculature can also be used in the repair of incomplete and complete clefts of lip, and in all reoperations of the lip.

Cleft Lip↗