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A family with unusual Waardenburg syndrome type I (WSI), cleft lip (palate), and Hirschsprung disease is not linked to PAX 3.

An unusual family with Waardenburg syndrome type 1 (WSI), cleft lip (palate), and Hirschsprung disease is not linked to the PAX 3 gene since there is an obligate crossover which has occurred between PAX 3 DNA markers and the disorder in this family. This family may also have anticipation of the WSI traits as the proband's grandmother is nonpenetrant, his mother has dystopia canthorum, and severe cleft lip (palate), while the proband has dystopia canthorum, severe cleft lip (palate), and Hirschsprung disease. Thus, a locus other than PAX 3 is implicated in this Waardenburg-like syndrome with Hirschsprung disease and cleft lip (palate).

Base Sequence↗

Squamous-cell carcinoma of the upper lip.

Squamous-cell carcinoma involving the upper lip grows more rapidly and is more difficult to control than squamous-cell carcinoma of the lower lip. The lesion usually is histologically more undifferentiated than squamous-cell carcinoma of the lower lip and metastases develop earlier. A case report of a patient with a squamous-cell carcinoma in an upper lip with regional metastases is presented and illustrated.

Carcinoma, Squamous Cell↗

Repair of central upper lip (philtral) surgical defects with island pedicle flaps.

BACKGROUND: Surgical defects of the central upper lip (philtrum) are a particularly difficult area to achieve satisfactory cosmetic and functional repair. Reconstruction of the central upper lip has been accomplished primarily through the use of side-to-side closure, bilateral advancement or rotation flap, and full-thickness graft. Repair may be complicated by distortion of the vermilion border, obliteration of the normal contour of the philtrum, eclabium, and trapdooring of the flap. OBJECTIVE: We review the options for reconstruction of this area and describe our experience using an island pedicle flap to complete reconstruction. METHODS: Four patients presented with basal cell carcinomas of the mid upper lip (philtrum). Tumors were cleared by Mohs micrographic surgery. Reconstruction was achieved by island pedicle flaps utilizing donor tissue from the superior philtrum. RESULTS: The patients had excellent cosmetic results with minimal distortion of the vermilion border or obliteration of the philtrum or philtral ridges. Scars healed in a nearly imperceptible fashion, keeping within one cosmetic unit (the philtrum) without extending along the vermilion border as seen in bilateral advancement or rotation flaps. CONCLUSIONS: Island pedicle flaps may be an effective cosmetic and functional repair of selected surgical defects of the central upper lip involving the philtrum.

Aged↗

Prevalence of upper lip posture and incisor overjet.

1,159 children (612 girls and 547 boys) aged 11-12 years were examined to determine the range and mean overjet values in four defined upper lip-maxillary central incisor relationships. No clinically significant differences were found on comparison of the data relative to each upper lip position. The findings suggest that upper lip posture is adaptive to the maxillary central incisor angulation and that the upper lip musculature is unlikely to influence the development of the incisor occlusion.

Child↗

Commissural lip pits in Israeli Jews of different ethnic origin.

The prevalence of commissural lip pits in a group of 2462 Israeli Jews was determined, and a relation of commissural lip pits to ethnic background was noted. Results showed the presence of commissural lip pits in 17.4% of the entire sample; 9.7% were unilateral and 7.7% were bilaterally located. The Ashkenazi group showed a significant higher prevalence of commissural lip pits (19.4%) when compared to the prevalence in the Sephardic group (14.1%) and the Eastern group (21.1%).

Adolescent↗

Physical characteristics of the lips underlying vowel lipreading performance.

To evaluate the relationship between physical characteristics of the lips during vowel production and vowel lipreading confusions, four female talkers were videotaped producing 15 American English vowels and diphthongs in an /h/-V-/g/ context. Ten normal-hearing adults identified the stimuli through lipreading. Three analyses were performed. First, using confusion matrices for individual and pooled talkers, the stimuli were located in a two-dimensional space using multidimensional scaling. The ten monophthongs revealed a clear lip spreading/rounding dimension and a tongue height dimension, and while diphthongs also showed influence of lip rounding, more variability on the tongue height dimension was apparent. Second, tracings were made of the talkers' lips on a single videotape field representing the maximum opening or constriction for each of the 40 monophthong tokens (ten vowels X four talkers), and six physical measurements of the tokens were derived as descriptors of the vowel nuclei. Third, difference scores and other measures of physical pairwise similarity were used as predictors of two ways of representing the vowel lipreading confusions in a multiple regression paradigm. Results indicated that the physical measures were moderately successful as predictors of vowel perception (accounting for approximately 50% of the variance in the perceptual distance measure), although considerable differences in the strength of the prediction occurred among talkers.

Lip↗

Speed, amplitude, and asymmetry of lip movement in voluntary puckering and blowing expressions: implications for facial assessment.

The context of voluntary movement during facial assessment has significant effects on the activity of facial muscles. Using automated facial analysis, we found that healthy subjects instructed to blow produced lip movements that were longer in duration and larger in amplitude than when subjects were instructed to pucker. We also determined that lip movement for puckering expressions was more asymmetric than lip movement in blowing. Differences in characteristics of lip movement were noted using facial movement analysis and were associated with the context of the movement. The impact of the instructions given for voluntary movement on the characteristics of facial movement might have important implications for assessing the capabilities and deficits of movement control in individuals with facial movement disorders. If results generalize to the clinical context, assessment of generally focused voluntary facial expressions might inadequately demonstrate the full range of facial movement capability of an individual patient.

Adult↗

Measurement of maximal expiratory pressure: effect of holding the lips.

BACKGROUND: Minor differences in technique may account for the wide range of published normal values of maximum expiratory and inspiratory pressures. The effects of holding the lips while the subject performed a maximal expiratory pressure manoeuvre were investigated in this study. METHODS: Maximum static expiratory pressures (PEmax) obtained with a cylindrical tube by means of lip compression by the subject and technician aided compression were compared in 20 men (mean age 27 years) and 20 women (mean age 28 years). RESULTS: Technician aided lip compression was associated with higher maximum expiratory pressure than compression by the subject in both men (195 v 110 cm H2O) and women (134 v 80 cm H2O). CONCLUSION: Compression of the lips and corners of the mouth should be performed by a trained technician for maximum expiratory pressure measurements when a cylindrical mouthpiece is used.

Adult↗

Lip sun protection factor of a lipstick sunscreen.

BACKGROUND AND OBJECTIVE: There is a well-documented need for effective human UVA and UVB photoprotection. Since there are important anatomical variations, the sun protection factor (SPF) of a lipstick sunscreen was measured on the anatomical site intended for use. METHODS: The SPF tests were performed according to Federal US and European COLIPA guidelines. Prior to performing a test on the lip, the minimal erythemal dose (MED) of the unprotected back skin was determined. Subsequently, the sunscreen SPF was measured on the anatomical target site (lip). The evaluator was blinded with respect to scoring the SPF of each sunscreen treatment. Individual test sites were assigned to one of the following treatment conditions: (1) no treatment (MED of unprotected skin); (2) test formulation; (3) reference standard. RESULTS: The MED on unprotected back skin was found to be 25% lower than on unprotected lip skin. The SPF of the lipstick sunscreen was measured 2 units lower than the SPF determined in the classical way on the back skin. CONCLUSION: It was hypothesized that the higher MED of the lower lip compared with back skin was due to the adaptation of this tissue to the continuous exposure to UV radiation.

Cosmetics↗

Lip and tongue function differently affected in individuals with multiple sclerosis.

Clinical dysarthria test scores on lip function and tongue function were compared for 77 dysarthric as well as non-dysarthric subjects with multiple sclerosis (MS) and 15 control subjects. Results show that tongue function was significantly more severely affected than lip function in individuals with MS. Furthermore, tongue function, but not lip function, was significantly more severely affected in the MS individuals with no dysarthria compared to the control group. Test items requiring increased rate of movement (oral and verbal diadochokinesis) were significantly more severely affected than the items requiring range and force of movement, but only in the dysarthric MS subgroup. Moderate correlations were found between tongue and lip function and neurological deficit scores, number of years in disease progression, and perceptually perceived consonant and vowel precision. Consequently, tongue dysfunction can be detected clinically and subclinically using a dysarthria test procedure, and as an early sign of articulatory dysfunction it should be an early target in therapeutic interventions.

Adult↗

A monozygotic conjoined twin pregnancy discordant for laterality of cleft lip.

Conjoined twins discordant for phenotype of cleft lip are reported. One had right-sided cleft lip, while the co-twin had left-sided cleft lip. Both twins had a normal 46,XY karyotype. Genotyping at 50 polymorphic loci revealed that the twins were identical (monozygotic). Our analysis suggests that the laterality of cleft lip is more affected by the process of twinning than by genetic factors.

Adult↗

Early palatal changes in complete and incomplete cleft lip and/or palate.

Early palatal development in various complete and incomplete forms of cleft lip and/or palate (CLP) was studied from birth to 3 months of age by means of dental casts. Palatal morphology (shape) and dimensions--based on reproducible reference points--were determined in a group of 128 CLP children and 68 normal children who served as controls. Substantial normal palatal growth during the first 3 months of life was observed. Round arch forms changed into oval arch forms. Growth mainly takes place in the sagittal direction (+4 mm) (transverse: +1 mm). Palates of CLP children differed significantly dependent on the type of cleft and whether the cleft was complete or incomplete. Cleft lip and alveolus children and bilateral cleft lip and palate children had more elongated palatal arches, whereas unilateral cleft lip and palate children and cleft palate children had wider palatal arches than the control group. Incomplete clefts differed from the control group in the same direction as their complete cleft forms, though less distinctly. Preoperative orthopedics used in CLP patients does not stimulate growth. On the contrary, it even restricts growth.

Cleft Lip↗

Variability of lip and jaw movements in the speech of children and adults.

One purpose of the present study was to examine displacement variability of lower lip and jaw movements to determine whether sounds that are generally learned earlier and should, therefore, have been practiced more (e. g., stops and nasals) would be less variable than sounds that tend to develop later (e. g., fricatives). It was also of interest to determine whether individual articulators such as the lower lip and the jaw show any differences in displacement variability, given that lower lip gestures may need to be more precise than jaw movements. Repetitions of several labial-initial, CVC stimuli embedded in short phrases produced by three groups of children (5-, 8-, and 11-year-olds) and a group of adults were examined to determine the variability of articulatory gestures. No evidence was found to suggest that fricatives were more variable than stops or nasals for any of the groups. For the children but not the adults, lower lip gestures tended to be more variable than jaw movements.

Adult↗

Median cleft of the lower lip: report of two new cases and review of the literature.

Median clefts of the lower lip and mandible are rare craniofacial clefts. Couronné in 1819 was the first to describe the condition. The midline cleft of the lower lip was classified by Tessier as a type 30 craniofacial cleft. Recently, the total number of the reported cases had increased to about 66 in the world literature. In addition, 2 more patients are presented here. The first case involves only a small notch in the vermilion; the deformity was treated by Z-plasty. In the second case, a midline incomplete cleft of the lower lip, a sublingual abnormal frenulum, a complete cleft in the mandible, a bifid sternum, a presternal skin tag, and a ventricular septal defect in the heart were present. At operation, Z-plasty of the lingual frenulum released the normal-sized tongue. The lip cleft was corrected by a simple V excision followed by closure in 3 layers. The mandibular segments were "vitalized" with a bone rongeur and immobilized in the predetermined position with an interosseous stainless steel wire. Because the bone fusion was complete, the stainless steel wire was taken out after 3 months so that it would not prevent mandibular development. Our treatment methods and others are discussed.

Abnormalities, Multiple↗

Role of suprahyoid neck dissection in the treatment of squamous cell carcinoma of the lower lip.

Treatment of squamous cell carcinoma of the lip is primarily surgical. Unlike other oral lesions, lower lip cancers do not metastasize to lower cervical lymph nodes without invading submental and submandibular lymph nodes. This study presents 30 patients with N0 lower lip carcinoma who were treated by en bloc resection of the tumor with suprahyoid neck dissection. Occult metastasis was found in 4 patients (13%). Four patients, 3 of whom had no occult metastases, died of local or regional uncontrollable disease. Suprahyoid or modified radical neck dissection appears to be beneficial, even in small tumors of the lower lip, in detecting occult metastases.

Adult↗

Somatosensory-evoked fields for gingiva, lip, and tongue.

To localize the oral primary somatosensory cortex, we measured somatosensory-evoked fields for the lip, gingiva, and tongue in six healthy subjects. The latency of the first peak of the posterior-oriented current in the contralateral hemisphere was 50.9 +/- 8.3 ms for the gingiva, significantly shorter than those for the lip and tongue peaks. The equivalent current dipole was localized on the central sulcus. The gingival dipole was localized significantly inferior to the lip dipole but not different from the tongue dipole. The moment of the gingival dipole was significantly smaller than that of the lip dipole but not different from that of the tongue dipole. Differences in the above parameters were negligible between the left and right, anterior and posterior, and upper and lower locations within the same organ, except that the dipole location for the anterior upper tongue was significantly inferior to that for the lower tongue.

Adult↗

A lip-activated appliance in early orthodontic treatment.

After reviewing the modes of action and types of lip-activated appliances, three cases were reported. A mandibular lip-activated appliance was used to gain space among the incisors and mesial to the mandibular permanent first molars; a maxillary lip-activated appliance was used to correct an anterior crossbite by labial movement of the incisors; and a modified lip-activated appliance was used to expand maxillary molars buccally.

Activator Appliances↗

[Reconstructive surgery of the lower lip with esthetic-functional recovery: report of 2 cases].

Two cases of patients with large squamous cell carcinoma in the lower lip, that were submitted to the reconstructive surgery, using technique of lateral progress with reconstruction of the red lip, always tends the concern of the recovery not only functional as well as aesthetic of these patients ones, are reported. A classification is given suggesting the main locations of the squamous cell carcinoma of the lip, allowing better definition with relationship to the surgical technique to be used in each case, depending on the location and involvement or not of the lip comissure.

Adult↗