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At least 1,513 records · Page 84Linked to original sources
PubMed1983

Cleft lip: morbidity and mortality in early repair.

A fifteen-year survey of primary lip repairs done at The New York Hospital revealed that lip closure can be accomplished during the first week of life with no mortality and with major morbidity slightly higher than that in repairs done after one week of age. Modern anesthetic techniques have markedly reduced respiratory complications from lip closure. Adequate postoperative sedation coupled with careful patient monitoring should appreciably reduce the incidence of wound dehiscence.

Cleft Lip↗
PubMed1983

Palatal grafts for lip reconstruction.

Palatal mucosal grafts are used to provide bulk and improve the contour of lip defects. Since the palatal grafts are markedly different in color, they must be placed behind the wet-dry mucosal line so that they cannot be easily seen at conversational distances. The contrast with the red vermilion is too great for this graft to be used as a cosmetic lip substitute, but when the graft is used as a living tissue expander in the posterior position, it improves subtle lip contours.

Adult↗
PubMed1986

A rare patient with a false median cleft lip associated with multiple congenital anomalies.

A girl manifesting a false median cleft lip associated with hypertelorism, anophthalmos, hydranencephaly with holoprosencephaly, and osteogenesis imperfecta, among other disorders, survived and was fed mainly milk products up to the age of 11. Then, surgical closure of the false median cleft lip was undertaken to improve the face aesthetically and to make the child more acceptable to society at large. The patient's median cerebrofacial dysgenesis with other anomalies was unique, compared with disorders reported in the literature. The embryological distinction between a false and true median cleft lip is also discussed.

Abnormalities, Multiple↗
PubMed1987

Nostril sill augmentation in secondary cleft lip.

In most cases, after successful correction of primary cleft lip deformity, some problems remain to be solved. One of them is nostril sill depression, which should not be overlooked in cleft lip repair. However, there have been few reports on the anatomy of the depressed nostril sill and methods for augmenting the sill depression. The anatomy of the depressed nostril sill, its relationship to surrounding tissue, and the gross features of nostril sill depression in cleft lip deformity were reviewed, and a method in which a scar flap and a suture-fixation technique are used was developed for augmenting the depression. The clinical results of this method in 16 patients are presented.

Cicatrix↗
PubMed1992

Cleft lip repair by soft-tissue expansion.

I report herein a newly devised method of cleft lip repair that involves the expansion of cheek skin by tissue expander and transferring the scar from the philtrum to the nasolabial fold, or reducing a broad scar to a finer and less conspicuous one without leaving tension. The method, having been applied in three patients with good results, is thereby recommended for patients with severe cleft lip deformity wherein a tight lip is present.

Adolescent↗
PubMed1994

Traumatic self-inflicted bite with embedded tooth fragments in the lower lip.

An unusual case of traumatic self-inflicted bite of the lower lip in a 7-year-old girl is presented. As a result of the bite, due to a fall, four fragments of the right upper incisor tooth were embedded in the lower lip. The large tooth fragment appeared 18 days later, protruding through the skin of the lower lip. Radiographs confirmed the presence of these tooth pieces, which were removed under local anesthesia. Early diagnosis and surgical removal of the tooth fragments could prevent undesirable foreign-body reactions and scarring.

Accidental Falls↗
PubMed1997

Functional reconstruction of total lower lip defects with a radial forearm free flap combined with a depressor anguli oris muscle transfer.

Two total lower lip reconstructions were accomplished by combining a radial forearm free flap and a depressor anguli oris muscle transfer. The radial forearm flap was used to reconstruct the inner surface of the lower lip. The bipedicled musculofascial flap, which includes both depressor anguli oris muscles, the depressor labii inferioris muscles, and the mentalis muscles, was elevated onto the chin and sutured superiorly to the modioli to obtain innervated sphincter function. Good results were obtained both aesthetically and functionally. Electromyography revealed almost normal mobility of the depressor anguli oris muscles 6 months after the operation. No drooling was seen during mastication, and no air leakage was observed during puffing of the cheeks. This is an effective procedure for the reconstruction of the sphincter function of the lower lip.

Aged↗
PubMed1998

Further experience with upper lip flaps for reconstruction of the ala nasi and alar base defects.

Reconstruction of the ala nasi and the alar base presents problems because of complex contours, skin color and texture, and limited availability of mobile, adjacent skin. A large percentage of basal cell carcinomas occur on the nose. When excised with adequate safety margins, these lesions create a defect too large for direct repair. This paper describes the use of the upper lip flap for reconstructing alar base defects and reconstructing the inner lining of the ala nasi in full-thickness defects of the ala nasi as an alternative to other procedures proved to be effective on this region. The base of the flap rests on the base of the columella. It is raised just over the underlying orbicularis oris muscle. The resulting donor defect is closed primarily. The outer aspect of defects of the ala nasi are covered with either a full-thickness skin graft, a forehead flap, or a cheek flap. The upper lip flap was used on 10 patients to reconstruct full-thickness defects of the ala nasi, for which an alar base needed to be reconstructed. The results were satisfactory in most patients. An upper lip flap can be used safely to reconstruct the ala nasi and alar base defects either alone or in combination with other flaps.

Aged↗
PubMed2003

Use of octyl-2-cyanoacrylate in cleft lip repair.

Octyl-2-cyanoacrylate (Dermabond; Ethicon, Somerville, NJ) is a synthetic tissue adhesive recently approved for skin closure. This study was designed to assess its effectiveness for use in clefts lip repairs. Sixty-four patients with unilateral, bilateral, or midline cleft lip defects were repaired. The ages at repair ranged from 4 days to 19 months, with an average of 46.5 days. Follow-up ranged from 6 months to 3 years. No complications were found. Several advantages were observed: shorter operative time, formation of a protective barrier, simplified incision care, no need for suture removal, and improved scar outcome. This study supports octyl-2-cyanoacrylate as an alternative to skin sutures in primary cleft lip repair.

Cleft Lip↗
PubMed1994

Upper lip reconstruction with a radial forearm free flap.

Although there are several methods available for lip reconstruction, the challenge for plastic surgeons is young children, in whom there is no laxity of skin. Free-tissue transfer is the method of choice in young children to avoid large unsightly scars and severe distortion of facial appearance. The radial forearm free flap is an ideal flap for lip reconstruction because it is thin and can be folded to restore both the skin and the inner lining. We present reconstruction of half the upper lip in a young girl, in whom the radial forearm free flap was folded to replace the full-thickness defect.

Animals↗
PubMed2002

Masks depicting hemifacial microsomia and cleft lip.

All masks are created by craftspeople. Accordingly, most masks are generally predictable in dimensions, and the portraitures usually depict the faces and heads of humans. The authors found some masks representing the features of craniofacial anomalies, such as hemifacial microsomia and, rarely, cleft lip. Reviewing the legends of wearing masks with a medley of grotesque features, the authors could deduce the tone of society in those days. A mask, "crooked mouth," of Native Americans shows typical lineament of hemifacial microsomia. The deformity of the face was legendarily regarded as resulting from trauma caused by either "one's fault" or a "curse of God." "Yangban" (noblemen of aristocratic class) customarily wore the cleft lip mask in age-old Korean masquerade revels. Laymen ridiculed Yangban by making cleft lip masks for them. The authors presume that the victims of craniofacial deformities were treated contemptuously at that time.

Cleft Lip↗
PubMed2003

Incidence of cleft lip and palate in the northeast of Mexico: a 10-year study.

In Latin American countries, studies on the incidence of cleft lip and palate are not widely available. A 10-year retrospective study was carried out to determine the incidence of cleft lip and palate at the Autonomous University of Nuevo Leon's University Hospital. The study included data from patients who attended the plastic surgery outpatient clinic from January 1990 to December 1999. The author reviewed 10,843 files from which 376 patients were selected to identify the following variables: time of the year in which the first consultation took place, gender, birthplace, type of cleft, age of both parents, and medications taken during pregnancy. The highest incidence was found in patients aged 1 to 6 months. Ninety-four patients had a primary palate cleft; 76 had a secondary palate cleft; and 206 had primary and secondary palate clefts. The gender distribution of the 206 patients with primary and secondary clefts was 127 boys and 79 girls. The mean parent age was 29.5 years (father) and 25.7 years (mother). The incidence of cleft lip and palate in the cited hospital was 1.1:1000 births. Clefts of the left side occurred more often than of the right. Boys were affected more commonly than girls.

Adult↗
PubMed2003

Surgical treatment in unilateral cleft lip-nose patients: long-term follow-up using a personal approach based on rose and spina techniques.

A 24-year follow-up with simultaneous treatment of the lip, nose, and palate in the neonatal period is presented. The first author operated on 92 patients in the neonatal period using a personal approach based on the Rose and Spina techniques. Technical details of the primary repair are described. The unilateral cleft lip-nose is operated on through a curved skin incision, with an upper third Z-plasty. Extensive detachment of the musculature is realized without incising the sulcus. Two flaps close the mucosal layer in an S-shaped position. The nose is approached through a precartilaginous incision on the cleft side, and "V-Y" advancement of a mucocartilaginous flap is realized to restore the normal alar cartilage shape and position. The follow-up showed normal development of the ala with position maintenance without nasal stenosis in 95% of the cases. Good lip functional results were seen in 100% of the cases. Minimal skin scar revision procedures were required in 10% of the cases.

Cleft Lip↗
PubMed2006

Primary and revision cleft lip repairs using octyl-2-cyanoacrylate.

The purpose of our retrospective review is to examine our method and outcomes for the application of octyl-2-cyanoacrylate for the repair of primary and revision cleft lips in both pediatric and adult patients. Records and photographs were reviewed and analyzed for patient age, type of cleft, revision or primary repair, complications, length of follow-up, and aesthetic outcomes. Eighteen patients, both children and adults, who underwent cleft lip repairs using tissue adhesive performed by a single surgeon between 1999 and 2003 were included. Twelve patients underwent primary repair and 6 patients underwent revision repair. Repairs were performed using the Millard rotation advancement technique and the Mohler variant. The lateral advancement flap was kept long and redundant in its transverse dimension to create a pressure fit everting the skin edges with minimal sutures to set up the closure for application of the tissue adhesive. Seventeen of eighteen patients had excellent cosmetic outcomes. One patient had minor necrosis of the tip of the advancement flap. No allergic reactions, wound infections, or dehiscences occurred. The use of octyl-2-cyanoacrylate for the skin closure of primary and revision cleft lip repairs in both children and adults results in excellent cosmetic outcomes. Employing our pressure-fit technique for skin eversion prior to application of the tissue adhesive may be advantageous. The lack of suture removal in the pediatric population and decreased operative time are additional benefits.

Adolescent↗
PubMed1978

Genetic counselling and genetics of cleft lip and cleft palate.

Modern neonatal care and advanced plastic surgical correction have led to the survival of most newborns with oral clefts. These children are likely to reproduce. A slight increase in the incidence of oral clefts may be expected in the future. The genetics of cleft lip and cleft palate is reviewed. The inheritance is usually multifactorial. With normal parents the risk of having a first affected child with cleft lip is about one per thousand, the risk of having a second affected child 4 per cent and the risk of having a third affected child 10 per cent. If a parent has already a cleft lip, the risk of having a first affected child now is 4 per cent, while the risk of having a second affected child is 10 per cent. The methodology of genetic counseling is given.

Abnormalities, Drug-Induced↗
PubMed1977

Lip and laryngeal flaps for reconstruction of the floor of the mouth following glossectomy.

Following glossectomy, the reconstruction of the floor of the mouth is a major problem facing the head and neck surgeon. We have devised split-lip and laryngeal mucosal flaps for this. In selected patients, they have a significant advantage over distant skin flaps. The initial postoperative deformity, from the lip being drawn into the mouth, is corrected by a secondary operation with split-skin graft reconstruction of the vestibule. These lip and laryngeal flaps do not require a delay procedure prior to the cancer surgery, and the operating time is considerably reduced. The cosmetic and functional results have been satisfactory.

Glossectomy↗
PubMed1983

The Tennison Lip repair revisited.

Tennison presented his method for the repair of the single cleft. He was the first to recognize and to preserve the cupid's bow by lowering the peak in the margin of the cleft. He incised the medial side of the cleft and filled the space with a triangular flap from the lateral side. We have modified the Tennison repair based on the vertical height of the normal side, as did Randall and Hagerty. We make the lip 1 mm shorter in the vertical height than the normal side because some of our repairs were too long. Other modifications include a 1-mm offset at the vermilion, and in certain lips that are too long in the newborn, a triangle is excised beneath the alar base to shorten the vertical height. The details for planning the incisions and accomplishing the surgery are given. Certain patients required a V-to-Y procedure to augment a vermilion deficiency, but none of these patients required a secondary procedure. This emphasizes the need for careful planning to get it right at the primary repair. The operation is indicated for the incomplete cleft to the very wide cleft, and in no patient was a lip adhesion required. We no longer operate on the nose at the primary repair.

Adolescent↗
PubMed1983

Tongue-flap reconstruction of the lip vermilion in hemifacial atrophy.

The lips are key features to be considered in facial balance. Correction of lip atrophy in Romberg's disease, therefore, contributes significantly to restoration of facial symmetry. Along with other ancillary surgical procedures used for facial reconstruction in hemifacial atrophy, tongue flaps provide an excellent means of correction of the lip deformity with minimal morbidity and good results.

Adolescent↗