• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.23-26
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• 2023

Lower lip reconstruction in cases with a full-thickness defect over one-third of the vermilion is challenging. Numerous conventional techniques have been applied with unsatisfactory surgical outcomes because of microstomia and oral commissure blunting due to shortened horizontal lip length. Herein, we present a case in which a full-thickness lower lip defect of more than one-third of the horizontal lip length was covered with a novel mucosal roofing flap reconstruction to minimize the loss of horizontal lip length and to preserve mouth opening. No recurrences or metastases were observed during 3 years and 6 months of follow-up, with horizontal lower lip length maintained and mouth opening of 2.5 finger breadths.

• Archives of Craniofacial Surgery
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• v.20 no.4
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• pp.265-269
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• 2019

Congenital hypoplasia of the depressor anguli oris muscle is a rare cause of asymmetrical crying facies in newborns. The clinical manifestations range from mild to severe asymmetry and may persist up to adulthood. In the current case, the patient did not exhibit other congenital anomalies or paralysis of other branches of the facial nerve. This adult patient presented with severe asymmetrical lower lip deformity during full mouth opening since birth. A chromosomal study for the detection of 22q gene deletion yielded negative results. The electromyography findings of the lower lip were insignificant. Depressor labii inferioris muscle resection was not effective, but bidirectional (horizontal and vertical) fascia lata grafting improved the aesthetic appearance of the asymmetrical lower lip. The patient showed improved lower lip symmetry during full mouth opening at 1 year after the surgery. Therefore, the details of this rare case are reported herein.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.168-174
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• 2005

Reconstruction of the lower lip requires consideration of several factors. There should be retained sensation, maintenance of oral sphincter function, and a large enough opening for the mouth. In addition, it is important to achieve an aesthetically acceptable appearance. Webster's modification of Bernard operation is one of good methods which satisfy above mentioned goals. The purpose of this article is to present the results and review the perioperative problems after reconstruction of the lower lip by this operation. We reviewed seven patients after surgical reconstruction by the same method between January of 1996 and December of 2003. Five patients were male and two were female. The mean follow-up period was 15 months. We obtained functionally and cosmetically acceptable appearance after reconstruction. Most of the reconstructed lower lips were large enough for full mouth opening, but one patient required additional commissuroplasty, and one other patient was treated with wound revision for dehiscence resulting from protrusion of mandibular lateral incisor tooth. All other patients accepted their facial appearance. In conclusion, careful planning and consideration for dental problems and proper closure tension may ensure satisfactory outcome & lower lip competence, when using this modified operative method for lower lip reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.49-54
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• 2011

A case of Behcet's syndrome found in a 22 years old male was is reported along with the histological and immunohistochemical studiesfindings. He The patient had had received prolonged medical therapy of anti-inflammatory agents for the conjunctival ulcer, genital ulcer, oral ulcer, and intestinal ulcers since the first onset of the Behcet's syndrome about approximately 7 years agoearlier. Recently, he felt the athickening of both corners of his lip causing that caused mouth opening difficultydifficulties. A plastic rReconstructive surgery was performed to enlarge the size of the oral orifice by multiple Z-plasty incisions, and finallywhich resulted in proper enlargement of the circumferential length of the lip. During the operation, a scar-like thick fibrous tissue was obtained and examined pathologically. In theThe microscopic observation the revealed the submucosal lesion was to be diffusely fibrosed with the a distribution of sclerotic collagen bundles. Particularly, sSeveral foci of collagen degeneration were found observed in the deep connective tissue, and the degenerating collagen bundles were gradually lost their fibrillar appearance. In the immunohistochemical observations, the foci of collagen degeneration was were strongly positive for IgK, but almost negative for TNF${\alpha}$ lysozyme, and MMP-3. Taken together, it was presumed that tThe submucosal fibrosis was presumed to have firstly presented in this study was probablybeeninduced by the prolonged anti-inflammatory therapy, which may inhibit the removal of sclerosed collagen bundles by the cell-mediated immunity and proteolytic digestion of macrophages, and that it was secondarily aggravated by the deposition of immunoglobulins derived from an autoimmune origin. Therefore, even after the successful plastic surgery of the lip to ameliorate the mouth opening difficulty, the recurrent submucosal fibrosis of lip should be carefully managed in the follow-up treatment.

• Speech Sciences
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• v.11 no.2
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• pp.193-210
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• 2004

In this paper, we develop a real time lip-synch system that activates 2-D avatar's lip motion in synch with an incoming speech utterance. To realize the 'real time' operation of the system, we contain the processing time by invoking merge and split procedures performing coarse-to-fine phoneme classification. At each stage of phoneme classification, we apply the support vector machine (SVM) to reduce the computational load while retraining the desired accuracy. The coarse-to-fine phoneme classification is accomplished via two stages of feature extraction: first, each speech frame is acoustically analyzed for 3 classes of lip opening using Mel Frequency Cepstral Coefficients (MFCC) as a feature; secondly, each frame is further refined in classification for detailed lip shape using formant information. We implemented the system with 2-D lip animation that shows the effectiveness of the proposed two-stage procedure in accomplishing a real-time lip-synch task. It was observed that the method of using phoneme merging and SVM achieved about twice faster speed in recognition than the method employing the Hidden Markov Model (HMM). A typical latency time per a single frame observed for our method was in the order of 18.22 milliseconds while an HMM method applied under identical conditions resulted about 30.67 milliseconds.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.244-248
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• 2012

Many types of upper lip reconstruction have been introduced to treat defects after a tumor excision or trauma. The authors treated two cases of upper lip defects. A 35-year-old woman presented with a squamous cell carcinoma of the left upper lip that had invaded the corner of the mouth. After resecting the tumor, the defect was $3.7{\times}3.5cm$ in size. A 52-year-old woman presented with a dog bite of the right upper lip. The defect measured $4.0{\times}2.2cm$ in size. The two cases were reconstructed by combined rotation and advancement of a cheek flap. This technique produced a good functional outcome that allowed for oral competence and created an opening of adequate size. A combination of rotation and an advancement flap can be used to treat upper lip defects in a single-stage procedure. This approach produces a good functional and cosmetic outcome.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.2
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• pp.133-139
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• 2004

Congenital bilateral idiopathic hyperplasia of the coronoid processes presents with limited mouth-opening without visible maxillofacial deformity or temporomandibular joint dysfunction / disorder. According to Blanchard et al and McLoughlin et al, it was lnitially described in 1853 by Langenbeck, and the first cases were reported by Holmes in 1956. Since then, there have been regular reports of a certain number of cases. In 1995, McLoughlin et al recorded 79 published cases of bilateral hyperplasia of the coronoid processes. Among them, Fabie et al have found only 3 published cases relating to children younger than 8 years, and have presented the first case of objectively diagnosed restricted mouth opening from birth by pediatricians. Authors have experienced 2 child patients with mouth opening limitation who was diagnosed congenital bilateral idiopathic hyperplasia of the coronoid processes without any other TNJ morphology in Dept of Oral and Maxillofacial surgery, Seoul National University Dental Hospital in 2004. Coronoidectomy was performed and postoperative active mouth opening exercise is indicated. Authors report 2 cases of congenital bilateial idiopathic hypeiplasia of the coronoid processes with literature liview.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.73-76
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• 2011

Purpose: Congenital midline upper lip sinus is a rare lesion. There are two postulates that can account for the formation of the upper lip sinus based on two major theories of the development of the face: the fusion theory and the merging theory. However, congenital midline lower lip sinus is very rarely reported and described. We report a case of a congenital midline sinus of the lower lip in a 6-year-old female. Methods: A 6-year-old girl presented with a nipple like swelling on the midline lower lip. Physical examination revealed about $5{\times}5$ mm protruding round mass with a just small opening that was non-tender to palpation. The mass was not associated with any skin changes. It umbilicated at the apex and contains a fistulous tract, discharging clear fluid. Only, simple radiologic finding shows bony spur on the lower one third of mandibular symphsis. Results: A small transverse ellipse is made around the opening and elevated mass with sharpe dissection. The tract is excised using the probe and dye as the guide. The tract was extended to periosteum of the lower one third of the mandible. The tract and involved periosteum were excised en bloc, and removed protrusion of the mandibular bone using diamond burr. Microscopic examination of the resected sinus revealed the fistulous tract itself, consisting of fibrous connective tissue covered with cornified stratified squamous epithelium, was observed in the center of the sample. In 6 months follow-up, This patient had a good result was obtained by the method of fistulectomy alone. Conclusion: Midline cranoifacial fistulas represent rare lesions resulting from abnormal fusion of embryologic structures. Our case report describes the excision of a congenital midline sinus of the lower lip in a 6-year-old female. This case represents the first report of a lower lip sinus presenting in a girl as a mass in the skin of the chin with extension to the midline of the mandible. However, the etiology of this rare congenital sinus remains obscure.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.4
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• pp.516-530
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• 1999

The current clinical technique for occlusal vertical dimension recording is based on marking the skin reference points on the patient's face and measuring between these points using caliper-like device. And it is difficult to achieve reliable measurements by this technique because of movable soft tissue. The purpose of this study is to reveal the stability of skin reference points by comparing the relative movement between extra-oral skin reference points and intra-oral reference points using X-ray fluoroscope. 10 test subjects were divided into 2 groups : Group I (natural dentition) and Group II (denture-wearer whose vertical dimension was lost) and Group III consists of identical test subjects to Group II with their upper denture removed and record base inserted. Attaching the 3 mm diameter steel ball to nose tip, lower lip, chin and to existing denture (or record base), fluoroscopic examination and recording were taken during 2 jaw opening and closing movements. After subsequent digitization using personal computer, 1219 still pictures with 0.1 second interval were made. Using the 2 dimensional graphic software, measurements between reference points were executed. Dividing the entire jaw movement into 3 ranges (total, 1st half opening, 2nd half opening), rate of movement and relative movement between extra-oral and intra-oral reference points were calculated and statistically analyzed. The results of this study are as follows. 1 Within the same experimental group, no statistical difference was found in the stability of skin reference between lower lip point and chin point during total range of jaw opening and closing movement (p>.05) 2. In the first half range of jaw opening, statistical difference was found between Group I (natural dentition) and Group II (denture wearer) (p<.05) Group I has greater skin reference stability than Group II. 3. In the first half range of jaw opening, statistical difference was found between Group I and Group III (record base wearer) (p<.05). Group I has greater skin reference stability than Group III. 4. In the first half range of jaw opening, no statistical difference was found in the stability of skin reference between Group II and Group III (p>.05). 5. In the second half range of jaw opening, no statistical difference was found in the stability of skin reference between any experimental groups (p>.05). 6. In patients with their occlusal vertical dimension lost, employing other measuring references rather than skin is recommended because of low stability.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.4
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• pp.380-385
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• 2008

Microstomia can be occurred as a result of direct injury to tissues such as chemical, thermal and electrical burns, and animal bites. It also may be secondary to contracture of burned perioral skin, or may result from scarring after reconstructive lip surgery. Narrowing of the oral aperture is not only disfiguring, but also limiting the oral access needed for introduction of food, insertion of dentures, oral hygiene, and dental treatment. Limited mouth opening may also interfere with mastication and speech. Few reports exist regarding correction of microstomia and reconstruction of the corners of the mouth. A 16-year-old girl with a bilateral cleft lip and palate presented with the limited mouth opening (approximately 20 mm), the esthetic problem due to the small lip, and the cleft lip-nasal deformity. The microstomia was corrected by bilateral commissuroplasty using "over and out" buccal mucosa flaps proposed by Converse. The intercommissure distance was increased from the preoperative 40 mm to the postoperative 60 mm. The one-year postoperative intercommissure distance was 54 mm, because the 6 mm relapse was occurred. The bilateral commissuroplasty using "over and out" buccal mucosa flap could increase the width and general size of the oral aperture and improve the lip appearance.