• Archives of Plastic Surgery
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• v.35 no.5
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• pp.574-580
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• 2008

Purpose: Philtral deformity is a stigma of secondary cleft lip nose. It occurs from the false arrangement of orbicularis oris muscle and the scar of previous operation. Various methods have been used to correct this deformity. We successfully corrected philtral deformity using overlapping of orbicularis oris muscle flap. Methods: From November 2000 to August 2007, we performed 39 cases of correction of philtral deformity in secondary cleft lip nose with overlapping of orbicularis oris muscle flap. Their age ranged from 5 to 53 years old. Existing scar tissue of previous operation was deepithelialized and preserved as scar flap. Lateral orbicularis oris muscle flap was elevated, advanced and overlapped upon medial muscle flap after dissection of orbicularis oris muscle of both sides. Reconstruction of philtral column was made from overlapping area by fixation of end part of lateral muscle flap to the point between philtral dimple and column. The degree of muscle flap advancement was decided by correction state of lateral muscle bulging. Correction of nostril floor depression or whistle deformity was also performed with preserved scar flap, if necessary. Results: Realignments of orbicularis oris muscle were possible in the majority of the patients and final results of philtral reconstruction were satisfactory mostly. Correction of nostril floor depression and whistle deformity was also achieved. Additional correction was performed later to 4 patients in whom insufficient reconstruction was noted. No significant complication was observed. Conclusion: More natural and symmetric philtrum was acquired with overlapping of orbicularis oris muscle flap. To the authors' knowledge, it is an easy and effective method for correction of philtral deformity through anatomical rearrangement of distorted orbicularis oris muscle with relatively simple procedure.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.16.1-16
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• 1982

The lips play an important role of passage of food as well as articulation and production of intelligible speech. So, the orbicularis oris muscle which composes the lip must act as a sphincter for the right structure. Also, the muscle conforms to the shape of the lips to make words. The surrounding cheek muscles antagonize and synergize to position the orbicularis oris sphincter. It is highly significant from the standpoint of reconstruction that the surrounding muscle can be separated from the orbicularis oris muscle without loss of sphincteric competence as long as the facial nerves and vessels remain intact. The authors performed the reconstruction of a lower lip defect due to human bite and achieved an excellent result from a functional and cosmetic aspect. This report with the literature is herewith submitted.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.55.1-55.7
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• 2019

Background: Transverse facial clefts are Tessier's number 7 facial cleft among numbers 1-15 in Tessier's classification of craniofacial malformations, which varies from a simple widening oral commissure to a complete fissure extending towards the external ear. Case presentation: In a patient with a transverse facial cleft, to functionally arrange the orbicularis oris muscle and form the oral commissure naturally, we performed a surgical procedure including orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty. Conclusion: We achieved good results functionally and esthetically by orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty. The surgical modality of our anatomical repair and 3 months follow-up results are presented.

• Archives of Plastic Surgery
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• v.40 no.1
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• pp.62-65
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• 2013

The philtrum plays a key role in the appearance of the upper lip and nostril sill. Therefore, construction of the philtrum is crucial for attaining a natural appearance of the upper lip. We used a flipping myoplasty of the orbicularis oris muscle on a patient with a flat philtrum in order to effectively reconstruct the philtral dimple and column. A 35-year-old female presented to our department with the complaint of a flat upper lip. A superficial layer of the orbicularis oris muscle on the median aspect of the upper lip was vertically incised and elevated to a thickness of 2 mm. Both sides of the elevated muscle flap were then folded to the lateral sides so that the border could be sutured onto the outer portion of the orbicularis oris muscle. The patient was observed for one year postoperatively. Her philtrum deepened by 1.25 mm, with the central angle of her Cupid's bow improving from a preoperative measurement of $146^{\circ}$ to $128^{\circ}$ postoperatively. In a patient with an indistinct philtrum, a flipping orbicularis oris myoplasty was performed to attain a definite philtral column and a philtral dimple. Natural upper lip movement was maintained, and an aesthetically and functionally satisfactory reconstruction was achieved.

• Archives of Plastic Surgery
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• v.38 no.2
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• pp.143-147
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• 2011

Purpose: A Tessier classification number 7 cleft is an uncommon malformation that results from a failure of mesenchymal fusion within the maxillary and mandibular prominences of the 1st pharyngeal arch. Many operative techniques of the number 7 cleft repair have been proposed to restore function and improve aesthetics. Fifteen patients underwent repair of a number 7 cleft over 13 years by a modification of the surgical Technique, and an appraisal of the operative outcome is reported herein. Methods: A retrospective review was conducted involving 15 patients with number 7 clefts who underwent surgery from 1996 to 2009. The changes in surgical technique included skin closure, attachment of the orbicularis oris muscle, and position of the repaired commissure; the changes were analysed with a review of the medical records and the outcomes of surgery were analysed via photographs. Specifically, the technique of skin closure was changed from the a Z-plasty to a linear closure, the orbicularis oris muscle overlapped attachment was replaced by a side-to-side approximation with horizontal mattress sutures, and the position of the repaired commissure was changed from 1 mm laterally to 1 mm medially in reference to the non-cleft side. Results: A Z-plasty caused additional cutaneous scarring, an overlapped attachment of the orbicularis oris muscle caused a thick oral commissure, and the repaired commissure migrated to the lateral side, so a 1 mm, laterally-positioned commissure caused asymmetry. The altered procedure included a linear skin closure, a side-to-side orbicularis oris muscle approximation, and a 1 mm, medially-positioned commissure, which together resulted in a good outcome. Conclusion: The altered procedure for repair of a number 7 cleft as described herein, yields a short scar, no functional problems with the orbicularis oris muscle, a thin oral commissure, and symmetry of the repaired commissure.

• The korean journal of orthodontics
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• v.20 no.1
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• pp.23-45
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• 1990

It is the aim of this study to determine the effects of facial denervation on physiological properties of facial muscles and facial bones in growing rabbits. Experimental animals of fifty two Oryctolagus cuniculus rabbits were employed. Unilateral dissection of facial nerve was carried out on twelve rabbits, bilateral dissection of facial nerve was made on another twelve rabbits and the other twenty rabbits were on unilateral dissection of facial nerve for the histochemical analyses. Six rabbits on the bilateral surgical sham operations and six rabbits of non-intervention served the control groups. EMG records of the orbicularis oris, buccinator and masseter muscles as well as lateral and dorsoventral cephalometric films were taken and analyzed at 0, 1, 2, 5 and 8 weeks respectively. The orbicularis oris, buccinator and masseter muscles of both sides were removed from the animals of the histochemistry group and muscle fibers were classified on the basis of histochemical staining for $\alpha$-GPD, NADH-D and myosin ATPase. EMG activities of orbicularis oris and buccinator muscles were vanished immediately after denervation. Recovery of activities were detected one week after denervation in buccinator and five weeks in orbicularis oris muscles. Histochemical properties of masseter muscles remained as fast glycolytic through the experimental period. Orbicularis oris muscle fibers showed the gradual diminution of size and ratio of the slow oxidative fibers accompanied with atrophy, phagocytosis and vacuolation as well as the augmentation of fast oxidative glycolytic fibers. The buccinator muscle manifested the augmentation of fast oxidative glycolytic fibers at five weeks of experiment. Visual changes in morphology of craniofacial area were not evident, however it variety of subtle changes were apparent from statistical analysis of cephalometric measurements. It is concluded facial nerve regulates the physiological properties of facial muscles and interrelation between the function of the facial muscles and changes of facial bones would be in some degrees.

• Journal of Acupuncture Research
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• v.33 no.4
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• pp.93-100
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• 2016

Objectives : To find an acupuncture point where more exact Surface Electromyography(SEMG) measurement can be drown, through the study of measurement of orbicularis oris. Methods : Of healthy people from 19 to 40 years of age, who did not fall under exclusion criteria (22 males and 22 females), were selected as subjects, after relaxation for 10 minutes, and they were told how to pronounce 'O' and 'U' with their lips puckered. The SEMG figures were measured with attaching disposable electrode on acupuncture point of right-and-left Hwaryo(LI19) and 1 cun away from Seungjang(CV24) on both sides when the subjects pronounced 'O' and 'U'. Results : The average value was highest on left 1 cun away from Seungjang(CV24) in pronouncing 'O' and 'U', and the average SEMG value was higher in the order of right 1 cun away from Seungjang(CV24), right Hwaryo(LI19), left Hwaryo(LI19). Average of the lower orbicularis oris is statistically higher than that of the upper orbicularis oris, which has significant meaning. However, there was no significant difference when compared by pronunciation. Average of percentage mark of differences of right-and-left measured value of each pronunciation and each acupuncture point : Pronounced 'O' and the upper part of orbicularis oris: $16.76{\pm}11.29%$, pronounced 'O' and the lower part of orbicularis oris: $22.41{\pm}12.92%$, pronounced 'U' and the upper part of orbicularis oris: $17.10{\pm}9.89%$, pronounced 'U' and the lower part of orbicularis oris : $19.20{\pm}10.82%$. Conclusion : The difference of pronunciation will not affect the results in SEMG measurement. In addition, the average of the lower orbicularis oris is statistically and significantly higher than that of the upper orbicularis oris.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.5 no.1
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• pp.22-28
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• 1994

Previous studies reveal that in English there is no EMG evidence fur the feature tense-lax distinction. The technique of electro-myography(EMG) was used to see if the existing claim holds true, particularly in unstressed syllable. It was found that in unstressed syllable, the peak EMG amplitude from the orbicularis oris superior muscle was significantly greater in /p/ than in /b/, while in stressed syllable this difference was negligible. It was hypothesized that in stressed syllable, /p/ and /b/ may be differentiated by the EMG activities from a muscle other than the orbicularis oris superior muscle, e.g. the respiratory muscles relating to 'aspiration' or depressor anguli oris muscle. In Korean, there was a clear labial gestures for the feature tense-lax distinction. The phoneme-sensitive manifestation of stress and some possible reasons for the inter-speaker variability in the data and the variability within a given speaker were discussed.

• 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.

• The korean journal of orthodontics
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• v.25 no.2 s.49
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• pp.175-185
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• 1995

This study was undertaken to investigate the activities of genioglossus and orbicularis oris muscle between normal occlusion and anterior open bite group. 39 subjects without the experience of orthodontic treatment and T.M.disorder were selected for this study. 20 subjects were normal occlusion. 19 subjects were anterior open bite. The twenty items were measured from the cephalometric headplates, and EMG recording of the genioglossus, orbicularis oris muscle were taken at rest position, water swallowing, jaw opening, isometric tongue protrusion, maximum tongue protrusion. All data were analyzed and processed with the computer statistical method. The following results were obtained: 1. Except at rest position. the muscle activities of genioglossus muscle in anterior open bite were higher than in normal occlusion with singificatn difference. 2. Except druing water swallowing, the muscle activities of orbicularis oris muscle in anterior open bite were higher than in normal occlusion with significant difference. 3. During maximum tongue protrusion, the geniolossus muscle of anterior open bite subjects showed the highest muscle activity. 4. Anterior open bite showed closer interrelationship between facial morphology ad the genioglossus, orbiculars oris muscle activities than that of nomral occlusion with significatn difference.