• Title/Summary/Keyword: Lower lip

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Unilateral cleft lip: evaluation and comparison of treatment outcome with two surgical techniques based on qualitative (subject/guardian and professional) assessment

  • Adetayo, Adekunle Moses;Adetayo, Modupe Olushola;Adeyemo, Wasiu Lanre;James, Olutayo O.;Adeyemi, Michael O.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.3
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    • pp.141-151
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    • 2019
  • Objectives: The outcomes of the treatment of unilateral cleft lip can vary considerably due to variations in repair techniques. The aim of this study was to evaluate and compare treatment outcomes of surgical repair of unilateral cleft lip using either the Tennison-Randall or Millard technique based on (qualitative) parent/subject and professional assessments. Materials and Methods: This was a prospective, randomized, controlled study conducted at Lagos University Teaching Hospital between January 2013 and July 2014. A total of 56 subjects with unilateral cleft lip presenting for primary surgery who satisfied the inclusion criteria were recruited for the study. Subjects were randomly allocated to surgical groups A or B through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard rotation advancement technique. Surgical outcome was assessed using qualitative evaluation by the guardian/subject and independent assessors based on a modified form of the criteria described by Christofides and colleagues. Results: Of the 56 subjects enrolled in this study, 32 were male, with a male to female ratio of 1.3:1. Fifteen of the guardians/subjects in the Tennison-Randall group were most bothered about the lower part of the residual lip scar, while 12 guardians/subjects in the in the Millard group were most bothered about the upper part of the scar. More noses were judged to be flattened in the Millard group than in the Tennison-Randall group. Assessors observed a striking disparity in scar transgression of the philtral ridges between the two groups. Conclusion: Essentially, there were no major difference in the overall results between Millard rotation-advancement and Tennison-Randall repairs. Both Millard and Tennison-Randall's techniques require significant improvements to improve the appearance of the scar on the upper part and lower part of the lip, respectively.

A Case of Myxoid Nerve Sheath Myxoma of the Lower Lip (아랫입술에 발생한 점액양 신경초 점액종 1예)

  • Park, Taejung;Kim, Boyoung;Choi, Sohee
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.63-65
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    • 2015
  • Nerve sheath myxoma is a benign tumor of the peripheral nerves that rarely occurs in the lip area. Among the few reported cases, no lesion has previously been reported on the lip in Korea. We report a case of nerve sheath myxoma occurring on the lip of a 34 year-old woman with a brief review of the literature.

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Evaluation of facial appearance in patients with repaired cleft lip and palate: comparing the assessment of laypeople and healthcare professionals

  • Alhayek, Samar;Alsalem, Mohammed;Alotaibi, Yazeed;Omair, Aamir
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.5.1-5.5
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    • 2019
  • Background: The present study aimed to determine whether laypeople and professionals rate the facial appearance of individuals with repaired complete unilateral or bilateral cleft lip and palate (UCLP, BCLP) similarly based on viewing full facial images. Methods: The study followed a cross-sectional analytical design where five young patients aged 10 to 14 years, who had completed all stages of their unilateral or bilateral cleft lip and palate treatment (bilateral: three, unilateral: two), were evaluated by two groups. The assessment was done by laypeople and 97 qualified professionals (33 orthodontists, 32 plastic surgeons, and 32 oral and maxillofacial surgeons). Professionals were not involved in any stage of the patients' treatment. Results: The facial appearance assessment of the professional groups on different facial aesthetics was significantly lower than that of laypeople, and they had higher perceived need for further treatment. On the other hand, laypeople had higher aesthetic ratings and lower perceived need for further treatment. Differences were also observed between the assessments of the professional groups. Participants who had lower aesthetic assessments of the repair tended to report a higher influence of cleft lip and palate on social activities and professional life. Conclusion: Differences in perception exist between healthcare professionals and laypeople. The discrepancies between the professional groups could be attributed to different treatment modalities and protocols.

Successful Surgical Treatment of Severe Lower Lip Avulsion in Two Cats

  • Jang, Kwangsik;Chae, Yangwon;Yang, Euisin;Jo, Hyun Min;Shim, Kyung Mi;Bae, Chunsik;Kang, Seong Soo;Kim, Se Eun
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.264-271
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    • 2022
  • Two Korean short-haired cats were admitted to the Veterinary Medical Teaching Hospital, Chonnam National University, with severe lower lip avulsion. In the first case, the treatment was performed using the tension-free suture technique with rubber tube stents. The second case was treated using the tension-free suture technique with rubber tube stents for lip avulsion and using the cerclage wiring technique for alveolar fracture. The teeth around the alveolar fracture were extracted and bone graft and collagen membrane were applied at the alveolar fracture site to stabilize the mandibular alveolar fracture. Thereafter, the cerclage wire was placed circumferentially around the mandible. In both cases, normal function of the oral cavity was successfully recovered by repairing the anatomic abnormality. In conclusion, tension-free suture technique can be a treatment option for bilateral lower lip avulsion in cats.

Correction of Secondary Cleft Lip Deformities by Scar Excision and Abbe Flap Coverage: Photogrammetric Analysis (이차구순열변형에서 상순반흔제거술 후 Abbe 피판을 이용한 재건: 사진계측학적 연구)

  • Han, Ki-Hwan;Kwak, Min-Ho;Yeo, Hyeon-Jung;Kwon, Hyuk-Joon;Kim, Jun-Hyung;Son, Dae-Gu
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.747-754
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    • 2011
  • Purpose: The Abbe flap procedure has been used to correct disharmony of the upper and lower lips as well as for making a philtrum for patients with secondary cleft lip deformities. But the Abbe flap procedure adds two scars in addition to the prior operative scar on the upper lip. This study was conducted to determine the treatment outcomes of esthetic subunit excision of the scar on the philtrum and Abbe flap coverage for correction of cleft lip deformities with photogrammetric analysis. Methods: This study investigated a total of 11 patients with cleft lip deformities who underwent scar excision with Abbe flap coverage, and the patients were followed up for at least 6 months. Under general anesthesia, a mushroom-shaped Abbe flap was drawn on the lower lip with a width of 8 mm and a height 1~2 mm longer than that of the philtral midline. The epidermis and dermis of the scar on the upper lip were excised. In the cases with alar base depression, the orbicularis oris muscle was split vertically and transposed to the alar base. The Abbe flap was harvested as a pedicled flap containing a small amount of muscle and this was rotated 180-degree to be inserted into the upper lip. Mucosa, muscle, subcutaneous tissue and skin were closed in layers. The flap was divided at the 7~14 postoperative day. The postoperative outcomes were evaluated by using photogrammetric analysis. Three indices were measured from the standard clinical photographs taken before and after the surgery. For anthroposcopic assessment, observers described the postoperative outcomes using an ordinary scale method. Results: The postoperative values obtained in the photogrammetric analysis showed improvement as compared with the preoperative ones. Improved anthroposcopic outcomes were also noted. Conclusion: Scar excision and Abbe flap coverage were proven to be effective in improving protrusion and the height of the upper lip, the scar of the upper lip and the symmetry of Cupid's bow and the philtral column, as well as formation of the philtral dimple.

The Reconstruction of the Lip Defect due to Electrical Burn (Case Report) (전기적화상에 의한 구순결손의 재건-증례보고-)

  • Min, Byung-Il;Kim, Byeong-Rin;Kim, Kyoung-Won;Park, Jin-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.3
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    • pp.63-67
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    • 1990
  • Electrical burns of the lips are most frequently seen in small children, who are apt to chew on electrical cord or plug, the ends of extension cords in their mouth, saliva creates a short circuit across the terminals within the plug, causing an electrical burn. Tissue destruction with electrical burns is sudden and extensive. Extensive, deep coagulation necrosis is instaneously produced by the extreme temparatures of electrical arc. If the child is well grounded, the circuit flow through his body may cause cardiac arrest. The purpose of this report is to document two cases of electrical lip burn and reconstruction of the lip defect with some local flap techniques. For case 1, Z plasty & V-Y plasty and lengthening of the commissure and in case 2, Abbe flap technique was used and scar was revised later. Z-plasty and V-Y plastry were used for scar release and Abbe flap was designed on lower lip to meet the need of upper lip. For short of right lip width, lengthening of the commissure was done. We are to report the improvement with forementioned operation on the patient of electrical burn upon the lip.

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A clinico-statistical study of soft tissue changes of upper lip & nose following Le Fort I maxillary movement (Le Fort I 상악골이동술 후 상순과 비부의 연조직 변화에 대한 임상통계학적 연구)

  • Park, Jong-Oh;Lee, Sang-Chull
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.310-318
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    • 2000
  • The purpose of this study was to assess the soft tissue changes of upper lip & nose using 38 patients who treated with Le Fort I osteotomy for the correction of dentofacial deformities. Patients were devided into three groups. One was advancement group of maxilla(Group I, N=14), another was impaction group of maxilla(Group II, N=12) and the other was combination group(advancement & impaction)(Group III, N=12). Preop. and 1 month postop. (T1), preop. and 6 months postop.(T2) were analyzed and compared. The results obtained were as follows : 1. The upper lip thickness(UL-VP) moved anteriorly approximately 62% of the horizontal maxillary change and this was significant in the advancement group(Group I) 2. The upper lip length(Stm-Sn) and the lower border of upper lip(Stm) moved superiorly 25%, 40% of the maxillary impaction group(Group II) (P<0.05) 3. There was significancy in the upper lip thicness(UL-VP) approximately 56% of the combination group(Group III) (P<0.05) 4. The nasolabial angle decreased in all groups, but there were no significancy.

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SECONDARY CHEILORHINOPLASTY OF BILATERAL CLEFT LIP AND NOSE DEFORMITIES (양측성 구순 비변형 환자의 이차 구순비성형술)

  • Kim, Jong-Ryoul;Hwang, Dae-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.5
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    • pp.422-428
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    • 2007
  • The columella, nasal tip, lip relationship in the secondary bilateral cleft deformity remains an enigma and a great challenge for the cleft surgeon. A subset of patients with bilateral cleft lip still require columellar lengthening and nasal correction, despite the advances in preoperative orthopedics and primary nasal corrections. An approach to correct this deformity is described. This consists of 1) lengthening the columella, 2) open rhinoplasty, allowing definitive repositioning of lower lateral cartilages, ear cartilage grafting to the tip and columella when necessary, 3) nasal mucosal advancement, 4) alar base narrowing and 5) reconstruction of the orbicularis oris as required. In surgical repair of the cleft lip nose, the timing of the operation(during lip closure, before or after the puberty growth sput), and the operative technique play a key role in the final result. In this study, 13 cleft lip patients who had undergone a secondary cheilorhinoplasty at the Department of Oral and Maxillofacial Surgery, Pusan National University Hospital were evaluated to check the proper time and method of the operation.

Tongue-Lip Adhesion Using an Alveolar Protector Appliance for Management of Pierre Robin Sequence (피에르 로빈 연속증의 치료로써 치조 보호 장치를 이용한 혀-하순 유착술)

  • Lee, Jang-Won;Park, Beyoung-Yun
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.547-551
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    • 2011
  • Purpose: Pierre Robin sequence is a congenital malformation in which micrognathia causes glossoptosis and airway obstruction. If conservative treatment fails, surgical procedures such as tongue-lip adhesion can be performed. However, this procedure remains a subject of debate, with favorable results being countered by reports of complications. To overcome the above limitations, we revised the traditional method of tongue-lip adhesion using an alveolar protector. Methods: Between 1992 and 2011, a total of eight patients were identified with Pierre Robin sequence and were treated with tongue-lip adhesion. Two of these eight tongue-lip adhesion procedures were performed with an alveolar protector. The operative technique for tongue-lip adhesion was similar to that described in other published reports. The alveolar protector was inserted between the ventral surface of the tip of the tongue and the lower labial sulcus. Results: Tongue-lip adhesion failed in two patients because of wound dehiscence. The primary surgical success rate was 66.7%. In the two tongue-lip adhesion procedures performed with the alveolar protector, we observed no postoperative complications. Conclusion: Resistance to traction of the tongue can be encountered with nonunionized symphysis menti, causing loosening of the traction suture through the symphysis menti. This can lead to backward positioning of tongue, resulting in dehiscence of tongue lip adhesion. The alveolar protector is a good adjunct to tongue-lip adhesion because this method avoids postoperative loosening of the traction suture and wound dehiscence. It is a simple and effective auxiliary method that yields functional improvement.