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PubMed1998

[Correction of nasal septal deformities of the unilateral cleft lip].

OBJECTIVE: Septal deformities are very common in patients with unilateral cleft lip nose. The deformities are influential on the morphology of the external nose and respiratory function. The study was conducted to correct the septal deformities. METHOD: The operation procedure includes correction and replacement of the deviated septum to the middle position; correction of the displaced alar cartilage with the suspension method and correction of soft tissue deformities of the nose and lip. Twelve patients were treated with this method from 1994 to 1995. RESULT: Postoperative follow-up of 3-12 months demonstrated satisfactory results. CONCLUSION: Correction of septal deformities plays a very important role in the operation for the unilateral cleft lip nose.

Abnormalities, Multiple↗
PubMed1998

[Anatomic study of the musculus depressor septi nasi in unilateral cleft lip nasal deformity].

OBJECTIVE: This study was to investigate the nasal musculature and its relationship with the deformities of the unilateral cleft lip nose. METHOD: The anatomic and histological examination and comparison of the musculus depressor septi nasi (MDSN) were performed in 33 normal cadavers and 30 patients with unilateral cleft lip undergoing the operation for secondary nasal deformities. RESULT: It was found that the MDSN in the cleft side of a unilateral cleft lip nose is lacking. CONCLUSION: Because of the anatomic deficiency on the cleft side, the function of the normal side is pathologically increased. The functional imbalance between the normal and abnormal side may bring about dislocation and malformation of the base of nasal columella as well as the septal structures.

Abnormalities, Multiple↗
PubMed2000

[Cleft lip and palate. Epidemiologic analysis: report of 60 cases].

The authors reviewed 60 cases of cleft lip and palate between November 1996 and May 1998. Any family history of cleft lip and palate and associated syndromes was noted, to detect a possible mode of transmission. A family history of cleft lip and palate was reported in 14 cases (23%). Possible autosomal dominant transmission was observed in this series. A syndromic form was observed in eight cases (13%), with one case of Van der Woude's Syndrome (VWS), and another of velo-cardiofacial Syndrome (VCFS). Molecular and chromosomal studies are indicated in both cases. A Pierre Robin sequence (PRS) was found in six cases.

Cleft Lip↗
PubMed2001

Web-based educational tool for cleft lip repair using XVL.

Recent web-based technologies have brought a variety of new possibilities to the field of medical information. Nevertheless, transferring 3D patient models through usual low-band-width networks is difficult because of the large size of data file. XVL (eXtensive VRML with Lattice), a new framework for 3D Data representation with high quality surface shape, has solved this problem. In cooperation with Lattice Technology Inc., we have created XVL-formatted patient 3D models. The XVL model takes less than 100 kilobytes, whereas the same quality model in Virtual Reality Modeling Language(VRML) format requires more than 5 megabytes. Because of the many advantages of XVL, we have created a 3D web-based educational tool for repair of cleft lip--plastic surgery for congenital defects of the lips that requires complex incisions and reconstruction. Our system can interact with the model and 3D visualization of the incision lines, displacement of skin flaps, and suturing. Our educational tool for cleft lip repair has demonstrated that the XVL model and its web-based application can open up new possibilities for 3D medical information systems. We are currently refining the XVL model and developing XVL-based applications to simulate the actual surgery on the World Wide Web.

Cleft Lip↗
PubMedDate not supplied

Associated localization of morphea and lichen planus of the lip in a patient with vitiligo.

Morphea, lichen planus and vitiligo are common diseases, but seldom associated. Morphea or lichen planus in the lips have not frequently been reported, and an associated localization of both lesions in the lip mucosa is indeed a rare event. A case of morphea and lichen planus localized in the upper lip mucosa in a patient with vitiligo is reported. Immunohistochemistry revealed a clear prevalence of T-lymphocytes in the inflammatory infiltrates of morphea and in the band-like infiltrate of the lichen, a finding consistent with previous reports of morphea, lichen planus, and vitiligo. The inverse ratio found between CD8+ and CD4+ lymphocytes, compared to other reports, seems to confirm that the pathogenesis of morphea and lichen planus evolves through different stages. The present report, besides presenting a rare case, may prompt to consider a common pathogenesis among morphea, lichen planus and vitiligo.

Humans↗
PubMed2001

Adult patients with treated complete cleft lip and palate. Methodological and clinical studies.

The purpose of the present thesis was to investigate the quality of life, satisfaction with treatment, prevalence of temporomandibular disorders, psychosocial distress, and occlusal stability in a treated group of adults with complete cleft lip and palate (CLP). Sixty-eight adults (44 men and 24 women) with a mean age of 24.2 years (range 19.5-29.2) with treated CLP were compared with a gender- and age-matched group with no clefts. The CLP subjects were born between 1968 and 1977 and had undergone standardised plastic surgery at the Department of Plastic Surgery, University Hospital, Linköping, Sweden. Logopaedic, phoniatric, otological, and orthodontic examinations and treatment had been provided locally, supervised by the Cleft Plate Team. The subjects answered a multidimensional, self-report, standardised questionnaire regarding psychological and somatic conditions. The subjects underwent a clinical TMD examination and an evaluation of the occlusion. The reliability of the multidimensional questionnaire was analysed for the CLP group by a test-retest study within a 2-3 week interval and most questions showed an overall good reliability. A panel of professionals judged the outcome of the surgical treatment on colour slides of the CLP subjects. The dental plaster casts of 39 subjects born with complete unilateral cleft lip and palate (UCLP) were analysed (mean age 24.7 years, range 20.2-29.3) and compared with the dental plaster casts taken at mean age of 19.1 years (range 16.0-20.6). The overall level of quality of life was rather high in both groups. The CLP group rated some detached aspects, such as life meaning, family life, and private economy, significantly lower than did the group without clefts. Overall aspects such as well-being and social life were affected by having a treated cleft but not the more practical and tangible aspects of their daily living. There was an overall high level of satisfaction with all the different part of the body in both groups, but the CLP group reported significantly more dissatisfaction with their nose, lips, mouth, profile, and overall facial appearance than the group without clefts. The professionals and the subjects with CLP were generally not very satisfied with the results of surgical treatment. Thirty of the subjects with CLP (47%) wished to have more operations. The professional group recommended further operations in 38 of the subjects (59%) in particular, rhinoplasties. The CLP group had significantly higher frequencies of cross-bite than the group without clefts, but no differences regarding TMD pain were found between the two groups. In the subjects with treated UCLP, there was a significant deterioration in the occlusal score and the maxillary arch dimensions between 19 and 25 years. This was irrespective of the type of retention. The persisting morphological malocclusion with a low frequency of interferences has had no influence on TMD symptoms in the group of CLP patients studied. The conclusion is that the CLP subjects in the present study seemed to be psychosocially well adjusted to their disability. However, 47 per cent wished to have further surgical treatment. The persisting malocclusions did not provoke TMD symptoms.

Adaptation, Psychological↗
PubMed1999

[A new approach for secondary deformities of unilateral cleft lip nose].

OBJECTIVE: The aim of this work was to correct the secondary deformities of unilateral cleft lip nose. METHODS: On the basis of patho-anatomical study and the comprehension on the cleft lip nose, a new approach to correct the secondary deformities of unilateral cleft lip nose was designed and used. During operation, an intranasal and marginal combining incision was made to explore the alar cartilages and to from a mucosal-cartilage flap in the nasal vestibule. After the deformity of septal cartilage and the abnormalities of the alar base on the cleft side were repaired, the total alar cartilage was repositioned and rotated with suspension and V-Y advancement to correct the nasal deformities. RESULTS: Since 1993, a total of 92 cases were treated by the above procedure and satisfactory results were obtained. CONCLUSION: The clinical applications showed that there were several advantages for this method, and good results can be gained by repositioning the total alar cartilage on the cleft side.

Abnormalities, Multiple↗
PubMed2001

[Bilateral cleft lip and palate: experience from a center with a multidisciplinary approach].

The aim of this work is to analyse the global experience of a center where a pluridisciplinar approach of the child affected with a cleft lip and palate is regularly done. Since january 1980 until january 2000, a total of 36 children (8 F, 28 M) with bilateral cleft lip and palate were treated. Only 5 children were born at this hospital. The others (n = 31) were referred soon after birth (24/31) or later for treat sequels. A multidisciplinary team evaluated every case. The parameters analysed were: surgical protocol, aesthetic and speech outcome, hearing disturbance, complications and the number of secondary lip surgeries. Surgical approach consisted on a soft palate closure before 3 months follow by a bilateral cheiloplasty (6 months) and a hard palate closure before 4 years of age, in the majority of cases (24/36). The esthetical result was evaluated in 25 children and was acceptable in the great majority (22/25). 16 children were submitted to tympanic draining in order to treat their secretory otitis. Speech outcome was analysed in 27 children and was good in 23. With a follow-up of 8.4 years, 15 children (8 treated soon on this center and 7 that came for their sequels) were treated for complications. There was a media of 4.5 surgeries per children.

Child, Preschool↗
PubMed2001

Recovery of DNA for forensic analysis from lip cosmetics.

To obtain a reference DNA profile from a missing person, we analyzed a variety of personal effects, including two lip cosmetics, both of which gave full DNA profiles. Further investigations were undertaken to explore this previously unreported source of DNA. We have tested a range of brands and types of lip cosmetics. Our studies have revealed that lip cosmetics are an excellent source of DNA, with almost 80% of samples giving a result. However, artifacts are frequently observed in the DNA profiles when Chelex is used for the DNA extraction and additional DNA purification procedures are required to ensure that an accurate DNA profile is obtained.

Cosmetics↗
PubMed2001

Cleft lip and palate: a review for dentists.

The goals of primary closure of cleft lip and palate include not only re-establishing normal insertions for all of the nasolabial muscles but also restoring the normal position of all the other soft tissues, including the mucocutaneous elements. Conventional surgical wisdom, which recommends waiting until growth is complete before undertaking surgical correction of the postoperative sequelae of primary cheiloplasty, carries with it many disadvantages. If, after primary surgery of the lip, orolabial dysfunctions remain, they will exert their nefarious influences during growth and will themselves lead to long term dentofacial imbalances. These imbalances can significantly influence facial harmony. Unless accurate, symmetric and functional reconstruction of the nasolabial muscles is achieved during the primary surgery, not only will the existing dentoskeletal imbalances be exaggerated, but other deformities will be caused during subsequent growth, among which the most important are nasal obstruction and mouth breathing, reduced translation of the maxilla, dysymmetry of the nose and inability of the patient to symmetrically project the upper lip

Alveolar Process↗
PubMed2001

Reconstruction of total lower lip, labial commissure and palatomaxillary defect with composite island cheek flap.

Functional and cosmetic restoration of total lower lip, labial commissure, and palatomaxillary defects can be achieved by using multiform flaps. The possibility of reconstruction of these areas with composite island cheek flap is presented. The flap was used in three patients who were surgically treated between 1993 and 1998. In one female patient, total lower lip and chin defect was restored with a small contralateral platysma muscle cutaneous flap. The functional and cosmetic result was achieved with composite island cheek flap. In the other two cases, reconstruction was performed without another flap. Composite island cheek flap is supplied with bloody by the facial artery and vein, and contains mucous membrane, muscle and skin of the cheek. In two cases, the flap was formed by the anterior part of the buccal muscle, and in the case with the reconstruction of labial commissure, the greater and lesser zygomatic muscles with levator muscle of the angle of mouth were used. By freeing the blood vessels from the surrounding structures, isolation and transsection of minor vessel branches allowed straightening of the tortuous main vessels. With this technique, excellent functional and satisfactory cosmetic results were achieved in a single act, with minimal morbidity for labial commissure, and total lower lip or palatomaxillary defect reconstruction.

Aged↗
PubMed2002

[Clinical application of a retrograde nasolabial fold island flap based on the upper lip artery].

OBJECTIVE: To explore a new method for enlarging the rotation range of the nasolabial fold flap. METHODS: We designed a retrograde nasolabial fold island flap pedicled with the upper lip artery for repairing facial defects. The anatomy of the upper lip and the vascular supply to the nasolabial skin were observed. RESULTS: All the flaps in 7 cases survived completely with satisfactory results. CONCLUSION: The retrograde nasolabial fold island flap pedicled with the upper lip artery enlarged the rotating range of the nasolabial fold flap. The flap is recommendable for its consistent pedicle and abundant vascular supply.

Arteries↗
PubMed1999

[One-time operation in infant cleft lip and palate plus alveolar process].

OBJECTIVE: To improve safety and viability of one-time operation in the therapy of cleft lip and palate and cleft alveolar process. METHODS: Under the air-vein anesthesia, one-time operations were performed in 42 patients with complete cleft lip and palate plus cleft alveolar process. After rehabilitation in ICU, all patients were put into wards, and left hospital 4-7 days after operation. RESULTS: The situation during anesthesia and operation was good. There were no statistically significant changes in blood pressure, oxygen saturation of blood, heart rate and cardiac rhythm before, during and after operation. No anesthetic accident and no complication happened. The loss of blood was about 42.7 +/- 6.5 ml and the duration of operation was about 139.2 +/- 18.6 minutes. The rehabilitation was successful after operations. First intention took place in almost all patients' incisions, and palatal fistulas appeared in only 2 cases. CONCLUSION: Under the control of provisioned pediatric anesthesia and rehabilitation, one-time complete cleft lip and palate plus cleft alveolar process closure is safe and viable.

Alveolar Process↗
PubMed2000

[Geometrical analysis of operative designs in unilateral cleft lip repair].

OBJECTIVE: To study the differences in geometric principle in cleft lip repair between Millard and Tennison-Randall's method. METHODS: The moving patterns of the peaks of cupid's bow along the cleft on both sides varied according to the operative designs respectively. On the above basis, the larger vertical distance that the peaks of cupid's bow would drop in both operative designs respectively, which were calculated under the similar clinical conditions. RESULTS: It was found that the most obvious characteristic in Millard's design is to make the rotational axle on both cupid's bow peaks along the cleft drop farther away on the horizontal direction. However the Tennison-Randall's characteristic is to make the center of the rotational axle as near as possible to the cupid's bow peaks on the vertical direction. CONCLUSION: It is concluded that Millard's design conforms to the requirement of reconstructing the lip on the physiological aspect, but Tennison-Randall's design complies more on the geometric principles, which is the reason why both methods of cleft lip repair can not be replaced by each other. And this study will make both kinds of operation designs be applied clearly and easily.

Cleft Lip↗
PubMed2001

[The study of operative design in unilateral cleft lip-repair between individual procedural method as compared to rotation advancement and triangular flap method].

OBJECTIVE: To compare the relationship and differences between individual operative procedural design with the Millard and Tennison methods in cleft lip repair. METHODS: The author specifically analyzed and compared the end point of incision on noncleft side of unilateral cleft lip in three kind of operative respectively. In addition, the operative design was discussed and found out to be more reasonable. RESULTS: The individual operative procedural design have wider indication and adaptable to change and function than Millard and Tennison methods alone from the geometrical configuration point of view. CONCLUSION: Therefore, the author conclude that the individual operative procedural design is practical and applicable than other operative design in cleft lip repair.

Cleft Lip↗
PubMed1999

[The influence of Millard-lip-repair on maxillary growth: an experiment study in rabbits].

OBJECTIVE: To study the effects of the cheiloplasty(Millard rotation-advancement lip-repair) on the maxillary growth. METHODS: Thirty Japanese white rabbits were randomly divided into three groups, Group I (unoperated control group), Group II (unrepaired control group) and Group III (repaired with Millard-lip-repair). All the animals were sacrificed and measured on the clean slulls directly at 26 weeks postoperatively (30 weeks old). RESULTS: It was found that Group III (Millard repair group) had the anterioposterior growth disturbance of maxilla than Group I and II, while the height of maxilla and width of posterior dental arch were larger than that of the two control groups for compensation, and the nasal septum of Group III deviated to the cleft side. CONCLUSION: Millard-rotation-advancement lip-repair operation has inhibitory effects on maxillary growth.

Animals↗
PubMed1976

Scanning electron microscopy of the lip denticiles of Ascaris suum adults of known ages.

Purebred Hampshire pigs, farrowed and maintained under conditions precluding extraneous helminth infection, were exposed to a single dose of 10,000 Ascaris suum infective eggs. The pigs were killed at intervals of 28, 41, 55, 86, 115, 145, 175, and 206 days after infection. At necropsy, no gross lesions were found in the lungs or livers of infected pigs. The worms were recovered from the small intestine, identified, counted, and fixed. The heads were excised, critical point dried, mounted en face, and examined by scanning electron microscopy. Worms 28 to 115 days old had unworn denticles that were triangular when viewed laterally but blunt when viewed tangentially. Wearing of the denticles was observed first with 145-day-old worms; wearing increased with age both in numbers of denticles affected and in degree of wear so that by 206 days after inoculation, almost all denticles in the center of the lip were worn. Worn denticles appear truncated when viewed from any angle. The denticles outside the central area were not affected by wear. The size of the denticles varies not only between specimens of the same age, but also on each specimen. However, average denticle size is directly related to the size and, accordingly, to the age of the worm. External to each denticle is a corresponding depression that we have called the denticular groove. One 28-day-old specimen had some extra denticles aligned irregularly along the lip; this irregularity gave the appearance of a double row. The denticles of the two subventral lips are similar to those of the dorsal and are equally affected by wear. There was no detectable difference in denticles of male and female worms. Since wear can now be specifically correlated with age, we conclude that the denticles are functional and become worn through use. Consequently, adult A. suum may be an even more injurious pathogen than heretofore supposed.

Animals↗