• Korean Journal of Acupuncture
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• v.41 no.3
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• pp.90-100
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• 2024

Objectives : This study examined the historical evolution of the GV26 acupuncture point, focusing on its location, therapeutic indications, and anatomical relevance to the philtrum region. Methods : We reviewed 18 historical acupuncture texts, analyzing the descriptions of GV26's location and associated indications. Results : The location of GV26 has varied over time. Early texts like the A-B Classics of Acupuncture and Moxibustion described it at the center of the philtrum groove, while some 16th-century texts shifted it closer to the nasal cavity. However, many sources continued to emphasize the central philtrum groove as the correct location. GV26 was historically indicated for conditions such as cold-type headache, epilepsy, edema, nasal and eye symptoms, respiratory issues, post-stroke symptoms, jaundice, pestilence, mouth-related symptoms, and low back pain. Epilepsy, edema, and post-stroke facial symptoms were consistently cited across texts, while other indications varied. Cadaveric studies show that the superficial orbicularis oris muscle divides into the upper nasalis and lower labialis portions. Needling the upper third of the philtrum stimulates the thinner, closer-to-maxilla upper nasalis portion, potentially providing stronger stimulation, while needling the center targets the lower labialis portion. Conclusions : Historical variations in GV26's location reflect an evolving understanding of its anatomical and therapeutic significance. The upper third of the philtrum groove may be more effective for acute conditions requiring strong stimulation, whereas the central groove may better address a broader range of conditions. These findings highlight the importance of historical and anatomical context in optimizing GV26's clinical use.

• Korean Journal of Cleft Lip And Palate
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• v.10 no.2
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• pp.67-74
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• 2007

After Tennison introduced a triangular flap method which, for the first time, preserved the Cupid's bow, Randall gave this method a sound mathematical basis. This method is also called as an inferior triangular cheiloplasty which is characterized by making a small triangular flap from the lateral border of cleft destined to be fitted into an incision on the medial side of cleft. He postulated that the height obtained was equal to the sum of the median of the two triangles used in the cheiloplasty. Using this technique, a 22 month-old male patient with incomplete unilateral cleft lip was corrected primarily. The deviation of the columella and flattening of the nostril on the cleft side were minimal. The operation was done under general anesthesia and patient was healed uneventfully. We tried to improve the symmetry and esthetic feature of philtrum, nostril sill, alar-facial groove, preventing the notch formation on the nostril floor, and to reconstruct the muscle sling in the upper part of lip. The shape of Cupid's bow was restored, and the symmetry of columella was regained as a result. In summary, the inferior triangular cheiloplasty is effective to correct the primary unilateral cleft lip, results in the restoration of favorable anatomy and function.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.427-432
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• 2010

Purpose: The purpose of this study is to estimate muscle defect by ultrasonography in the patients with secondary deformities of the lip. We investigated the association between the muscle defect in the repaired cleft lip and the philtral appearance not only at resting state but also maximal puckering. Methods: From December 2006 to November 2007, 52 children were evaluated after primary or secondary cheiloplasty. Digital photographs were taken both from the front and both three quarter views in repose and at maximal pucker. Video clips were also taken in repose and at maximal pucker. A panel of four, scored the philtral ridge and dimple seen on these photographs and videos by using two visual analog scales. Eminence of the philtral ridge was scored by a 5 point grading scale, from "conspicuous groove" to "normal philtral ridge" and the philtral dimple was scored by 3 point grading scale, from "no dimple" to "prominent dimple". Ultrasound images of the upper lip were made using a linear array transducer at the resting position of the lip and evaluated by a single radiologist. Results: The philtral ridge eminence scored $2.79{\pm}0.54$ and $1.40{\pm}0.53$ at resting and maximal pucker, correlating with "flat" and "conspicous groove". The philtral dimpling scored $1.44{\pm}0.53$ and $2.27{\pm}0.66$ at resting and maximal pucker, correlating with "no dimple" and "slight dimple". Ultrasound imaging showed the average muscle dehiscence to be $3.78{\pm}2.14$ mm at resting position. Correlation between the muscle defect in ultrasound imaging and philtral ridge eminence at rest was statistically significant (p<0.050), but was not significant (p=0.756) at maximal pucker using Spearman's rank correlation. Correlation between the muscle defect in ultrasound imaging and philtral dimpling was not statistically significant both at rest (p=0.920) and at maximal pucker (p=0.815) using Spearman's rank correlation. Conclusion: Quantitative assessment of the muscle defect using ultrasonography correlates with the static philtral appearance, but does not correlate with the dynamic appearance. Also, the size of the muscle defect does not show any correlation with the philtral dimpling. Our findings reveal that ultrasound imaging partially reflect static appearance of philtrum but cannot reflect dynamic appearance and suggest the need for further research to evaluate dynamic appearance.