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At least 1,279 records · Page 71Linked to original sources
PubMed1978

Lengthening of the short columella associated with bilateral cleft lip.

Operations for lengthening the columella can be classified into three groups on the basis of source of material: lip, nose, or ear. When seen in profile, the middle of the lip provides one-fourth to one-third of the forward projection of the columella as compared with the level of the alar bases. Complete bilateral cleft lips usually benefit from columellar lengthening, but symmetrical, incomplete clefts rarely require it. Ancillary procedures, such as correction of a retruded maxilla by Le Fort I osteotomy or by contour build-up, can enhance the overall result. Our experience with advancement of skin from the floor of the nose and ala [15], skin from the alar margins at the tip [7], prolabial advancement flaps, fork flaps, and composite earlobe grafts is reported.

Adolescent↗
PubMed1980

Problems and reconstruction of "dish face" deformity due to cleft lip and palate.

This paper deals with the unique aspects and surgical indication of "dish face" deformity, including "flat face" deformity, due to cleft lip and palate. The importance of deformities of the nose and lip caused by cleft lip and palate and the role of their reconstruction in the treatment of "dish face" deformity are described in detail. For the protruding chin and pseudoprognathism, vertical osteotomy of the ramus of the mandible is recommended over advancement osteotomy of the hypoplastic maxilla.

Cleft Lip↗
PubMed1983

Steeple flap reconstruction of the lower lip.

A new method of lower lip reconstruction using a full-thickness cheek island flap based on the facial vessels is described. The functional potential of the method is assessed in six patients. The technique outlined is simple in design and execution. It is capable of total lower lip reconstruction without appreciable microstomia. Other major techniques of lip reconstruction are briefly reviewed.

Adult↗
PubMed1989

Congenital sinuses of the lower lip: reappraisal of Van der Woude syndrome on the basis of nine patients.

Congenital sinuses on the lower lip in association with cleft lip, cleft palate, or both are rare and occur in four syndromes, namely Van der Woude syndrome, popliteal pterygium syndrome, orofacial digital syndrome, and the ankyloblepharon filiform adnatum. The most common and best studied among these--the Van der Woude syndrome--is believed to be due to an autosomally dominant gene with 80 to 100% penetrance and a variable expressivity. We present our study of 9 patients with congenital lower lip sinuses and the penetrance in their families. On the basis of our observations we conclude that this syndrome may have low penetrance among the populations studied.

Cleft Lip↗
PubMed1994

Cross lip flap in vermilion reconstruction.

Lips may need to be repaired because of congenital malformations, benign or malignant tumors, or trauma. When a large portion of the lip is involved in the defect, or when this portion is cosmetically relevant, the repair may be particularly challenging and requires a perfect technique. We devised a surgical technique for the reconstruction of the vermilion that involves the use of a large portion of the mucosa vestibularis and of the underlying musculus orbicularis. The mucosa and muscle are taken from one lip and are rotated to cover the quantitative and qualitative defect of the opposite prolabium. Two stages are required in this procedure.

Adolescent↗
PubMed2002

New technique of one-stage reconstruction of a large full-thickness defect in the upper lip: bilateral reverse composite nasolabial flap.

Lips are important features because of their location, function, and aesthetics. Reconstruction of the upper lip presents the surgeon with one of the greatest challenges. Total upper lip reconstruction is a frequent and demanding procedure, and its difficulty is related to the size and the site of the loss of the aesthetic subunits such as the Cupid's bow and the philtral columns.

Aged↗
PubMed1985

Principles and techniques of bilateral complete cleft lip repair.

Important principles for repair of bilateral complete cleft lip are symmetry, primary orbicularis continuity, proper prolabial size and shape, median tubercle and mucocutaneous ridge formation from lateral lip tissue, and early construction of nasal tip and columella with anatomic placement of the alar cartilages. A two-stage repair employing techniques based on these concepts is described. At the initial procedure, the lateral crura are positioned and a tiny biconcave prolabium is shaped in anticipation of the changes with growth. The second stage (nasal correction) includes apposition of the alar genua, medial crural relocation, and intranasal transposition of banked forked flaps without disjunction of the columella-labial angle. The complete bilateral cleft lip is a four-dimensional problem.

Cleft Lip↗
PubMed1985

In utero cleft lip repair in A/J mice.

Reconstructive in utero microsurgery for repair of unilateral cleft lips has been technically achieved in the A/J mouse fetus. The period of gestation was undisturbed, and following birth, the gross and histologic appearance of the lips was nearly normal with no evidence of scar formation. The absence of a lip scar after human cheiloplasty may require the as yet undefined advantages of fetal wound healing.

Animals↗
PubMed1985

Primary correction of unilateral cleft lip nasal deformity: a 10-year review.

A 10-year follow-up of patients who underwent primary correction of their cleft lip nasal deformity is presented. These are the first 10 consecutive patients who were treated following a change in treatment plan in 1973. Primary correction of the cleft lip nasal deformity essentially consists in elevating the displaced alar cartilage at the time of lip repair. There has been no interference with nasal growth, and the position of the alar cartilages and nasal tip has been maintained.

Cartilage↗
PubMed1986

Bilateral cleft lip reconstruction.

Over a period of 8 years 140 bilateral cleft lips were operated using a muscle-repositioning banked fork-flap cheiloplasty. The use of buccal mucosal flaps in the intercartilaginous incision is helpful to decrease scarring and contracture by facilitating alar cartilage repositioning and wound closure without tension. Adding mucosa from the inferior turbinate makes complete wound closure relatively easy without tension. A lateral lip orbicularis muscle flap with white skin roll and vermilion is recommended for reconstruction of the Cupid's bow. Muscle continuity by freeing the muscle in one sheet and repositioning in front of the premaxilla with creation of a buccal alveolar sulcus is stressed to prevent the necessity of reentering the lip in a second procedure. The elongation of the columella is done at 1 to 6 years of age by advancing nasal floor tissue onto the columella and repositioning the alar cartilages superiorly and medially. When nasal floor tissue is inadequate, columellar lengthening is done by the use of a composite free ear graft.

Child, Preschool↗
PubMed1988

Reduction cheiloplasty for upper lip hemangioma.

A technique for reconstruction of the upper lip following excision of a cavernous hemangioma is presented. An apron-vermilion flap from the inner third of buccal side is elevated, allowing good exposure of the hemangioma. Following removal of the hemangioma, the excessive mucosa-vermilion flap is reduced to form an accurate upper lip shape. This method achieves a pleasing contour of the upper lip.

Child, Preschool↗
PubMed1989

Unilateral gate flap for reconstruction of the lower lip.

A unilateral gate-flap technique consisting of a nasolabial island flap is presented for the reconstruction of defects in the lower lip after excision of large, laterally located epidermoid tumors. The amount of healthy tissue resected is optimal. The reconstructed lower lip retains sensation and muscle function and is continent with a satisfying appearance. Temporary flap edema and a vermilion notch at the apex of the flap are both avoidable problems. This method may be used in selected patients with large advanced epidermoid cancers of the lower lip.

Aged↗
PubMed1990

The elastic flap for lip repair.

These cases illustrate a new concept in lip repair. This approach recognizes the great inherent elasticity of the oral cavity and takes advantage of the florid blood supply of the region. Recent laboratory studies of Taylor et al., as well as the works of Manchot and Salmon, are combined with anthropologic observations of tribal customs to formulate another way of looking at lip reconstruction. Triangularization of surgical defects, lip switching, and mobilization of distant flaps are avoided by taking advantage of stretched local tissues. Preoperative expansion is discussed as a future option.

Adolescent↗
PubMed1992

A method with three triangular flaps as a secondary operative procedure after reconstruction of the lower lip by Estlander's method.

We have devised a new method for secondary commissuroplasty after reconstruction of the lower lip using Estlander's method with both aesthetically and functionally satisfactory results. This method consists of forming two equilaterally triangular mucosal flaps on the vermilion and a small triangular skin flap in the new position of the commissure and transposing these three flaps to reconstruct the commissure. In the present paper, we reported the procedure and the results. This method produces extremely good results, obtaining favorable commissure form and reconstruction of the mucosa of both upper and lower lips without leaving an unnatural-looking color change in the mucosa or a step deformity in the vermilion. It can be expected that our method will improve the results of Estlander's operations after tumor resection in the lower lip.

Aged↗
PubMed1997

Reconstruction of defects of the entire vermilion with a buccal musculomucosal flap following resection of malignant tumors of the lower lip.

We reconstructed a defect of nearly the entire lower vermilion using a buccal musculomucosal flap following resection of a malignant tumor of the lower lip and obtained satisfactory results. The buccal musculomucosal flap was semi-spindle shaped and pedicled at the angle of the mouth. A flap measuring as much as 1.5 cm in width and 5 cm in length could be raised while ensuring that fibers of the buccinator muscle extended over its entire length. Using this technique, it was possible to reconstruct a wide defect following tumor resection and removal of almost the entire lower vermilion by means of only a transposition of a unilateral buccal musculomucosal flap after about one-quarter of the lower lip had been excised and sutured primarily. Reconstruction with this technique is a two-stage operation, and a secondary minor touch-up operation is performed on the angle of the mouth at the same time as repair of the dog-ear of the pedicle. Advantages of this technique are that food can be taken orally soon after the operation, hemodynamics in the flap are maintained stably because the flap contains fibers of the buccinator muscle, and the vermilion is given a natural eminence. In addition, postoperative drooling is minimized, and sensation returns to the vermilion within the early postoperative period. Based on these advantages, we think our technique should be the first choice for carrying out reconstruction of defects that are located mainly in the lower lip vermilion because this is a safe and reliable method with which we performed 12 cases of vermilion reconstruction without flap necrosis and with satisfactory aesthetic and functional results.

Aged↗
PubMed1998

Presurgical columellar elongation and primary retrograde nasal reconstruction in one-stage bilateral cleft lip and nose repair.

We present a new combined approach to primary bilateral cleft lip, nose, and alveolus repair using presurgical nasoalveolar molding combined with a one-stage lip, nose, and alveolus repair. Presurgical alveolar molding is used to bring the protruding premaxilla back into proper alignment with the lateral segments in the maxillary arch. Presurgical nasal molding produces tissue expansion of the short columella and nasal lining. A coordinated surgical approach involves a one-stage repair of the lip, nose, and alveolus. The nasal repair uses a retrograde approach in which the prolabial flap and columella are reflected over the nasal dorsum by continuing the dissection behind the prolabium up the membranous septum and over the septal angle. Tissues are dissected out from between the tip cartilages, and the domes are sutured together in the midline. This method joins a new class of bilateral cleft repairs that place the primary emphasis on correction of the deformity of the nasal tip cartilages.

Alveolar Process↗
PubMed2000

Three-dimensional nasolabial displacement during movement in repaired cleft lip and palate patients.

The objective of this study was two-fold: (1) to explore the suitability of a novel modified Procrustes fit method to adjust data for head motion during instructed facial movements, and (2) to compare the adjusted data among repaired unilateral (n = 4) and bilateral (n = 5) cleft lip and palate patients and noncleft control subjects (n = 50). Using a video-based tracking system, three-dimensional displacement of 14 well-defined nasolabial landmarks was measured during four set facial animations without controlling for head motion. The modified Procrustes fit method eliminated the contributions of head motion by matching the most stable landmarks of each video-recorded frame of the face during function to frames at rest. Its effectiveness was found to approximate that of a previous method (i.e., use of a maxillary occlusal splint to which stable dentition-based markers were attached). Data from both the unilateral and bilateral cleft lip and palate patients fell outside the normal range of maximum displacements and of asymmetry, and individual patients demonstrated greater right-versus-left asymmetry in maximum displacement than did individual noncleft subjects. It is concluded that the modified Procrustes fit method is fast, is easy to apply, and allows subjects to move the head naturally without the inconvenience of a splint while facial movement data are being collected. Results obtained using this method support the view that facial movements in cleft patients may be severely hampered and that assessment of facial animation should be strongly considered when contemplating surgical lip revisions.

Adolescent↗