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At least 1,063 records · Page 59Linked to original sources
PubMed2002

Lip repair techniques and their influence on the nose.

The cleft nose has long been a problem when closing the lip in a cleft palate patient. More today than in the past, close attention is paid to the outcome of the nasal form, nasal base, and the position of distorted structures like the alar cartilage and the septum. The different techniques of lip closure can be used simultaneously with the nasal correction. But different methods of lip repair without primary nasal correction also influence the nasal form. It seems that the reconstruction of the nasolabial muscles (including the orbicularis muscle) is an important factor to gain a symmetrical nose after the primary operation. Although the results are very promising, it cannot be stated that no further operations will be needed later. But since growth disturbance has not been reported until now, most of the authors dealing with primary nasal correction recommend it simultaneously with the lip repair. Further investigations are needed to define the outcome after the cessation of growth.

Cleft Lip↗
PubMed2004

Foetal facial clefts: prenatal evaluation of lip and primary palate by 2D and 3D ultrasound.

INTRODUCTION: To examine whether three-dimensional ultrasound (3D US) is an accurate diagnostic method of clinical use in the ability to define the location and extent of facial clefting prenatally, compared to two-dimensional ultrasound (2D US). METHODS: 18 foetuses suspected or diagnosed to suffer from a facial cleft by 2D US were examined with a targeted 3D US. 2D US and 3D US results were compared with postnatal outcome. RESULTS: Comparison of the number of foetuses with a cleft lip + primary palate diagnosed correctly with 2D US with the results of adjunctive 3D US (true positive + true negative) showed that adjunctive 3D US correctly diagnosed more cleft lips (100 %; 15/15 foetuses vs. 66 %; 12/18 foetuses) and more cleft primary palates (100 %; 12/12 foetuses vs. 58 %; 7/12 foetuses). CONCLUSION: Interactive review of standardised 3D multiplanar images allows to systematically evaluate lip defects and abnormalities of the maxillary tooth-bearing alveolar ridge. The accuracy of adjunctive 3D ultrasound is superior to 2D ultrasound alone for extensive prenatal diagnosis of cleft lip with or without cleft primary palate.

Cleft Lip↗
PubMed1989

[Reconstruction of the upper lip using the mucosal eversion technic].

A one-stage reconstruction technique for upper lip defects is presented. This technique uses everted mucosal advancement flaps for the reconstruction of the vermilion border of the lip. It is an extension of Meyer's method employed in the reconstruction of the lower lip (1973) and differs from Camille Bernard's procedure in that horizontal incisions with bilateral triangular skin excisions are used instead of the more unaesthetic perpendicular incisions in the nasolabial fold, leaving a scar along the vermilion border. The method is suitable for reconstructing the upper lip after excision of up to 80% of its substance, and is superior to traditional methods in terms of both the functional and aesthetic results obtained.

Adult↗
PubMed2002

Desmoplastic malignant melanoma of the lip: a report of 6 cases and review of the literature.

Desmoplastic malignant melanoma is a rare neoplasm consisting primarily of spindle-shaped melanoma cells embedded in a fibrous stroma, with approximately 6% of cases occurring in the lip. A literature search revealed that most reported cases occur in sun-exposed areas in older men. Few cases of desmoplastic malignant melanoma of the lip in young people (in their mid-twenties) have been described. We report 6 previously undocumented cases of labial desmoplastic malignant melanoma occurring in young individuals and review 20 cases from the literature. Physicians should consider the possibility of desmoplastic malignant melanoma in young people who present with atypical lip lesions, which on histopathologic analysis demonstrate spindle-cell hyperplasia. Although this diagnosis is rare and there have not been reports of such patients in the literature thus far, our findings should alert clinicians to the possibility of desmoplastic malignant melanoma as a diagnosis for lip lesions in young people.

Adult↗
PubMed1997

Genome scan for teratogen-induced clefting susceptibility loci in the mouse: evidence of both allelic and locus heterogeneity distinguishing cleft lip and cleft palate.

Nonsyndromic clefting of the lip and palate in humans has a highly complex etiology, with both multiple genetic loci and exposure to teratogens influencing susceptibility. Previous studies using mouse models have examined only very small portions of the genome. Here we report the findings of a genome-wide search for susceptibility genes for teratogen-induced clefting in the AXB and BXA set of recombinant inbred mouse strains. We compare results obtained using phenytoin (which induces cleft lip) and 6-aminonicotinamide (which induces cleft palate). We use a new statistical approach based on logistic regression suitable for these categorical data to identify several chromosomal regions as possible locations of clefting susceptibility loci, and we review candidate genes located within each region. Because cleft lip and cleft palate do not frequently co-aggregate in human families and because these structures arise semi-independently during development, these disorders are usually considered to be distinct in etiology. Our data, however, implicate several of the same chromosomal regions for both forms of clefting when teratogen-induced. Furthermore, different parental strain alleles are usually associated with clefting of the lip versus that of the palate (i.e., allelic heterogeneity). Because several other chromosomal regions are associated with only one form of clefting, locus heterogeneity also appears to be involved. Our findings in this mouse model suggest several priority areas for evaluation in human epidemiological studies.

6-Aminonicotinamide↗
PubMed1998

Our treatment of cleft lip and cleft palate.

Our principle in cleft lip and cleft palate repair is all-round personal treatment. That is, treatment concentrates not only on cleft lip and cleft palate repair, but also considers the patient comprehensively in terms of his or her personality. In this report, we present patients with cleft lips and/or cleft palates for whom we performed surgical treatments in the past 25 years. We performed primary operations for 402 patients and secondary operations for 120. Cleft lip and cleft palate should be managed with consideration for otolaryngeal aspects as well as plastic surgical ones because of the nature of the disease. We therefore treated our patients from the standpoints of both medical fields, and gained much appreciation from parents whose children suffered from the congenital anomaly.

Child↗
PubMedDate not supplied

Experience of teenagers born with cleft lip and/or palate and interventions of the health nurse.

The objective of this study was to describe and understand the experiences of teenagers with cleft lip and/or palate. The human ecology approach of Bronfenbrenner (1979) was chosen as a basis for this study. From this perspective, the living environment of teenagers with cleft lip and/or palate was considered, and as such, qualitative research from an ethnographic standpoint was conducted. The data were collected by semistructured interviews and recorded on magnetic tape. Ten teenagers, between 15 and 17 years of age, were chosen and consulted while undergoing therapeutic treatment and surgery in a cleft lip and/or palate clinic. The results of this study indicate that teenagers born with this congenital malformation experience various physical, functional, or interactional problems throughout their development. To improve this situation, nursing care has been developed to enable the nurse to act within the multidisciplinary team treating cleft lip and/or palate cases, thereby allowing the teenager to develop in an environment that offers a better quality of life.

Adaptation, Psychological↗
PubMed2001

Tibia as donor site for alveolar bone grafting in patients with cleft lip and palate: long-term experience.

Tibial bone grafts were studied in 137 patients with clefts of the lip and palate. Twenty-one had clefts of the lip and primary palate and 116 had complete unilateral clefts of the lip and palate. Bone grafting was performed secondarily or late secondarily. Bone was harvested from the proximal part of the tibia distal to the tuberosity through an incision about 15 mm long. The mean follow-up time after bone grafting was 5.5 years (range 2-11). There were no operative, or early or late postoperative complications reported (such as haematoma, fracture, or shortening of the limb). Harvesting time was about 15 minutes. The possibility of operating with two teams makes the total operating time shorter. Bleeding was negligible (less than 15 ml) and the amount of bone obtained was always sufficient. Patients were mobilised the next day and were back to full physical activity by one month. Indications for tibial bone grafting included facilitation of tooth eruption into the graft, giving bony support to the neighbouring teeth, making it possible to insert a titanium fixture, raising the alar base of the nose, and closing an oronasal fistula. Compared with iliac, cranial, mandibular, and costal donor sites, using the tibia took less time, gave less bleeding, made it possible for two teams to operate simultaneously, gave a smaller scar, and there were minimal complications and satisfactory quantity and quality of bone in all cases. The results suggested that the tibia is an excellent choice of graft for residual alveolar clefts in patients with cleft lip and palate.

Alveolar Process↗
PubMed2002

Feeding behaviour of infants with cleft lip and palate.

AIM: To determine whether the feeding behaviour of infants with cleft lip and palate is improved with a type-P teat, which is widely used in Japan by such infants, compared with a standard teat. The difference in intra-oral movements between the type-P teat, modified for the evaluation of feeding behaviour, and an unmodified type-P teat was also compared using ultrasonography. METHODS: In part 1 of the study, 15 infants aged 2 to 3 mo and 7 infants aged 2 wk were evaluated for sucking pressure, expression pressure, frequency and duration of sucking. All the infants had a complete unilateral cleft lip and palate without any other abnormalities. In part 2, an ultrasonographic analysis of intra-oral movement was done for 5 infants enrolled in part 1 of the study. RESULTS: Sucking pressure did not occur in all infants. It was found that feeding efficiency improved with the type-P teat compared with the standard teat. The expression pressure with the type-P teat was significantly higher than that with the standard teat, and the feeding frequency with the type-P teat was lower than that with the standard teat. CONCLUSION: A type-P teat is suitable for infants with cleft lip and palate who have sucking difficulties. However, a type-P nipple with a squeezable bottle does not fully solve the feeding problems of infants with cleft lip and palate. New artificial teats that allow a higher expression pressure are desirable, and the measurement of the expression pressure may be helpful in the evaluation of artificial nipples.

Cleft Lip↗
PubMed1993

Nasal airway, lip competence, and craniofacial morphology.

The aim of the present investigation was to demonstrate whether children selected by their open lip posture show differences in their nasal airway resistance and facial morphology compared to children with closed lip closure. Thirty-two children with poor lip competence were compared to a control group of 20 with secure mouth closure. Patients with poor lip competence showed a significantly higher ML-NSL angle and also ML-NL angle. Anterior rhinomanometry, as well as measurements of the pharyngeal space on lateral headfilms, displayed no significant differences between the two groups. The same material was also grouped cephalometrically into skeletal open and skeletal deep bite configurations. The mean value of the nasal airway passage was lower in the skeletal open group, but not at a significant level.

Airway Resistance↗
PubMed1993

Ectopic eruption of the maxillary first permanent molars in children with cleft lip and/or palate.

The purpose of this study was to analyse the prevalence of ectopic eruption of maxillary first permanent molars in children with cleft lip and palate, and evaluate the influence of both local and genetic factors. Radiographs from 225 children, 125 girls and 100 boys, were studied. The prevalence in cleft children was found to be more than four times higher than in non-cleft children (4.3 per cent). In children with cleft lip or cleft lip and alveolar process the prevalence was 15.4 per cent and in children with cleft palate only it was 28.8 per cent. A notable finding is that the ectopically erupting molar was not related to the cleft side. In children with surgically corrected cleft lip in combination with cleft palate or with cleft palate only, the surgery may have influenced the prevalence to some extent, but the main explanation for the increased prevalence of ectopic eruption in cleft children is a genetic aetiology.

Chi-Square Distribution↗
PubMed1998

An ultrasound investigation of the lip levator musculature.

The aims of this study were to determine if there were any differences in the thickness of the lip levator musculature in men and women, and whether the height of the smile line in adults was related to the thickness of the lip levator musculature. Thirty Caucasian (13 males, 17 females), and 24 Asian (11 males, 13 females) undergraduate dental students participated in this study. The subjects were placed in high, medium, and low smile-line groups, according to the height of their upper lip while smiling. The thickness of the levator labii superioris and zygomaticus major muscles was measured on ultrasound scans of the relaxed muscles. Gender, right-left side, and ethnic differences in muscle thickness were determined, and the thicknesses of the lip levator musculature in subjects in the high, medium, and low smile-line groups were compared. There were significantly more women than men with high smile-lines and the zygomaticus major muscle was significantly thicker in the women, as compared with the men. There were, however, no statistically significant differences in muscle thickness in the three smile-line groups. While it appears that women have higher smile-lines and significantly thicker zygomaticus major muscles than men, the height of the smile line is not due to the thickness of either the levator labii superioris or zygomaticus major muscles.

Adolescent↗
PubMed2000

The effect of a maxillary lip bumper on tooth positions.

The effect of the use of a lip bumper with anterior vestibular shields on the maxilla was studied in twenty-two 9-14-year-old children with a space deficiency in the maxillary dental arch. The lip bumper was used for 1 year. The effect of the treatment was evaluated from dental casts and profile cephalograms made before and after treatment. Both the width of the maxillary dental arch at the premolars and the length of the arch increased significantly by about 2 mm. The effect of the treatment on the antero-posterior position of the first molars was small. In one subject the molar was distalized 2.8 mm. The average effect was, however, a reduction in the anterior movement of the molar within the face by about 0.5 mm, i.e. the maxilla moved anteriorly 1 mm, but the molar only 0.4 mm. No skeletal effects were found when the group of subjects treated with a lip bumper was compared with a reference sample of untreated individuals. The main effects of a maxillary lip bumper thus seem to be a widening of the dental arch across the premolars, a moderate increase in arch length due to eruption and slight proclination of the incisors, and moderate distal tipping of the first molars.

Adolescent↗
PubMed1999

The incidence of cleft lip and palate deformities in the south-east of Scotland (1971-1990).

This retrospective study reports the incidence of infants born with the cleft lip and palate anomaly within the Edinburgh Cleft Units catchment area, between 1 January, 1971, and 31 December, 1990. The importance of accurate data collection for local, regional, and national data bases is discussed with reference to the recent CSAG report on cleft lip and palate services in the UK. Five-hundred-and-two cleft lip and palate patients were identified (291 males, 211 females). The incidence is reported as 1.4 per 1000 live births (1 in 711). Twenty-five per cent of clefts affected the primary palate, 45 per cent affected the secondary palate, and the remaining 30 per cent were clefts of both the primary and secondary palate. Overall, a higher percentage of males were affected (58 per cent males to 42 per cent females). Clefts of the secondary palate, however, were more common in females (56 per cent females to 44 per cent males). Data presented in this study is similar to that previously reported from UK centres. It is suggested the accuracy of the UK cleft lip and palate data collection needs to be improved. Prospective data collection in a standardized format carried out on a national basis has to be a priority as recommended by the CSAG report.

Catchment Area, Health↗
PubMed1983

Ultrasound study of the nose and upper lip before birth.

A review of 2,000 patient scans was utilized in the evaluation of the development of the nose and lips. The results of this study clearly demonstrate that it is possible to identify easily and reliably the anatomical nose, nostrils, and upper lip from 15 weeks' gestation onward. It is also possible to show the nose and lips at 11 weeks. However, this is much more difficult owing to the relatively disproportionate size of transducer and fetus at that point of gestation. The utility of the technique of facial ultrasound is related to the detection of cleft lip and cleft palate as previously reported.

Cleft Lip↗
PubMed1984

Bilateral cleft lip and palate: presurgical treatment.

Patients with bilateral cleft lip and cleft palate problems may present with severe tissue disparities. A good surgical repair without tension may be difficult to achieve. With proper presurgical orthodontic management the tissues can be brought into good relationships, permitting a one-stage surgical repair under optimal conditions. An appliance can be used to secure the lateral arches in proper position. Then external gradual traction can reposition the lateral arch and central arch segment relationships, establishing a more normal arch. After lip repair the "artificial palate" denture is worn until palate repair. The common types of situations encountered are categorized and illustrated with case reports. Not only is this approach more advantageous surgically, but it also helps feeding, provides and maintains good early arch form, and theoretically could contribute to speech. It avoids lip adhesions and can be accomplished within the time that is usually allowed before lip repair.

Cleft Lip↗
PubMed1984

Bilateral cleft lip repair: "putting it all together".

The surgical repair of the bilateral cleft lip should take into consideration restoration of normal anatomy throughout the lip. If it is well done, it contributes to both form and function. A composite technique is presented here, with additions taking advantage of all tissues and based on this principle. Preoperative orthodontic preparation is used to achieve more satisfactory spatial relationships when appropriate and to permit a one-stage repair without lip adhesions. The technical aspects are clearly outlined and supported by case presentations. The technique saves all tissue; avoids tightness; provides good muscular function; constructs a labial sulcus providing for proper movement of the lip; provides good nasal sills and floors; is adaptable to complete or incomplete clefts; can be easily revised or used for secondary revisions in other cases, and so on.

Cleft Lip↗
PubMed1984

Cleft lip nasal deformity.

The nasal deformity in the cleft lip patient is produced by the lower lateral cartilage being subluxed inferiorly and laterally, which falsely lengthens the nose on the cleft side. The columella is not short. It simply extends laterally to a dipped area in the rim of the nostril. The cleft lip nasal deformity is correctable at the time of primary lip repair by advancing the lower lateral cartilage superiorly and medially. The correction will last with the cartilage fixed to the upper lateral cartilage-septal junction, its normal position. A deficient repair will not improve. A good repair will last, will not interfere with growth of the nose, and will free the patient from years of unnecessary embarrassment . Correction of the cleft lip nasal deformity in the adult requires repositioning of the lower lateral cartilage similar to what can be and should be done in the infant.

Adolescent↗