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PubMed1978

Theoretical principles and technique of functional closure of the lip and nasal aperture.

Since many approaches to the closure of the cleft lip have not satisfied the hopes placed into them, the author has gone back to the principles stated by Veau (1938). His anatomical findings are presented. They form the basis of his technique of functional closure of the lip and nasal aperture: Careful dissection of all muscles involved, anatomical repositioning of all structures of the lip and the nasal entrance, and wide subperiosteal dissection. Careful reconstruction of a normal anatomical situation leads not only to better appearance and good mobility of the area concerned, but also to an enhanced growth of the underlying bony structures. Primary osteoplasty has been used, but does not seem to be necessary. The early results of this technique are very satisfying, however, later re-evaluation has to be made.

Cleft Lip↗

PubMed1983

The importance of the musculus nasalis and the use of the cleft margin flap in the repair of complete unilateral cleft lip.

The deformities of the lip and nose in cleft lip patients are intimately inter-related and their repair should not be independent procedures. The reconstruction should be dynamic, taking into account the different functions of the groups of the perioral musculature. For the lip repair, attenuation of the musculus nasalis of the sound side and the formation of the levator sling are believed to be important. Nasal repair consists of upward transpositioning of the origin of the musculus nasalis and of plicating the nasal fascia, followed by the transfer of the bi-lobed cleft margin flap to the piriform margin.

Cleft Lip↗

PubMed2000

Persistent lipsticks and their lip prints: new hidden evidence at the crime scene.

Latent lip print test results produced by permanent lipsticks are presented in this work. This cosmetic product, contrary to conventional lipsticks, does not leave visible prints and can thus be overlooked at the crime scene. As print vehicles the study used ceramics, glass, cotton fabric and paper. Lip prints were left to dwell for different periods and were later developed using aluminum powder, cobalt oxide powder and magnetic powder. The results show that identifiable lip prints can be obtained up to 30 days after being produced.

Ceramics↗

PubMed2000

Maxillary sinus development and sinusitis in patients with cleft lip and palate.

OBJECTIVE: Sinusitis is frequently associated with cleft lip and palate. The present study was performed in an attempt to investigate maxillary sinus development in relation to the occurrence of sinusitis in cleft patients. METHODS: Forty-seven consecutive patients with cleft lip and alveolus with or without cleft palate underwent computed tomographic scans of the maxilla. The cross-sectional area of the maxillary sinus at the level of the zygomatic arch was measured, and the soft tissue density shadow of the sinus was scored on a 4-point scale. RESULTS: The cross-sectional area of the sinus was significantly smaller in the child group (10 years or less) than in the adolescent group (11-20 years, P<0.001) and the adult group (over 20 years, P<0.02). The cross-sectional area significantly increased with age in the child group (r=0.552, P<0.001). The growth rate became slower in the adolescent group. The cross-sectional area then gradually decreased with age in the adult group (r=-0.64, P<0.05). Sinusitis was observed in 15 patients (32%) and in 20 sinuses (21%). Severe sinusitis was more common in the child group than in the patients over 10 years of age (P<0.05). CONCLUSION: These results indicate that maxillary sinusitis associated with cleft lip and palate occurs preferably in the developing sinuses of children.

Adolescent↗

PubMed1993

Change in lip vermilion height during orthodontic treatment.

The extent that the height of the vertical aspect of the vermilion of the lips decreases during treatment may determine the ultimate esthetic results for a particular patient. Marked decrease in vertical height of the vermilion may prove to be esthetically pleasing for the patient with excessive vermilion; whereas it may prove esthetically disastrous for the patient exhibiting relatively small vermilion heights before treatment. Frontal esthetics should equal the profile in importance when treatment planning. The objectives of this study were (1) to quantify vermilion height changes when incisors are retracted, (2) to determine whether the pretreatment vertical position of the upper lip on the maxillary central incisor is associated with vermilion height changes, and (3) to relate vermilion height changes to incisor retraction. Cephalometric films from 40 adult female orthodontic patients (20 Class I and 20 Class II, Division 1) were measured with dial calipers. Significant decrease (paired t tests, P < 0.05) of the mean vermilion heights of both lips occurred during treatment in the patients with Class I relationships (upper 0.75 mm, lower 0.95 mm) and Class II, Division 1 relationships (upper 0.75 mm, lower 0.60 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1996

A pressure-distribution sensor (PDS) for evaluation of lip functions.

The purpose of this study was to develop and to test a pressure-distribution sensor (PDS) for evaluating lip functions. The PDS is fabricated as a disposable cartridge and is based on the principle of optical-pressure conversion used in tactile sensors of robot arms. Its advantages are in measuring sealing forces, contact area, and pressure-distribution patterns of the lips at maximum effort. We used the PDS to evaluate pressure-distribution patterns of long-face subjects with extremely large interlabial distances. The results suggest that the PDS is a useful device for evaluating lip sealing functions and their changes after orthodontic therapy or orthognathic surgery.

Disposable Equipment↗

PubMed1996

Effects of reverse headgear treatment on sagittal correction in girls born with unilateral complete cleft lip and cleft palate--skeletal and dental changes.

Patients with cleft lip and cleft palate often develop maxillary retrognathism. This is due to the combined effects of the congenital deformity and surgical repairs. Early protraction of the maxilla with extraoral forces helps to achieve more balanced skeletal harmony and favorable occlusion for future growth to occur. The purpose of the present study is to investigate the proportion of the skeletal and dental changes contributing to the improvement in a group of Southern Chinese girls born with unilateral complete cleft lip and cleft palate treated by the reverse headgear. This study only focused on treating a homogenous sample group, i.e., only girls with unilateral complete cleft lip and cleft palate. This design was deliberate so as to avoid having boys and girls with various types of cleft all pooled together for analyses as seen in most of the previous reports. In addition, comparison was made with girls matched in having a similar deformity, presenting a similar skeletal structure and maturity status to reveal the genuine treatment effect. The 9.7 months of reverse headgear treatment improved the sagittal jaw relationship (p < 0.01) and overjet (p < 0.01), which was effected by about two-thirds skeletal and one-third dental changes.

Case-Control Studies↗

PubMed1993

Median cleft lip without holoprosencephaly. Case report.

A patient with median cleft lip is reported, but the patient showed no evidence of holoprosencephaly, which was ruled out by MRI. When the neonate's head circumference is within two standard deviations of the mean and normotelorism occurs with median cleft lip, it can be assumed that the brain is not holoprosencephalic. The importance of this cannot be overemphasized because median cleft lip is commonly associated with holoprosencephaly and severe microcephaly. The mother developed overt diabetes mellitus after the patient was born. However, infants of diabetic mothers are known to be at increased risk of giving birth to infants with holoprosencephaly. Since a prediabetic woman may sometimes give birth to large and/or malformed infants before developing overt diabetes mellitus, it is intriguing to speculate that the prediabetic state might have resulted in a forme fruste of holoprosencephaly, affecting, in this case, only the face and not the brain.

Anodontia↗

PubMed1996

Squamous cell carcinoma of the lip: the role of electron treatment.

After skin cancer, squamous cell carcinoma (SCC) of the lip is the most common cancer of the head and neck. It can be treated in a variety of ways, including both surgery and radiotherapy. Many centres have reported excellent cure and local control rates for their chosen treatment method. Electron beam treatment is recognized as a method of treatment and has theoretical advantages related to its depth-dose characteristics. We report a retrospective study of the treatment with electrons of 26 patients with Stage T1-2 SCCs of the lip. With a median follow-up period of 31 months (range 1.5-60) 100% local control was obtained, although two patients required surgical salvage, one for a geographical miss. One patient presented with metastatic neck nodes, and one relapsed in the neck, but both were treated with a combination of surgery and radiotherapy and were free of disease at follow-up. Patients tolerated the acute radiation reaction well and the long term cosmetic and functional results were good. Two patients experienced minor soft tissue necrosis, one of whom required surgical treatment. Electron treatment for T1-2 SCC of the lip is an effective, well tolerated treatment for these patients, many of whom are elderly and frail.

Aged↗

PubMed2003

Dento-alveolar development in unilateral cleft lip, alveolus and palate.

BACKGROUND AND OBJECTIVE: Palatal surgery for cleft lip, alveolus and palate is considered to have the most powerful negative impact on maxillary growth. The aim of this study was to compare dento-alveolar development of the permanent dentition and morphology of the palate after surgery in unilateral cleft lip, alveolus and palate patients following two types of palatoplasty: supraperiosteal flap vs mucoperiosteal flap technique. PATIENTS: Thirty-eight patients born between 1976 and 1983 with a complete unilateral cleft of lip, alveolus and palate were studied. Fifteen patients were treated with supraperiosteal flaps (SP group), and the other 23 patients with mucoperiosteal flaps (MP group). In this cross-sectional study, dental casts of stage IV A of Hellman's dental age in each patient were used. METHODS: The following distances were measured: (1). transverse distance C-C', (2). transverse distance M-M', (3). palatal length, (4). palatal height. RESULTS: No statistically differences were seen between the SP and MP groups regarding C-C' and M-M'. However, palatal length and palatal height were significantly greater in the SP than in the MP group. CONCLUSION: The technique that leaves no denuded palatal bone is considered to be advantageous for the development of the alveolar process.

Adolescent↗

PubMed1993

Squamous cell carcinoma of the lip and oral cavity in The Netherlands; an epidemiological study of 740 patients.

The epidemiological data of 740 patients with primary squamous cell carcinoma (SCC) of the lips or oral cavity is reported. The mean age was 63 years. The mean onset of oral cancer in women was 7 years later than in men. Patients under the age of 40 years were mainly males. The male-to-female ratio ranged from 8.3 for the lower lip to 0.9 for the upper alveolar ridge with an overall ratio of 1.8. In the case of multiple oral SCCs the tongue was the most frequently affected site. No significant association was found between the age or gender of patients and the size of the tumour. However, a significant association was observed between the site and size of the tumour. Lesions of the lower lip had a significantly smaller size than tumours of other sites. Furthermore, a linear trend could be observed between the size of the tumour and the clinical stage of the neck.

Adult↗

PubMed1990

Primary unilateral cleft lip repair without primary rhinoplasty. A preliminary report.

A primary unilateral functional lip-plasty has been developed to improve the appearance of the asymmetrical nasal deformity and that of the lip scar in the cleft lip. A triangle is dissected from the lesser segment with the base located at the nasal alar base. The latter is rotated superior-horizontally and positioned at a semicurved release incision which is inferior to the columella. This C-junction of the nostril sill allows an alignment of the nasal structure without a primary rhinoplasty.

Cleft Lip↗

PubMed2006

Cartilaginous septum deviation in children with cleft lip, alveolus and palate--an MRI analysis.

INTRODUCTION: This study aimed to investigate by MRI examination the degree of deviation of the cartilaginous septum in relation to cleft size in patients with cleft lip, alveolus and palate. MATERIAL AND METHODS: Six children with cleft lip, alveolus and palate at age 5-20 days were examined with a 1.0 Tesla scanner using a head coil. The following parameters were evaluated: maximal cleft size (millimeter) and degree of the nasal septum deviation from the median-sagittal plane (degrees). RESULTS: Two children with bilateral clefts had no deviation; 3 children with unilateral (left-sided) cleft had a deviation to the right and 1 patient with a unilateral right-sided cleft a deviation to the left side. In all 4 patients, the degree of the nasal septum deviation increased with cleft size. CONCLUSION: Cartilaginous nasal septum deviation was noticed only in patients with unilateral cleft lip and palate toward the non-cleft side and was greater with increasing cleft sizes.

Alveolar Process↗

PubMed2006

Comparison of craniofacial morphology in patients with unilateral cleft lip, alveolus and palate with and without secondary osteoplasty.

PROBLEM: What kind of skeletal differences do exist between juvenile patients with unilateral cleft lip, alveolus and palate treated with or without secondary osteoplasty, and between cleft patients and non-cleft patients? PATIENTS AND METHODS: Thirty-nine patients with unilateral cleft lip, alveolus and palate at a mean age of 15.8 years who were surgically treated with (n = 18) and without (n 21) secondary osteoplasty were compared with a control group of non-cleft patients (mean age 15.1 years). The patients were analyzed using lateral cephalograms. Cephalometric analysis included common sagittal and vertical variables as well as measurements of anterior tooth position and soft-tissue profile. RESULTS: Analysis of lateral cephalograms revealed no significant differences between the two groups of cleft patients. The differences in comparison with the control group mainly revealed maxillary retroposition, a vertically open configuration, a steep position of the upper and lower anterior teeth and a decreased Holdaway-angle (flat midface). CONCLUSION: Secondary osteoplasty exhibited no significant influence on craniofacial growth in children with unilateral cleft lip and palate. Both groups of cleft patients are not markedly different regarding sagittal and vertical skeletal configurations.

Adolescent↗

PubMed1988

Reconstruction of soft tissues of the chin and lower lip region following excision of a basal cell carcinoma.

A rather unusual case of basal cell carcinoma of the labio-mental fold area is presented where it was possible to preserve the vermilion of the lower lip after wide excision. This made reconstruction with bilateral nasolabial flaps and a platysma myocutaneous flap possible. Thus the sensitivity of the lower lip could be partly preserved, a competent lip seal obtained, microstoma avoided and a good vestibulum reconstructed.

Basal Cell Carcinoma↗

PubMed1999

Trends in the incidence of lip, oral, and pharyngeal cancer: Connecticut, 1935-94.

Using Connecticut Tumor Registry data we explored trends in age-adjusted (AARs) and age-specific (ASRs) incidence rates for lip, oral, and pharyngeal cancer over the 60-year period 1935-94. Particular attention was given to findings from the most recent series of 5-year periods that have not been previously analyzed. There was a long-term decline in lip cancer AARs by period, and ASRs generally fell over time and with successive birth cohorts. This notable decrease in rates continued through 1990-94 and with the more recent cohorts, particularly among males. Oral cancer AARs for males peaked in the early 1960s and the late 1970s while rates for pharyngeal cancer increased into the late 1970s. For each of these sites, rates began to decline in 1980-84 and have continued to fall into the first half of the 1990s. Among females AARs for oral and pharyngeal cancer increased more than threefold between 1935-39 and 1980-84; however, encouragingly, and in sharp contrast to the earlier trend, rates fell during the most recent 10-year period. ASRs for oral and pharyngeal cancer were increasing by the birth cohort of 1900 and tended to increase through the cohort of 1920 for males and the cohorts of 1920-30 for females. ASRs for subsequent cohorts have remained relatively unchanged or decreased modestly. It is doubtful that the observed trends in lip, oral and pharyngeal cancer incidence are primarily artifactual, but more likely represent secular changes in exposure to environmental risk factors.

Adolescent↗

PubMed1991

Carcinoma of the lip: observations on its frequency in females.

Seventy-three patients with lip carcinoma were treated from 1970 to 1988 in the Otolaryngology Department of the Beilinson Medical Center. The most common histological type was squamous cell carcinoma which occurred in 68 patients; four tumours were basal cell carcinoma and one acinic cell carcinoma. Carcinoma of the lip is more frequent in males. Nevertheless, the frequency of carcinoma in females in our series was substantially higher than the average reported in the literature. Forty-nine patients were treated surgically and 24 patients were treated by irradiation. Analysis of the results among those treated by surgery and those treated by irradiation shows a difference in tumour local control which was statistically significant (p = 0.025). Surgical treatment is recommended because of the advantage of tumour margin assessment, avoidance of radiotherapy complications and rapid rehabilitation. Two rare cases of carcinoma of the lip in young patients (age under 20 years) are presented.

Adolescent↗

PubMed2002

Sebaceous lymphadenoma of the lip: report of a case of minor salivary gland origin.

A case of sebaceous lymphadenoma occurring in the lip of a 73-year-old female is described. The patient had noticed a painless mass in the region of her upper lip for a year. The surgically removed tumor, measuring about 10 mm in diameter, was located just beneath the lip mucosa, expanding into the submucosal and muscle layer. Histologically, the tumor was well encapsulated and consisted of scattered round-shaped islands of small squamous epithelial cells with focal but apparent sebaceous differentiation in a background of lymphoid stroma. This is the first case report of sebaceous lymphadenoma of minor salivary gland origin.

Aged↗