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PubMed2005

Luminous lip-prints as criminal evidence.

Luminescence is specially a useful property for the search of invisible evidences at the scene of a crime. In the latent fingerprints particular case, there are at one's disposal fluorescent reagents for their localization. The study of latent lip prints (that is lip prints from protective lipstick, or permanent or long-lasting lipstick that do not leave any visible marks) is more recent than fingerprints study. Because of the different composition of both types of prints, different reagents have been tried out on their developing. Although, lysochromes are particularly useful reagents to obtain latent lip prints, it may occur on coloured or multicoloured surfaces, the developing is not perceived due to contrast problems between the reagent and the surface where the print is searched. Again, luminescence offers the possibility to solve this problem. Nile Red is being studied as a potential developer for latent lip prints. The results on very old prints (over 1year) indicate that this reagent is highly efficient to get latent lip prints.

Forensic Medicine↗
PubMed2005

A surgical simulator for planning and performing repair of cleft lips.

UNLABELLED: The objective of this project was to develop a computer-based surgical simulation system for planning and performing cleft lip repair. This system allows the user to interact with a virtual patient to perform the traditional steps of cleft-lip repair (rotation-advancement technique). MATERIALS AND METHODS: The system interfaces to force-feedback (haptic) devices to track the user's motion and provide feedback during the procedure, while performing real-time soft-tissue simulation. An 11-day-old unilateral cleft lip, alveolus and palate patient was previously CT scanned for ancillary diagnostic purposes using standard imaging protocols and 1mm slices. High-resolution 3D meshes were automatically generated from this data using the ROVE software developed in-house. The resulting 3D meshes of bone and soft tissue were instilled with physical properties of soft tissues for purposes of simulation. Once these preprocessing steps were completed, the patient's bone and soft tissue data are presented on the computer screen in stereo and the user can freely view, rotate, and otherwise interact with the patient's data in real time. The user is prompted to select anatomical landmarks on the patient's data for preoperative planning purposes, then their locations are compared against that of a 'gold standard' and a score, derived from their deviation from that standard and time required, is generated. The user can then move a haptic stylus and guide the motion of the virtual cutting tool. The soft tissues can thus be incised using this virtual cutting tool, moved using virtual forceps, and fused in order to perform any of the major procedures for cleft lip repair. Real-time soft tissue deformation of the mesh realistically simulates normal tissues and haptic-rate (>1 kHz) force-feedback is provided. The surgical result of the procedure can then be immediately visualized and the entire training process can be repeated at will. A short evaluation study was also performed. Two groups (non-medical and plastic surgery residents) of six persons each performed the anatomical marking task of the simulator four times. RESULTS: Results showed that the plastic surgery residents scored consistently better than the persons without medical background. Every person's score increased with practice, and the length of time needed to complete the 11 markings decreased. The data was compiled and showed which specific markers consistently took users the longest to identify as well as which locations were hardest to accurately mark. CONCLUSION: These findings suggest that the simulator is a valuable training tool, giving residents a way to practice anatomical identification for cleft lip surgery without the risks associated with training on a live patient. Educators can also use the simulator to examine which markers are consistently problematic, and modify their training to address these needs.

Cleft Lip↗
PubMed2006

Comprehensive rhinoplasty technique to correct the bilateral cleft lip nasal deformity using conchal composite grafts.

INTRODUCTION: Anatomical abnormalities and heterogeneous tissue deficiencies of the bilateral cleft lip nasal deformity challenges the cranio-maxillofacial plastic surgeon to create a functional, yet aesthetically pleasing nose. The authors propose a comprehensive rhinoplasty technique to correct the bilateral cleft lip nasal deformity using composite conchal grafts. PATIENTS: Five children with bilateral cleft lip nasal deformities had nasal reconstruction using conchal composite grafts, averaging 5 years in age at time of surgery. Patient follow-up averaged 21 months. METHODS: An open tip rhinoplasty was performed using a 'V' shaped columellar incision. The conchal composite graft was obtained from the lateral aspect of the ear and was used to reconstruct the lateral alar mucosal defects. Conchal cartilage was used as a columellar strut. The columellar skin was closed in a 'V-Y' fashion, giving greater columellar length. RESULTS: Visual inspection confirmed that the cleft lip nasal deformity was improved in all patients. There were no postoperative complications. All patients had complete composite graft take with minimal donor site morbidity and deformity. CONCLUSIONS: This comprehensive rhinoplasty technique improves the abnormalities found in bilateral cleft lip nasal deformity by using the successful aspects of other methods and introducing the composite conchal graft.

Cartilage↗
PubMed2005

Intraoperative localisation of the lip sensory area by somatosensory evoked potentials.

Accurate localisation of the central sulcus enables maximum tumour resection with minimum morbidity in peri-Rolandic surgery. We investigated intraoperative somatosensory evoked potentials (SSEPs) with combined recording of lower lip and median nerve stimuli during craniotomy in nine patients with peri-Rolandic glioma. Using a custom clip electrode, the lip mucous membrane was stimulated with biphasic pulses with 0.2 ms duration, 10-14 mA intensity and a frequency of 0.7 Hz. Polarity inversion of the SSEP was detected across the central sulcus using median nerve and/or lower lip stimulation in eight of the nine patients in whom the tumour did not infiltrate the lip or hand sensory area. Recording of SSEPs with lower lip stimulation is useful if the resection margin is planned lateral to the hand representation area, if the hand representation area is not exposed by the craniotomy, or if the SSEPs for median nerve stimulation are not clear due to tumour infiltration.

Adult↗
PubMed2004

Lip cancer experience in Mexico. An 11-year retrospective study.

Lip cancer is the most frequent malignant neoplasm of the oral cavity; however, there is no information available on the incidence of this type of cancer in Mexico. This study provides information about the clinico-pathological features of lip cancer patients admitted at a cancer hospital in Mexico City during an 11-year period and describes the treatment modalities performed and their results. A total of 113 patients were studied. There were 74 men (65.5%) and 39 women (34.5%), ranging in age from 14 to 106 years (mean 70 years). In 53 cases (46.9%) an association was found between the disease and chronic sun exposure. Additionally, positive smoking antecedents were recorded in 58 cases (51.3%). As 15 patients were followed for less than 1 month, they were excluded for further analysis. There were 82 cases (83.7%) of squamous cell carcinoma, 10 (10.2%) basal cell carcinomas, and one case (1%) each of adenocarcinoma NOS, melanoma, adenoid cystic carcinoma, Merkel cell carcinoma, lymphoepithelioma and angiosarcoma. We observed an incidence of malignant neoplasms in the upper lip of 33.7%, which is higher than most of the published series and may be due to the fact that in this series we included all histological types of lip cancers. Fifty percent of the cases were found in stages III and IV. Cervical lymph node metastases were found in 21% of patients with no previous treatment, and they developed in 5.3% after treatment. Our data suggest that tumoral size is directly related to the possibility of developing node metastases, as none of them occurred in patients T1, whereas 10 (62.5%) of the patients in T4 presented them. Seven deaths were documented (7.1%), five of which corresponded to squamous cell carcinoma, one to Merkel cell carcinoma, and one to adenocarcinoma. Deaths were directly related to the disease in six cases, and one patient died due to surgical complications. Distant metastases were found in only two patients, one of which coursed with an adenocarcinoma and the other with a Merkel cell carcinoma. Based on the present results, we suggest that the differences encountered with respect to other series, particularly the higher incidence found in women, the frequent presentation of this type of neoplasms in the upper lip, the wide variety of histopathological diagnoses and the high frequency of cases with cervical lymph node affection, should lead us to search for multi-modal treatment alternatives in this population.

Adolescent↗
PubMed2006

Lip-splitting in transmandibular resections: is it really necessary?

Mandibular resection approach (Commando or Composite resection) is one of the fundamental techniques for oral and oropharyngeal large tumour resection. We reviewed the charts of patients who underwent a transmandibular resection for an oral and/or oropharyngeal cancer between 1980 and 2002. Of 700 patients who underwent a mandibular resection for cancer, 332 had been operated without lower lip splitting. A mono or bilateral en-block neck dissection was always performed, except in cases of relapses after a prior surgical treatment with neck dissection. We repaired 307 patients with flaps (pedicled or free flaps, with or without bone). Unsplitting of the lip never complicated resection and reconstruction. Furthermore the procedure was time sparing, as we avoided haemostasis and suture of the lip. The cosmetic results were better than those obtained by traditional technique. We used a non-lip-splitting technique also for pull-through, marginal mandibulectomy and, sometimes, for mandibular-swing approaches. In the latter case, the technique has some advantages and disadvantages and must be applied according to circumstances. We can conclude that lip-splitting in transmandibular resection for oral and oropharyngeal tumours is not necessary.

Humans↗
PubMed2004

Lip plumper prosthesis for a patient with a marginal mandibulectomy: a clinical report.

An intraoral prosthesis was fabricated to restore more normal contour to a patient's lower lip that was compromised following a marginal mandibulectomy performed to eradicate a malignant neoplasm. The surgical resection compromised the lower lip on the affected side because the marginal mandibular branch of the facial nerve was damaged during the surgical resection. The prosthesis successfully restored the lost lip support, reduced the incidence of lip biting, and improved the patient's oral competency. This clinical report describes the procedure for making an intraoral lip plumper prosthesis to improve patient esthetics and oral function.

Acrylic Resins↗
PubMed1997

Comparison of relative potencies of i.v. and i.c.v. administered 8-OH-DPAT gives evidence of different sites of action for hypothermia, lower lip retraction and tail flicks.

8-Hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT)-induced temperature reduction, lower lip retraction and tail flick responses are widely used models of 5-HT1A receptor function. To obtain information about the sites of receptors mediating these effects we measured these responses, parallel over wide dose ranges after intracerebroventricular (i.c.v., 0.6-67 micrograms/kg) and intravenous (i.v., 3-500 micrograms/kg) administration. Analysis of the dose-response curves provided evidence for a 9.8-fold ratio of the potency of 8-OH-DPAT following i.c.v. compared to i.v. administration on body temperature reduction (ED50 values are 5.1 and 50 micrograms/kg, after i.c.v and i.v. administration, respectively) and a 2.9-fold ratio in potency for lower lip retraction (ED50 values are 29 and 86 micrograms/kg, after i.c.v. and i.v. administration, respectively). 8-OH-DPAT was less potent in the induction of tail flicks than of the other responses and had a lower potency after i.c.v. than after i.v. administration (ED50 values, the first one extrapolated, are 526 and 246 micrograms/kg, after i.c.v. and i.v. administration, respectively). In addition, the i.c.v. ED50 for temperature reduction was significantly lower than those for lower lip retraction or tail flick responses. The relative potency, that is, the ratio of i.v. and i.c.v. ED50, was significantly higher for temperature reduction than for lower lip retraction or tail flick responses (ED50 i.v./ED50 i.c.v. values are 9.8, 2.9, and 0.47, respectively). These data provide evidence that distinct sites of action are involved in these models. Temperature reduction is mediated mainly by postsynaptic receptors in the close vicinity of the lateral ventricle. Receptors that mediate lower lip retraction are located more distantly in the brain, supporting previous evidence that they are somatodendritic autoreceptors, and receptors in the spinal cord are probably responsible for tail flick responses.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed2006

[Leiomyosarcoma of the lip].

BACKGROUND: Superficial leiomyosarcomas are rare malignant tumors that may be subdivided into cutaneous and subcutaneous cases. CASE-REPORT: A 58 year-old man was seen for a lower lip tumor that appeared 3 years earlier. Histopathologic and immunohistochemical examinations showed features of cutaneous leiomyosarcoma. DISCUSSION: Cutaneous leiomyosarcoma may derive from the arrector pili, smooth muscle of sudoral glands or genital dartoic muscle. The subcutaneous form arises from smooth muscle wall of blood vessels. Superficial leiomyosarcomas occur frequently in the extensor surface of the lower extremities and involve the mucosal area in rare cases. Only five cases arising in the lips have been described. Lip cutaneous leiomyosarcoma may derive from ectopic sweat glands of the lips or from a hypodermic tumor that extends to the lip.

Humans↗
PubMed1997

Minimizing upper lip and incisor teeth paresthesias in approaches to transsphenoidal surgery.

Currently popular transsphenoidal approaches to the pituitary include sublabial, external rhinoplasty, alotomy, and transnasal techniques. The conventional sublabial approach remains the workhorse method despite postoperative lip edema, potential difficulty for denture wearers, and troublesome persistent upper lip and incisor teeth numbness. We traced the courses of the nasopalatine, infraorbital, and anterior superior alveolar nerves in 41 cadaveric half-head dissection to determine the exact contribution to upper lip and incisor teeth innervation. We then conducted a retrospective patient survey of 25 sublabial, 28 external rhinoplasty, 23 alotomy, and 12 transnasal approaches to the hypophysis to assess the incidence of upper lip and incisor teeth paresthesias lasting longer than 1 month. We conclude that rhinoplastic techniques are superior to the sublabial approach in limiting upper lip and incisor teeth numbness without compromising neurosurgical exposure for hypophysectomy.

Cadaver↗
PubMed1996

Modification of the Abbé flap for reconstruction of the vermilion tubercle and Cupid's bow in cleft lip patients.

PURPOSE: This article reports on the modification of the Abbé flap for correction of mild tightness of the corrected cleft lip deformity. PATIENTS AND METHODS: Twelve patients with a moderately tight lip deformity, from 16 to 35 years old, underwent this procedure. Nine had a unilateral deformity and 3 a bilateral deformity. The flap, which was taken from the central portion of the lower lip vermilion, was designed to repair the vermilion tubercle and the Cupid's bow. A tiny portion of skin was included to facilitate closure of the donor site. It was inserted into the center of the upper lip and the pedicle was divided 1 week after operation. RESULTS: Each patient showed a more natural contour of the vermilion tubercle and the Cupid's bow. The scarring of the donor site was inconspicuous. CONCLUSIONS: Use of modified Abbé flap to reconstruct the contour of the vermilion tubercle and the Cupid's bow makes the upper lip look more natural.

Adolescent↗
PubMed1997

Bone grafting the piriform aperture deformity in isolated cleft lip patients: indication, technique, and results.

PURPOSE: This study was undertaken to determine the effect of a bone graft in the piriform aperture on the nasal deformity and orthodontic treatment of the cleft side teeth in isolated cleft lip patients. PATIENTS AND METHODS: All primary cleft lip repair was done 3 months after birth. Nine patients, four female and five male, with a mean age of 12.5 years (range, 8.2 to 24.8 years) and with a repaired cleft lip, were bone grafted between 1992 and 1996. The mean postoperative period was 2 years (range, 1 to 4 years). An iliac crest bone graft was placed in the piriform aperture deformity on the side of the cleft lip. The improvement in the nasal symmetry and angulation of the cleft side teeth were evaluated. The eight growing cleft lip patients (mean age, 11 years; range, 9 to 13 years) were compared with a control group of eight healthy growing children (mean age, 11 years; range, 9 to 13 years). The improvement of nasal symmetry was measured by the formula of the lobule portion of the columella index preoperatively and postoperatively. RESULTS: The mean lobule portion of the columella index preoperatively was 41.8% (SD, 4.4%; SE of Mean, 1.5%) and postoperatively was 44.2% (SD, 4.9%; SE of Mean, 1.6%) (P > .006, t-test for paired samples). The angulation of the cleft side teeth was improved by orthodontic treatment. CONCLUSION: Bone grafting the piriform aperture deformity results in a stable result and improves nasal symmetry and the angulation of the cleft side teeth.

Adolescent↗
PubMed1993

Mandibular growth in patients with cleft lip and/or cleft palate--the influence of cleft type.

A total of 229 adult white patients with cleft lip or palate were evaluated, through cephalometric radiographs, to determine cleft-type influence on mandibular structure and spatial position. The sample includes adult patients with unilateral complete cleft lip and alveolus (n = 50), complete cleft lip and palate (n = 118), and isolated cleft palate (n = 61). A group of 65 subjects with normal occlusion and without cleft lip or palate was used as a control group. All groups were matched according to sex. When compared, the cleft groups and the normal group showed that the mandibular structure was significantly different. The mandible in the cleft groups displayed shorter mandibular ramus and body length, without difference between the cleft types. Mandibular position relative to cranial base was similar in the cleft groups with involvement of the palate, and differed significantly from that observed in the group with cleft lip and alveolus and in the subjects without cleft. Palatal clefts induce a significant downward and backward rotation of the mandible associated with a more obtuse gonial angle. Thus a small mandible is a structural characteristic of all cleft types studied. However, mandibular shape and spatial position are strongly influenced in clefts that involve the palate.

Adolescent↗
PubMed1997

Squamous cell carcinoma of the lower lip in renal-transplant recipients. Report of six cases.

The incidence of squamous cell carcinoma of the lower lip in immunosuppressed renal-transplant recipients is considerably higher than in the normal population. In addition to immunosuppressive treatment, the most important risk factors for the development of lip cancer in these patients are exposure to sunlight and smoking habits. Regular surveillance of renal-transplant recipients and early biopsy of premalignant lesions of the lip allow early detection of lip cancer. Patients should also be advised to avoid unprotected exposure to sunlight, to use appropriate sunscreens and to stop smoking. Six cases of squamous cell carcinoma of the lower lip in renal-transplant recipients are described.

Adult↗
PubMed1992

Influence of surgery on maxillary growth in cleft lip and/or palate patients.

Using a sample of 204 caucasian adults of both sexes, with complete unilateral cleft lip and alveolus, isolated cleft palate and complete unilateral cleft lip, alveolus and palate, the influence of surgery on maxillary morphology and spatial position for the three main types of cleft lip and/or palate were evaluated. 113 cleft patients operated on at conventional timings were compared to 91 cleft patients who had never been operated on. Findings permit the conclusion that cheiloplasty in cleft lip and alveolus patients is associated with osseous remodelling in the anterior alveolar region, without significant changes in anterior nasal spine or other areas of the maxilla. In isolated cleft palate subjects palate repair does not promote significant changes in maxillary morphology and spatial position. The most evident effects were seen in the cleft lip, alveolus and palate group: reconstructive surgery in these patients leads to a severe maxillary retroposition associated with a downward rotation.

Adolescent↗
PubMed1999

Carbon dioxide laser evaporation of leukoplakia of the lower lip: a retrospective evaluation.

The purpose of this study was the retrospective evaluation of the treatment results of CO2 laser evaporation for 27 cases of leukoplakia of the lip. The data were derived from 23 patients who presented with leukoplakia of the lower lip during the period 1978-96. Four patients developed a second primary leukoplakia of the lip resulting in 27 cases of leukoplakia. All lesions were treated with a CO2 laser equipped with an operation microscope and micromanipulator. Short-term evaluation showed complete epithelialisation 4 weeks after CO2 laser evaporation; there was minimal scar formation and no subsequent interference with normal lip function. During long-term evaluation, four recurrences (14.8%) were diagnosed which developed between 5 and 31 months after treatment, these were retreated with CO2 laser evaporation. There was no development of squamous cell carcinoma in the CO2 laser-treated area. Selective removal of affected epithelium with minimal damage to surrounding structures is possible using CO2 laser evaporation, followed by excellent wound healing and good functional result. Treatment can be performed under local anaesthesia on an outpatient basis. The recurrence rate is low compared with the recurrence rate after surgical excision. Therefore, CO2 laser evaporation is considered a reliable and effective treatment modality for leukoplakia of the lip.

Aged↗
PubMed1976

Facial morphology and activity of temporal and lip muscles during swallowing and chewing.

The correlations between facial and bite morphology and the activity in the temporal muscle and in the musculature of the lip during swallowing and chewing were studied in 50 girls, aged 9-13 years. The activity was recorded electromyographically by determining the maximal mean voltage amplitude and morphologically by analysis of profile roentgenograms and dental casts. The activity in the lower lip during the swallowing was not correlated with any of the variables of the facial morphology with the exception of the width of the upper dental arch. On the other hand, the activity of the upper lip during swallowing, as in the anterior and posterior portions of the temporal muscle, was correlated with a number of variables used for measuring facial form. The activity was low in girls with a facial shape with anterior inclination of the maxilla and mandible, small face height, and pronounced prognathism. The activity in the upper lip during chewing varied, as in the lower lip, independently of facial form, while the activity of the temporal muscle during chewing showed the same relation to facial form as during swallowing. The number of chewing cycles required for trituration of the test media (apples and peanuts) was negatively correlated with the number of teeth and with age. This was interpreted as adaptation in such a way that the number of cycles decreased with development of the dentition.

Adolescent↗
PubMed1996

Lip adaptation to simulated dental arch expansion. Part 2: One week of simulated expansion.

An increase in resting lip pressure and the resulting disruption of the intraoral pressure equilibrium may be responsible for the poor stability found with orthodontically expanded dentitions. Passive expansion strategies seek improved stability by altering lip pressure, thus creating a new equilibrium. One of these strategies has been shown to alter pressure favorably. However, pressure changes associated with conventional expansion need to be studied before conclusions regarding the superiority of passive expansion can be drawn. The purpose of this study was to examine lip pressure changes after 1 week of simulated conventional expansion. Twenty-two subjects agreed to wear a mandibular expansion-simulating stent full-time for 1 week. Resting pressure was measured in the midline and right canine areas. Midline lip pressure decreased significantly after 1 week. Resting pressure was measured in the midline and right canine areas. Midline lip pressure decreased significantly after 1 week while pressure in the canine area did not change significantly. This finding suggests an adaptive response that varies according to anatomic location.

Adaptation, Physiological↗