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At least 829 records · Page 46Linked to original sources
PubMed2004

New technique for correction of the microform cleft lip using vertical interdigitation of the orbicularis oris muscle through the intraoral incision.

A microform cleft lip has three major components: (1) a minor defect of the upper vermilion border with loss of the mucocutaneous ridge; (2) a narrow ridge of tissue, resembling an exaggerated philtral column extending to the nostril sill; and (3) a deformity of the nostril. To attain the muscle continuity without an external scar on the upper lip, the author introduced a new method for the correction of a microform cleft lip deformity using vertical interdigitation of the orbicularis oris muscle through the intraoral incision to create the philtrum. Through the intraoral incision, a full-thickness incision is made down to the mucosa and the posterior portion of the muscle. Then, the remaining portion of the muscle is dissected. The medial and lateral muscle flaps are also detached from the oral mucosa and completely exposed and split into two leaves. The upper leaf of the lateral muscle flap is sutured to the dermis on the philtral dimple and base of the upper leaf of the medial muscle flap. Two leaves of each muscle flap are sutured together to create a vertical interdigitation to increase the thickness of the philtral column and to provide continuity of the muscle. A total of 12 patients with microform cleft lip were treated between August of 2001 and October of 2002. Seven of the patients were male and five were female, with an age range of 1 to 43 years. The follow-up period ranged from 6 months to 15 months, with an average follow-up of 9 months. The results of vertical interdigitation of the muscle were examined. All patients were satisfied with their results. The orbicularis oris muscle provided continuity and preserved good function. In all cases, the operation scar was not visible on the depressed philtral groove on the cleft side. Correction of cleft lip nasal deformity was performed in four patients and alar base advancement was performed in two patients. The advantages of the proposed procedure include the creation of an anatomically natural philtrum without an external visible scar through the intraoral incision, preservation of the continuity and function of the muscle, and sufficient augmentation of the philtral column by the vertical interdigitation of the muscle.

Adolescent↗
PubMed2004

Primary correction of unilateral cleft lip nasal deformity in Asian patients: anthropometric evaluation.

Previously it was thought that primary correction of nasal deformity in cleft lip patients would cause developmental impairment of the nose. It is now widely accepted that simultaneous correction of the cleft lip nasal deformity has no adverse effect on nasal growth. Thus, the authors tried to evaluate the results of primary correction of cleft lip in Asian patients. Of 412 cases of cleft lip, 195 cases were corrected by means of the conventional method from June of 1992 to June of 1997, and 217 cases were corrected by simultaneous rhinoplasty from July of 1997 to October of 2001. The average patient age was 3 months. Photographs and anthropometric evaluation were used to evaluate the results. Nasal tip projection, columellar length, and nasal width were measured in 60 randomized normal children, 30 randomized children treated with the conventional method, and 30 randomized children with primary nasal repair. Data were analyzed using t tests, and the level of significance was 5 percent (p < 0.05). In cases of simultaneous repair, nasal tip projection and columellar length were increased 24.8 percent and 28.8 percent, respectively. Nasal width was increased 12.3 percent in the cases of simultaneous repair and 12.6 percent in the cases without primary rhinoplasty. Simultaneous repair of cleft lip and nasal deformity in Asian patients showed that more symmetry of nostril and nasal dome projection and better correction of buckling and alar flaring were achieved. More balanced growth and development of the alar complex was achieved, and no interference with nasal growth was encountered.

Anthropometry↗
PubMed2006

Influence of lip support on the soft-tissue profile of complete denture wearers.

Complete dentures change the soft-tissue profile, although the exact relationship remains unclear. This study examined the relationship between the presence and degree of lip support provided by dentures and the lateral views of the facial appearance of edentulous patients. The subjects were five edentulous patients (three men and two women). Their facial appearances with experimental record blocks, with and without their complete dentures, were measured using a three-dimensional laser measuring system. The experimental record block for each subject had different conditions in the anteroposterior direction anteriorly but the same vertical dimensions posteriorly. The lateral digital facial images were displayed on a computer monitor, and the linear and angular measurements were analysed using image analysis software. The nasolabial angle was smaller and the labial points projected more with excessive lip support versus with deficient support. Moreover, the counter of the nose was affected by the labial flange of the record base, particularly in the facial appearance of one subject with highly atrophic residual ridges. The lip support affected the lower facial soft-tissue profile, including the lower part of the nose; the nasolabial angle and positional relationship between the lips and Ricketts's esthetic plane (E plane) are useful indexes for examining lip support.

Aged↗
PubMed1978

HLA phenotype frequencies in individuals with cleft lip and/or cleft palate.

The HLA types of 133 patients with cleft lip and/or cleft palate were determined. Caucasian patients with isolated cleft palate showed a possible association with HLA. Ten of 11 male patients had HLA--A2 as compared to one out of eight female patients (P less than 0.005). Caucasian males with cleft lip and cleft palate had a slight increased frequency of HLA--Aw24 (P = 0.07) and Mexican-American males with cleft lip and/or cleft palate showed an increase of antigen HLA-A28 (P = 0.07), though neither were statistically significant. Females with cleft lip and/or cleft palate from either racial group had no differences from the controls. The serum from 90 mothers of patients with cleft lip and/or cleft palate were reacted against their child's lymphocytes. Of these crossmatch tests, 12% were found to be positive. These preliminary results suggest that male patients with isolated cleft palate are worthy of further studies with respect of HLA associations.

Cleft Lip↗
PubMed1997

Lip augmentation with preserved fascia lata.

BACKGROUND: Presently available techniques for lip augmentation have an assortment of limitations. OBJECTIVE: To provide a safe, reliable method of lip augmentation on a long-term basis. METHODS: Through a stab incision in each quadrant, chips of human cadaver, banked fascia lata were inserted into intralabial pockets. RESULTS: Fascia lata grafting proved to be a simple effective technique of lip enhancement. Over the period of follow-up, enhancement was evident in most cases and no allergic reactions or infections occurred. Lip motion was satisfactory and paresthesia were minor. CONCLUSIONS: Fascia lata grafting is a simple, controlled technique for graded lip enhancement.

Fascia Lata↗
PubMed1981

Occupations with low risk of lip cancer show high risk of skin cancer of the head.

The standardized morbidity ratios (SMR) of lip and non-melanomatous skin cancer (basal-cell carcinoma excluded) of the head and neck in males were determined for different occupational groups in Finland. The data on all cases of these types of cancer diagnosed in Finland in the age group 35-69 years in 1971-75 were supplemented by information on occupations from the 1970 census (Central Statistical Office of Finland). The expected numbers of cases were based on the age and occupation-specific numbers of person-years computed by the Central Statistical Office, and the age-specific incidence rates of lip and skin cancers among the economically active population. The highest SMR of lip cancer among all the occupational groups was found in agriculture, forestry and fishing (1.64). In contrast, the SMR of skin cancer was not higher than expected in occupations related to agriculture and forestry. Significantly lower than expected risks of lip cancer were observed among highly educated white-collar workers, among whom the risk of contracting skin cancer was the highest (technical, scientific, humanistic and artistic work, SMR 1.78). The morbidity of both lip and skin cancers varies considerably by occupation, and the risks seem to be, at least in part, inversely related. Thus, it is probable that there are also differences in the risk factors, contrary to several earlier suggestions. The nature of these factors are discussed.

Adult↗
PubMed1994

CGRP (8-37) reduces the duration but not the maximal increase of antidromic vasodilation in dental pulp and lip of the rat.

In this study the newly developed blockers of substance P (CP-96,345) and calcitonin gene-related peptide (CGRP8-37) were used to examine whether substance P and CGRP are involved in the afferent nerve induced vasodilation in the rat lower incisor pulp and lip. Electrical stimulation of the inferior alveolar nerve (10 V, 2 ms, 10 Hz, 30 s) in the presence of phenoxybenzamine (3 mg kg-1) induced an immediate vasodilation in the pulp and lip (52 and 186% increase in blood flow respectively, n = 12) with a long duration. Infusion of 2 mg kg-1 CP-96,345, a dose that inhibited the vasodilator effects of substance P (5-25 ng kg-1) in oral tissues, did not have any effect on antidromic vasodilation in either tissue. After infusion of CGRP8-37 (0.3 mg kg-1) the duration of the antidromic vasodilation in the pulp and lip was significantly reduced by 72 and 67% respectively (P < 0.05, n = 4), whereas the maximal increase of the response was unaffected. The blocking effect of the drug was short-lasting. When combined infusions of CP-96,345 and CGRP8-37 were given, a similar reduction in the duration of antidromic vasodilation in the pulp and lip occurred but in this case the amplitude of vasodilation in the pulp was reduced (from 35 +/- 9 to 12 +/- 3%, P < 0.05, n = 4). However, in the lip, the amplitude of vasodilation was not significantly reduced. The present findings indicate an involvement of CGRP in the mediation of the late phase of antidromic vasodilation in rat oral tissues and a role of substance P in the initiation of antidromic vasodilation in the incisor pulp.

Afferent Pathways↗
PubMed2004

Long term follow up study of survival associated with cleft lip and palate at birth.

OBJECTIVE: To assess the overall and cause specific mortality of people from birth to 55 years with cleft lip and palate. DESIGN: Long term follow up study. SETTING: Danish register of deaths. PARTICIPANTS: People born with cleft lip and palate between 1943 and 1987, followed to 1998. MAIN OUTCOME MEASURES: Observed and expected numbers of deaths, summarised as overall and cause specific standardised mortality ratios. RESULTS: 5331 people with cleft lip and palate were followed for 170 421 person years. The expected number of deaths was 259, but 402 occurred, corresponding to a standardised mortality ratio of 1.4 (95% confidence interval 1.3 to 1.6) for males and 1.8 (1.5 to 2.1) for females. The increased risk of mortality was nearly constant for the three intervals at follow up: first year of life, 1-17 years, and 18-55 years. The participants had an increased risk of all major causes of death. CONCLUSIONS: People with cleft lip and palate have increased mortality up to age 55. Children born with cleft lip and palate and possibly other congenital malformations may benefit from specific preventive health measures into and throughout adulthood.

Adolescent↗
PubMed1995

Fetal cleft lip with and without cleft palate: US classification and correlation with outcome.

PURPOSE: To develop a prenatal ultrasonographic (US) classification of cleft lip with or without cleft palate (CL-P) and correlate the classification with fetal outcome. MATERIALS AND METHODS: During a 5-year period (1988 to 1993), 65 fetuses with CL-P were identified with prenatal US at one of two referral centers for high-risk obstetric cases. Sonograms from each case were prospectively and retrospectively evaluated. Clefts were classified into one of five categories: type 1, cleft lip alone (n = 5); type 2, unilateral cleft lip and palate (n = 15); type 3, bilateral cleft lip and palate (n = 20); type 4, midline cleft lip and palate (n = 21); and type 5, facial defects associated with amniotic bands or limb-body-wall complex (n = 4). RESULTS: The US classification correlated with severity of defect and fetal outcome. Type 4 and 5 clefts were universally associated with concurrent anomalies and a fetal outcome, type 1 clefts with a lower rate of anomalies (20%), and type 2 and 3 clefts with intermediate prognosis. Chromosome abnormalities also varied with the type of cleft as follows: type 1, 0%; type 2, 20%; type 3, 30%; type 4, 52%; and type 5, 0%. CONCLUSION: Prenatal classification of fetal CL-P correlates with fetal outcome. This classification should help counseling and management.

Abnormalities, Multiple↗
PubMed2001

Basal cell carcinoma on the vermilion border of the lip: a study of six cases.

BACKGROUND: The vermilion border of the lower lip is a frequent location of squamous cell carcinoma (SCC), but it is very rarely mentioned within the published series of basal cell carcinomas (BCCs). OBJECTIVE: We present 6 cases of BCC involving either mainly or exclusively the vermilion border of a lip. METHODS: We reviewed from our files all the cases of BCC diagnosed in a period of 11 years. RESULTS: A number of 3,477 BCCs were histologically diagnosed in that period; 2,872 (82.6%) of them were located on the head, and 66 (2.3%) of the latter (1.9% of all BCCs) were on the lips. In 6 cases, the neoplasm involved either mainly or exclusively the vermilion border of either the lower (5 cases) or the upper (1 case) lip. CONCLUSION: Not every carcinoma of the vermilion border of the lip is a SCC.

Adult↗
PubMed1999

Treatment outcome in cleft lip and palate: issues and perspectives.

In the last 40 years, great progress has been made toward a better understanding of many aspects of the cleft lip and palate defect, but there is still a long way to go before there is agreement on the optimal treatment procedures. With regard to the primary operations, it can be stated, in a somewhat simplified form, that there are two main schools of thought in cleft treatment. One advocates early closure of the lip and palate, a procedure which imparts a high priority to early speech function. The other recommends delayed closure of the hard palate, thereby according a high priority to the growth of the maxilla. A number of intercenter and multicenter studies have been carried out recently in an effort to elucidate which procedures give the best result, both esthetically and functionally. The results are ambiguous, and this has led a number of researchers to suggest that the randomized clinical trial is the only way to resolve the ambiguity. The fact that it has proved difficult to identify the optimal procedures in the field of cleft lip and palate treatment need not only be due to a less than optimal research design; a contributory factor might also be the great variability in craniofacial morphology and in the response to treatment in patients who have exactly the same cleft lip and palate diagnosis. Intensive research has made it possible to state categorically that clefts occur due to many different factors in an interplay between genetics and environment. Therefore, it is not likely that a single gene can be responsible for clefting. Since scar tissue presents many problems-for instance, impairment of growth-the reduction or prevention of scar formation has long been a desirable goal. The discovery that a fetus can heal without scar formation has led to many animal experiments. The timing of the surgical intervention on fetuses is critical, since late-gestation fetuses heal with adult-like scarring. There are still many unsolved problems connected with fetal surgery, and at present prenatal surgery for repair of cleft lip and palate is not ethically defensible in humans. On the other hand, it appears that there are considerable possibilities for the reduction of human scarring after surgery with the introduction of various wound-healing medications.

Animals↗
PubMedDate not supplied

Clindamycin-induced lip and nasal passage swelling.

OBJECTIVE: To report a severe case of clindamycin-induced lip and nasal passage swelling. DESIGN: Single case report. SETTING: Six hundred eighty-four-bed community hospital. CASE SUMMARY: A 34-year-old, insulin-dependent diabetic white man with worsening cellulitis and osteomyelitis of the left great toe was admitted for treatment with intravenous antibiotics. Intravenous clindamycin was the first agent administered. Within 5 minutes after initiating the drug (600-mg dose) the patient began to sneeze and his eyes began to tear and itch. Within 10 minutes, his lips and nasal passages began to swell. By the end of the infusion (approximately 20 min), the patient's lips were severely swollen and his nasal passages were completely closed off secondary to the swelling. The patient did not have difficulty breathing through his mouth and denied any shortness of breath. He did not develop a rash. His vital signs remained stable and no pharmacologic agents were administered for this reaction. No subsequent doses of clindamycin were given and complete resolution of all symptoms occurred within 24 hours. CONCLUSIONS: Severe lip and nasal passage swelling is an uncommon adverse reaction associated with the use of intravenous clindamycin. We believe this to be the first published case of nasal passage swelling and only the second case reporting lip edema associated with the intravenous form of this agent. Clinicians should be aware of this uncommon but potentially severe reaction.

Adult↗
PubMed1983

Lip and mentalis activity and its influence on incisor position--a quantitative electromyographic study.

In order to investigate both the relationship between perioral muscular activity and tooth position and also the clinical indicators of this activity, two quantitative EMG studies were carried out. The first investigated the reproducibility of the method in 16 adults. Subsequently, a study employing the same protocol was conducted on 41 subjects with untreated malocclusions. Activity was measured during speech, whilst chewing biscuit, swallowing saliva, resting, and in those subjects with incompetent lips, during lip-seal. In addition to the EMG recordings, measurements were taken from study models, lateral skull radiographs and of the clinical lip heights. In general between visits random variability was sufficiently small for the method to be applied experimentally. The results suggest that the effects of perioral muscular activity are determined by the presence or absence of competent lips. This was despite similar levels of activity in both groups except during chewing. Resting activity did influence incisor position in subjects with competent lips but the intermittent activity from chewing, speaking and swallowing, did not. No clinical indicators of the level of perioral activity were found.

Adolescent↗
PubMed2004

Lip and tongue piercing: experiences and views of general dental practitioners in South lancashire.

PURPOSE OF THE STUDY: To ascertain the numbers of patients with pierced lips or tongues seen by dentists during routine consultations. The study also examined the provision of advice by dentists, and the nature of piercing-related complications. BASIC PROCEDURE: A postal questionnaire was sent to dentists in two Primary Care Trust areas in South Lancashire. MAIN FINDINGS: Sixty-four of the 106 questionnaires were returned, giving a response rate of 60%. Sixty-two dentists (96.9%) reported that they had seen patients with lip or tongue piercings during the previous 12 months and that they had seen a mean number of 2.8 patients with lip piercing and a mean of 9.0 patients with tongue piercing. A total of 56.5% of the dentists gave advice on oral hygiene and 79.0% on possible damage to the oral structures. Twenty-seven dentists (43.5%) said that their patients had oral health problems as a result of lip or tongue piercing. PRINCIPAL CONCLUSIONS: The dentists who responded to the questionnaire commonly saw lip and tongue piercings. All dentists should therefore be prepared to offer appropriate advice. A public health information leaflet available in all medical and dental practices would help to ensure that patients were better informed about body piercing and its complications.

Cosmetic Techniques↗
PubMed2004

Predisposing factors to formation of cleft lip and palate: inherited craniofacial skeletal morphology.

OBJECTIVE: To identify inherited craniofacial morphologic features in individuals at high risk for cleft of the lip, cleft palate, or both. SUBJECTS: Twins without cleft from 33 pairs of monozygotic twins discordant for cleft lip, cleft palate, or both were studied. There were 17 males and 16 females of Caucasian origin, ranging from 3 to 18 years (15 with cleft lip and palate [CLP], 10 with cleft lip [CL], and 8 with cleft palate [CP]), collected from five craniofacial centers (United States and Canada). DESIGN: The twin without cleft (noncleft) from each set was compared with an age- and sex-matched control individual from the Burlington Growth Centre, Toronto, Ontario. Posteroanterior and lateral cephalograms were traced and digitized using a computer custom analysis. Descriptive statistics, Student's t tests, and analysis of variance were used to test 40 variables in a pilot study comparing the noncleft twin groups with the controls. Preliminary analysis permitted pooling of the CLP and CL groups (n = 25). To minimize false-positive significance, only 14 variables (from the maxillofacial area) were tested. RESULTS: Using the raw probabilities, eight variables showed significant differences between the pooled noncleft CLP and CL (CL[P]) twin group and the controls. However, when the level of significance was adjusted, only four (nasal width [p < .01], cranial base length [p < .05], cranial base width/length ratio [p < .001], and maxillary width/length ratio [p < .05]) were significantly different. No significant differences were confirmed between the noncleft CP twin group and the controls. CONCLUSIONS: The noncleft member of a discordant monozygotic pair has a number of facial characteristics that differ from the general population. These may predispose to the formation of a cleft lip or palate and may result from a deficiency or distortion of the mesenchyme that forms the craniofacial structures.

Adolescent↗
PubMed2005

The bacteriology of children before primary cleft lip and palate surgery.

OBJECTIVE: Bacterial infections can complicate any surgery. Knowledge of potentially pathogenic bacterial flora in children with cleft lip and palate allows appropriate risk management, including the need for prophylactic antibiotics. This project reviewed the bacteriology of children before primary cleft lip and palate surgery. DESIGN: A retrospective study of the results of nose, throat, and ear microbiological swabs taken from children, aged 1 to 26 months, before repair of primary cleft lip, cleft palate, or both was carried out. Swabs with Staphylococcus aureus and beta-hemolytic streptococcus were considered positive. RESULTS: From October 1987 to May 2002, 321 primary cleft lip or palate operations were performed in 250 patients. Results from 326 sets of preoperative swabs were available, including five repeat sets from patients whose operations were postponed. There were 235 (72.1%) negative sets and 91 (27.9%) positive sets. Of the positive swabs, 86 sets grew S. aureus, and 10 sets grew beta-hemolytic streptococcus. CONCLUSIONS: Children with unrepaired cleft lip and palate have a significant risk of carrying S. aureus and a small risk of carrying beta-hemolytic streptococci. These risks need to be considered when deciding on protocols for preoperative bacteriology tests and prophylactic antibiotics.

Antibiotic Prophylaxis↗
PubMed2005

Evaluation of esthetic, functional, and quality-of-life outcome in adult cleft lip and palate patients.

OBJECTIVE: Evaluation of esthetic, functional, and health-related quality-of-life (HRQoL) outcomes in adult patients with a repaired cleft lip and palate. The treatment for all patients was based on the so-called Vienna concept. PATIENTS/DESIGN: Seventy adult patients with a repaired complete cleft lip and palate, ranging in age from 18 to 30 years, were included in the study. Esthetic and functional outcomes were assessed by the patients themselves and by five experts using a visual analog scale. Patients also completed the MOS Short-Form 36 questionnaire to evaluate health-related quality of life. RESULTS: Patients rated their esthetic outcome significantly worse than the experts did. No significant differences were observed in the ratings for function. Female patients, especially, were dissatisfied with their esthetic outcomes. In a personal interview, nearly 63% of them asked for further treatment, particularly for upper-lip and nose corrections. The health-related quality-of-life questionnaire revealed low scores for only two subscales, namely social functioning and emotional role. In most subscales of health-related quality of life, patients who desired further treatment had significantly lower scores than did patients who desired no further treatment. CONCLUSION: Surgery of the lip and nose appears to be of prime importance for patients with a cleft lip and palate. Cleft patients who do not request secondary treatment are not always satisfied with the treatment. Patients with realistic expectations in regard to further treatment should be treated by specialists, whereas those with unrealistic expectations should be referred to a clinical psychologist.

Adaptation, Physiological↗
PubMed2006

Three-dimensional computer graphics for surgical procedure learning: Web three-dimensional application for cleft lip repair.

OBJECTIVE: In surgical procedures for cleft lip, surgeons attempt to use various skin incisions and small flaps to achieve a better and more natural shape postoperatively. They must understand the three-dimensional (3D) structure of the lips. However, they may have difficulty learning the surgical procedures precisely from normal textbooks with two-dimensional illustrations. Recent developments in 3D computed tomography (3D-CT) and laser stereolithography have enabled surgeons to visualize the structures of cleft lips from desired viewpoints. However, this method cannot reflect the advantages offered by specific surgical procedures. To solve this problem, we used the benefits offered by 3D computer graphics (3D-CG) and 3D animation. DESIGN AND RESULTS: By using scanning 3D-CT image data of patients with cleft lips, 3D-CG models of the cleft lips were created. Several animations for surgical procedures such as incision designs, rotation of small skin flaps, and sutures were made. This system can recognize the details of an operation procedure clearly from any viewpoint, which cannot be acquired from the usual textbook illustrations. This animation system can be used for developing new skin-flap design, understanding the operational procedure, and using tools in case presentations. The 3D animations can also be uploaded to the World Wide Web for use in teleconferencing.

Cleft Lip↗