• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.6
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• pp.390-396
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• 2022

Cleft lip lower-lip deformity is a secondary deformity in patients who underwent primary cheiloplasty of the upper lip, characterized by an enlarged and anteriorly rotated lower lip. In these cases, soft-tissue imbalances remain even after skeletal correction with orthognathic surgery, and additional soft tissue treatment is required for lip harmony and esthetic facial balance in CLP (cleft lip palate) patients. This study describes three cases of transverse myomucosal excision of the lower lip for correction of cleft lip lower-lip deformity to restore facial esthetic balance. Each patient underwent orthognathic surgery, rhinoplasty, or upper lip revision cheiloplasty according to condition. Postoperatively, volume of the lower lip decreased and lip harmony was improved in all three patients. The surgeon should fully understand the anatomical structure around the lips and be able to evaluate overall harmony of the soft tissue. When a lower lip deformity is present, careful surgical planning and execution are important for each patient.

• Phonetics and Speech Sciences
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• v.10 no.1
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• pp.23-31
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• 2018

In this study, we examined how the upper and lower lips articulate to produce labial /p/. Using electromagnetic midsagittal articulography, we collected flesh-point tracking movement data from eight native speakers of Seoul Korean (five females and three males). Individual articulatory movements in /p/ were examined in terms of minimum vertical upper lip position, maximum vertical lower lip position, and corresponding vertical upper lip position aligned with maximum vertical lower lip position. Using linear mixed-effect models, we tested two factors (word boundary [across-word vs. within-word] and speech rate [comfortable vs. fast]) and their interaction, considering subjects as random effects. The results are summarized as follows. First, maximum lower lip position varied with different word boundaries and speech rates, but no interaction was detected. In particular, maximum lower lip position was lower (e.g., less constricted or more reduced) in fast rate condition and across-word boundary condition. Second, minimum lower lip position, as well as lower lip position, measured at the time of maximum lower lip position only varied with different word boundaries, showing that they were consistently lower in across-word condition. We provide further empirical evidence of lower lip movement sensitive to both different word boundaries (e.g., linguistic factor) and speech rates (e.g., paralinguistic factor); this supports the traditional idea that the lower lip is an actively moving articulator. The sensitivity of upper lip movement is also observed with different word boundaries; this counters the traditional idea that the upper lip is the target area, which presupposes immobility. Taken together, the lip aperture gesture is a good indicator that takes into account upper and lower lip vertical movements, compared to the traditional approach that distinguishes a movable articulator from target place. Respective of different speech rates, the results of the present study patterned with cross-linguistic lenition-related allophonic variation, which is known to be more sensitive to fast rate.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.109-112
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• 2009

Purpose: Squamous cell carcinoma(SCC) of the lower lip is the most common malignant tumor comprising 90% of all lip SCC. The typical picture of SCC of the lower lip is of an ulcerated lesion with raised margins. Surgery is the treatment of choice for SCC of lower lip. Depending on the location and size of the tumor, different types of flaps are used. We used new method - 'both buccal mucosa transposition flap' for the reconstruction of the near total mucosal defect of the lower lip. Methods: This 67 - year - old men presented with the crusted $1cm{\times}1cm$ sized ulceration of the lower lip that was arised 30 years ago. There were no size and color change, except the bleeding and ulceration. At first, We diagnosed the SCC through the incisinal biopsy. Then We performed the wide excision of the tumor and reconstruction of the lower lip. After the excision of the whole tumor, the defect was measured at $8cm{\times}3.5cm$. We designed the buccal mucosa transposition flap taking care to avoid the parotid duct. The flap was made in a triangular shape for the reconstruction of defected lower lip. The donor site defect can be sutured primarily. Results: A patient in this study had no postoperative complications such as necrosis, dehiscence, infection of the flap or donor site. Reconstructed lower lip is relatively close to that of the natural lip; More satisfactory aesthetic and functional results can be obtained by using this technique rather than other techniques. Conclusion: 'Both buccal mucosa transposition flap' is reliable method for the reconstruction of the large lower lip mucosal defect. The operation is simple and performed in one stage, with no postoperative complications. This technique can offer consistently good functional and esthetic outcomes after reconstruction of lower lip mucosal defect.

• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.52-57
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• 1996

Since the upper lip does not receive direct actinic radiation, only 5% of lip tumors develop in the upper lip, while the lower lip is the site of the remainder. Among the lower lip cancer, squamous cell carcinoma is the most common tumor, especially the vermillion border of lower lip is the most common site. The aims of reconstruction of the lip are both aesthetic effect and functional restoration and the ideal procedure must produce a aesthetically normal, not-tao-tight lip and a good sensation and muscle tone of the lip. We have a satisfactory reconstruction of a subtotal loss of lower lip after squamous cell carcinoma extirpation using Gillies fan flap and the case is presented with reviewing a many published reports.

• The korean journal of orthodontics
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• v.32 no.5 s.94
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• pp.355-360
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• 2002

After orthodontic treatment, there are several changes in soft tissue profile. Changes appear at lower anterior facial profile area, especially upper and lower lip. But there are many individual variations in the pattern of changes. So, this study was conducted to find out that the basic upper lip thickness could be one of the factors that could influence the treatment results. The samples were composed of 43 adult patients who had their 4 first premolars extracted. Groups were classified by their basic lip thickness. In group 1(thin upper lip group), there was negative relationship between mentolabial angle and lower lip change. In group 2(average lip thickness group), upper lip change was related to upper incisor change, lower incisor change, lower lip change and nasolabial angle change. And lower lip change was related to upper lip change, upper incisor change, lower incisor change. In group 3(thick upper lip group), there was no relation between both lip change and other variables.

• The korean journal of orthodontics
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• v.22 no.1
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• pp.253-271
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• 1992

The purpose of this study was to investigate the difference of EMG activity of the Orbicularis oris and Mentalis muscle between normal occlusion and class III malocclusion group during various lip position and to find out whether any correlations exist between the muscular activity and craniofacial morphology. In this study, 50 subjects with a mean age of 22.9 Years (range 20.0-26.0) were investigated (25 subjects were normal occlusion, and 25 subjects were class III malocclusion). EMG data were recorded from the Orbicularis oris and Mentalis muscle during rest lip posture, lip position at maximum biting, lip position at maximum sealing effort, lip position at chewing, swallowing and phonation with the Medelec MS-25 electromyographic machine. Lateral cephalometric radiographs was taken with the mandible in intercuspal position on all subjects. All data were recorded and statistically processed. The findings of this study can be summerized as follows: 1. In normal occlusion, the maximal mean amplitude of upper lip during the lip position at chewing was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 2. In Class III malocclusion, the maximal mean amplitude of upper lip during the lip position at chewing, swallowing and phonation was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 3. Compare to normal occlusion, the Class III malocclusion was showed low maximal mean amplitude of upper lip during rest lip posture and the lip position at swallowing of saliva, and showed great maximal mean amplitude of lower lip and meantalis muscle during the lip position at chewing and phonation. 4. In normal occlusion, the maximal mean amplitude of upper lip during various lip position was not correlated with the length and thickness of upper lip, but the maximal mean amplitude of lower lip during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip. 5. In Class III malocclusion, the maximal mean amplitude of upper lip during rest lip posture was negatively correlated with the thickness of upper lip, and the maximal mean amplitude of lower lip and mentalis muscle during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not correlated with the cephalometric measurements of soft tissue. 6. The correlation between the maximal mean amplitude of orbicularis oris and mentalis muscle and cephalometric measurements of incisors was not nearly present. 7. In normal occlusion, the maximal mean amplitude of lower lip and mentalis muscle during the lip position at maximum biting was negatively correlated with the angle between palatal plane and mandibular plane. In Class III malocclusion, the maximal mean amplitude of upper lip, lower lip and mentalis muscle during function was negatively correlated with the length of maxilla, the maximal mean amplitude of upper lip and lower lip during function was negatively correlated with the SNA and SNPo, and the maximal mean amplitude of lower lip during the lip position at chewing was negatively correlated with the ANB.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.5
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• pp.292-296
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• 2023

Generally, if the size of a lip cancer defect exceeds 30% of the lower lip, a local flap or free flap is recommended. However, defects up to 50% of the lower lip in size have been reconstructed successfully by primary closure without a local flap or free flap. In one case, an 80-year-old male farmer who had smoked for more than 50 years presented with squamous cell carcinoma of the lower lip and underwent mass resection and supraomohyoid neck dissection. The defect accounted for almost 2/3 of the lower lip and was repaired by primary closure with V-shaped resection. Biopsy results confirmed pT2N0cM0 stage II disease with clear margins. In another case, a 68-year-old male also presented with squamous cell carcinoma of the lower lip and underwent mass resection. The defect accounted for about half the size of the lower lip but was repaired by primary closure with V-shaped resection. Both patients experienced no discomfort while eating or speaking and were satisfied with the cosmetic and functional outcomes with no evidence of recurrence. Thus, direct closure can be considered even in large lower lip cancers.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.185-188
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• 2000

The goals of lip reconstruction are to provide oral competence, adequate support for the lower lip, contour restoration, adequate lip sulcus, and adequate oral aperture. The composite radial forearm palmaris longus free flap is thin enough that it can be folded onto itself without a significant increase in bulk. The flap is easy to dissect, the pedicle contains long vessels of large diameter, and the skin is a good color and texture match for the perioral region. Moreover, the vascularized tendon can be used for lower lip reconstruction. This makes the flap ideally suited for total lower lip reconstruction. We experienced the case of total lower lip excision and reconstruction with the radial forearm free flap including palmaris longus tendon, so we reported that case with literature. The patient has a lower lip squamous carcinoma(T3NIM0), and performed a total lower lip excision with right modified radical neck dissection and left extended supraomohyoid neck dissection, and a reconstruction with radial forearm free flap includng palmaris longus tendon. The oral competence and masticatory function were nearly normalized and cosmetical result was very acceptable.

• Archives of Craniofacial Surgery
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• v.22 no.6
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• pp.324-328
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• 2021

Lip defects often occur following wide excision as a surgical treatment for squamous cell carcinoma of the oral cavity. Defects larger than one-half of the lip cannot be closed primarily and require flap surgery. Reconstruction of the oral sphincter function can be achieved by means of a local flap using the like tissue, rather than with a free flap utilizing different tissues. A defect of the lower lip requires reconstruction using different techniques, depending on its size and location. Herein, we present the case of a patient exhibiting a lip defect spanning more than two-thirds of the lower lip, after a wide resection due to squamous cell carcinoma. The defect was reconstructed using an Abbe flap and a staircase flap. Revision was performed after 16 days. The patient's oral competencies were fully restored 3 months postoperatively, and the esthetic results were ideal. Based on our experience, a combination of the Abbe and staircase flaps can produce excellent functional and esthetic outcomes in the reconstruction of a lower lip with a large defect. It can serve as a reliable reconstruction option for defects spanning more than two-thirds of the lower lip, not including the oral commissures.

• The korean journal of orthodontics
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• v.25 no.5 s.52
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• pp.627-634
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• 1995

The purpose of this study to analyze characteristics of soft tissue profile in Korean young adults. The sample consisted of 50 young adults (25 males and B females) who had pleasing and normal occlusion. Soft tissue analysis (facial convexity angle, nasolabial angle, H-angle, Z-angle, E-line to upper lip, lower lip, Sn-pog' to upper lip, lower lip) was performed on lateral cephlograms. Mem and standard deviation was obtained. When compared by other studies, mean profile of this sample was relatively straighter and both the upper and lower lips was more protrusive.