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At least 55 records · Page 3Linked to original sources

Double cross lip flaps for reconstruction of the lower lip.

Squamous cell carcinoma of the lower lip is a common tumor. Of the many methods available for reconstructing lower lip defects after radical excision, we found double cross lip flaps from each lateral side of the upper lip philtrum rotated into the defect of the lower lip to be an effective method, not only functionally but also cosmetically. The main reason why satisfactory results were obtained by this procedure is that the anatomical structure (skin-orbicularis oris muscle-mucosa, vermilion) of the upper lip is very similar to that of the lower lip. Our experience is with double cross lip operations in the management of lower lip cancers are described.

Adult↗

[The effect of lip repair on maxillary growth in patients with complete unilateral cleft lip and(or) palate].

OBJECTIVE: To investigate the different effects of lip repair on maxillary growth among patients with cleft lip and(or) palate, and also the possible mechanisms accounting for that differences. METHODS: The lateral cephalometric analysis was applied to 84 Chinese patients with unilateral cleft lip and(or) palate at the early stage of permanent dentition, which included 32 UCLA, 20 UCLP (CP unrepaired), and 32 UCLP, and 37 normal Chinese of the same age as controls. RESULTS: The patients with unilateral cleft lip and palate who had lip repaired while the palate was left unrepaired exhibited the similar inhibition on maxillary growth to those who had both lip and palate repaired but the patients with unilateral cleft lip and alveolus had much less inhibition on their maxilla. CONCLUSIONS: The cleft and tissue defect of patients with cleft lip and palate might be the main cause that induced the inhibitive effects of lip repair on maxillary growth.

Cleft Lip↗

Augmentation of the free border of the lip in cleft lip patients using temporoparietal fascia.

Deficiency of the free border of the lip is frequently encountered in secondary cleft lip deformities. The free border of the lip consists of the orbicularis oris marginalis muscle and its overlying subcutaneous tissue, vermilion, and mucosa. The pathology may involve any or all of these components. When there is an absolute shortage of subcutaneous tissue or orbicularis oris marginalis muscle, extra tissue from another source must be used for augmentation. A temporoparietal fascial graft is a simple and reliable method to increase the fullness of the free border of the lip. The tissue is soft in consistency and displays minimal resorption. Most important, more complicated procedures such as an Abbé flap or tongue flap may be avoided. From July of 1988 until June of 1992, the temporoparietal fascial graft was used successfully to correct deficiencies of the free border of the lip in 20 patients with cleft lip deformities. There were two graft exposures that healed with conservative treatment. The procedure is a useful method of augmenting both lateral lip and central lip deficiencies in secondary and tertiary cleft lip deformities.

Adolescent↗

Solar radiation, lip protection, and lip cancer risk in Los Angeles County women (California, United States).

A population-based case-control study of 74 women with lip cancer diagnosed from 1978 to 1985 in Los Angeles County (California, United States) and frequency matched to 105 controls investigated the risk of solar radiation and protection from lip sunscreening agents to explore the hypothesis that excess incidence of lip cancer seen in men is due partly to lower rates in women, conferred by frequent use of lip protection. We confirm the importance in women of risk factors similar to those found in men, i.e., fair complexion, sun exposure, and smoking. Risk was related strongly to lifetime solar radiation (odds ratio [OR] = 13.5 for highest quartile of exposure, 95 percent confidence interval [CI] = 4.5-40.6, P trend < 0.0001) and time spent outdoors (OR = 4.7 for highest quartile of average yearly hours, CI = 1.9-12.1, P trend = 0.01). Further, among women with high lifetime solar-radiation exposure, those who used lip protection once a day or less had twice the risk of lip cancer than women who used lip protection more than once a day (OR = 7.3, CI = 1.9-27.2 cf OR = 3.2, CI = 1.1-9.2). These findings show that solar radiation is a major risk factor for lip cancer and suggest that lip sunscreening is protective, thereby supporting the hypothesis that use of lipstick and other sunscreening agents by women has contributed to their lower incidence of this disease.

Adult↗

Anthropometric proportions in the upper lip-lower lip-chin area of the lower face in young white adults.

The relationships between measurements of the lower lip, chin, upper lip, and lower half and lower third of the face were studied. Fifteen new indices were formed with the help of eleven vertical linear, one horizontal linear, and two surface-arc measurements in the area. Neoclassic canons related to the lower face were not confirmed. On the average, the lower lip was 83% to 85% as large as the upper lip. The upper lip occupied one third of the lower face, while the lower lip occupied more than one third of the lower third of the face and the chin occupied the remainder. Skin covered 73.5% of the upper lip in males and 68% in females; it covered 63% of the lower lip in males and 61.1% in females. The remainder was covered by vermilion, more on the lower than on the upper lip and more protruding in females than in males. Proportion standards are a valuable contribution to the surface anatomy of the lower face of young white adults.

Adolescent↗

[Inhibitive effects of lip repair on maxillary growth in patients with complete unilateral cleft lip and palate].

OBJECTIVE: The aim of this study was to assess the isolated effects of lip repair on inhibition of maxillary growth in patients with complete unilateral cleft lip and palate. METHODS: The lateral cephalometric analysis were applied to 20 patients with unilateral cleft lip and palate who only had lip repaired in childhood, 32 patients with unilateral cleft lip and palate who had both lip and palate repaired in childhood, as well as 37 normal Chinese of the same age as controls. RESULTS: Both complete unilateral cleft lip and palate groups had almost the same significant degree of maxillary retrusion compared with the normal control group. CONCLUSION: Lip repair is one of important factors that could inhibit maxillary growth in patients with complete unilateral cleft lip and palate.

Adolescent↗

[Simultaneous repair of cleft lip and closure of cleft hard palate with vomer flaps in patients with unilateral complete cleft lip and palate].

OBJECTIVE: The purpose of this study was to retrospect the prognosis of simultaneous repair of cleft lip and closure of cleft hard palate with vomer flaps in patients with unilateral complete cleft lip and palate. METHODS: A retrospective study was carried out in 47 patients with unilateral complete cleft lip and palate and, simultaneously received repair of cleft lip and closure of cleft hard palate with vomer flaps. The duration of operation, as well as the blood loss during the operation was recorded, and compared with those patients who only received cleft lip repair. RESULTS: All the operations were successful, and the wound healed well. The procedure of simultaneous repair of cleft lip and closure of cleft hard palate with vomer flaps did not prolong the operating time, compared with simple cleft lip repair. No blood transfusion was needed due to closure of cleft hard palates with vomer flaps. CONCLUSION: Simultaneous repairs of cleft lip and closure of cleft hard palate with vomer flaps are safe for patients with unilateral complete cleft lip and palate.

Abnormalities, Multiple↗

Lip reconstruction of comparatively large defect including the commissure using remaining lip tissue: a modification of reconstructed method.

We present two reconstructed cases after malignant skin tumor of comparatively large defects of lip including the commissure using remaining lip tissue alone. After resecting a tumor including wedge-shaped full-thickness lip tissue, a full thickness oblique incision is made at the site 5 mm distant from the contralateral commissure. The rhomboid-shaped lower lip flap is created, transposed to the defect, and sutured with the defect margin, including the upper lip, to reconstruct the commissure. The cross lip flap is created at the contralateral side of the lower lip, 5 mm from the commissure, and the defect is closed with the crosslip flap. Although our method is applicable only to selected cases, we believe that it is useful in terms of maintaining symmetry of the lip and function of the commissure in the reconstruction of comparatively large defects including the commissure.

Aged↗

The cleft lip lower-lip deformity.

A patient with a repaired upper lip cleft may acquire a deformity in the lower lip. Records of 63 cleft lip patients who exhibited lower-lip abnormalities were analyzed in order to characterize the soft-tissue and skeletal configuration. The typical deformity was a hypertrophied, superiorly displaced, and anteriorly rotated lower lip. Skeletal analysis of the mandible revealed a variable and inconsistent degree of vertical elongation with posterior displacement of the chin. Operative correction of the cleft lip lower-lip deformity required evaluation of both the soft-tissue and skeletal abnormalities. Soft-tissue procedures gave permanent correction, provided there was a normal maxillary-mandibular relationship. Skeletal correction alone did not completely rectify the abnormal lower-lip posture.

Adolescent↗

Mucous-flap method for cleft-lip revision using transverse everted full-length lower-lip flap.

In patients who had undergone the first surgery for cleft lip and in whom the volume of tissue was smaller for the upper lip than for the lower lip, transfer of tissue from the lower lip using a full-length mucous flap allowed the tissue volume of the upper lip to be increased and external appearance of the lips to be improved. The subjects of this study were 6 patients who underwent this surgery between February and September 2001 and were followed for up to 3 years postoperatively. This surgery can be performed under topical anesthesia, without necessitating restriction on mouth opening and oral ingestion. Furthermore, it allows easy adjustment of the tissue volume in both upper and lower lips. This operative procedure is recommended for cases of cleft lip where surgical treatment has been performed before and the tissue volume is smaller in the upper prolabium than in the vermilion.

Adolescent↗

A cephalometric evaluation of lower lip in patients with unilateral cleft lip and palate.

OBJECTIVE: The aim of this study was to evaluate cephalometrically the lower lip position and area of patients with unilateral cleft lip and palate (UCLP) comparatively with Class I skeletodental normal subjects. PATIENTS: Lateral cephalometric and hand-wrist radiographs obtained from 24 patients with UCLP (mean age 12.86 years), along with 20 normal individuals (mean age 12.33 years) used as a control group, were examined. DESIGN: In addition to standard cephalometric dentofacial variables, lower lip area (superior, middle, inferior) was also measured using a digital planimeter on the lateral cephalograms. RESULTS: The superior and middle part of the lower lip areas were significantly smaller (p < .05) in the UCLP group, compared to the control group. The inferior and total lower lip areas of patients with UCLP were found to be significantly smaller than controls. The labiomental angle was also smaller (38.79 degrees). CONCLUSIONS: The results suggest that the lower lip of patients with UCLP is smaller, retruded, and curved, with a deep labiomental sulcus, compared with normal individuals during puberty. Therefore, practitioners should focus not only on the upper lip of patients with UCLP but also should consider the lower lip as it was found distinct from normal individuals during puberty.

Case-Control Studies↗

The influence of lip thickness and strain on upper lip response to incisor retraction.

Placement of teeth according to accepted cephalometric criteria does not necessarily ensure that overlying soft tissue will drape in a harmonious manner. The purpose of this research was to investigate the influence of maxillary lip thickness and lip strain on the relationship between dental and integumental tissue changes in orthodontically treated patients. Data were derived from pretreatment and retention lateral cephalometric head films of forty Caucasian subjects with Class II, Division 1 malocclusions. All patients were treated with edgewise appliances. Percentile groups were created for males and females according to the magnitude of maxillary lip thickness and lip strain. It was found that there was significant correlation between osseous changes and soft-tissue changes in both males (r= 0.83, p less than 0.01) and females (r = 0.85, p less than 0.01). Strong correlations were found between osseous changes and soft-tissue changes in subjects with thin lips (males, r equal to 0.92, p less than 0.01; females, r = 0.98, p less than 0.01), whereas no significant correlations were found in subjects with thick lips. Significant correlations were found between incisor changes and vermillion border changes in males (r = 0.61, p less than 0.01) and females (r = 0.51, p less than 0.05). Correlations were strong between incisor changes and vermilion border changes in subjects with high lip strain (males, r equal 0.92, p less than 0.01; females, r = 0.82, p less than 0.05) but were significant in subjects with low lip strain.

Adolescent↗

Scarless lip rehabilitation for the adynamic lip.

OBJECTIVE: Paralysis of the marginal mandibular branch of the facial nerve can be a debilitating condition resulting in compromised speech and oral incompetence. We describe a static procedure performed to address the functional and cosmetic deficits seen with an adynamic lip. METHODS: Three patients with complete facial nerve paralysis were evaluated after the scarless lip rehabilitation, a modification of the traditional wedge resection of the lower lip. The procedure is novel in that the removal of lip laxity and advancement of the contralateral innervated lip is achieved without an external facial skin incision. RESULTS: All 3 patients in the study reported improvement in oral competence and lip symmetry; however, articulation was less consistently affected. All 3 patients were able to drink from a glass without leaking from their oral commissure. No complications were seen in this series of patients. CONCLUSION: Oral incompetence and asymmetry are often the overlooked sequelae from complete facial nerve paralysis. Scarless lip rehabilitation of the adynamic lip is a novel, safe, and effective means to improve these functional and aesthetic deficits.

Aged↗

Primary repair of an incomplete unilateral cleft lip: avoiding an elongated lip and achieving a straight suture line.

The methods designed for the repair of a complete cleft lip should not be used to repair an incomplete cleft lip. This results too often in the postoperative drooping of the white lip on the affected side because in most incomplete cleft lips there is more tissue on the cleft side than in complete cleft lip. We present and discuss the refinements we made in our original technique for complete cleft lip in order to adapt it to incomplete cleft lip repair. The skin design at the white skin roll follows Cronin's method with an incision perpendicular to the vermilion border. The suture that pulls the edges of the angular incisions together pushes on the white skin roll caudally. This ensures that the peak of the Cupid's bow on the cleft side does not droop postoperatively. It also ensures that it does not take on an acute angle and that the vermilion border will be a continuous line without a break. We do not create a triangular flap at the vermilion border, but we raise a triangular flap at the alar base on the cleft side and advance it to the bottom of the columella. This creates the nostril sill and corrects the flared alar base. The resulting suture line is completely straight and runs along the philtral column. In this way, the postoperative elongation of the white lip on the cleft side can be prevented.

Cleft Lip↗

Measurement of lip posture and interaction between lip posture and resting face height.

A method for measurement of lip incompetence is described. Electromyographic techniques were used to obtain relaxation of the muscles of the lip and of a jaw elevator muscle. Standardized photographs were taken of the subject's profile, from which lip separation and face height were measured. Variation was found in successive measurements of lip posture, some of which appeared to depend upon mandibular posture. With the teeth in occlusion, lip separation was reduced. Active maintenance of lip contact by the subject was often associated with a reduction in lower face height, which may have been a direct consequence of the lip muscle activity, or of jaw elevator activity facilitating the lip closure.

Adolescent↗

Prevalence of a Simonart's band in patients with complete cleft lip and alveolus and complete cleft lip and palate.

OBJECTIVE: To investigate the prevalence of the presence of a soft tissue bridge (Simonart's band) in patients with complete cleft lip and alveolus and complete cleft lip and palate. DESIGN: Cross-sectional. SAMPLE: We assessed 407 consecutive unoperated patients first attending the Hospital for Rehabilitation of Craniofacial Anomalies of University of São Paulo, in Bauru, São Paulo, Brazil, in the year 2000. The patients were classified as presenting complete cleft of the primary palate or of the primary and secondary palate, unilateral or bilateral, as follows: unilateral cleft lip, bilateral cleft lip, unilateral cleft lip and palate, and bilateral cleft lip and palate. METHOD: Clinical examination. The band was considered as present whenever there was a soft tissue bridge between the separated alveolar ridges, regardless of volume and position. Results were analyzed by descriptive statistics and were expressed as percentages, according to the type of cleft. CONCLUSION: 31.2% of patients presented with Simonart's band. The band was observed more frequently in patients with unilateral clefts than in patients with bilateral clefts, and in patients with complete cleft lip and alveolus than in patients with complete cleft lip and palate.

Adolescent↗