Uncommon traumatic lip injury

Abstract

Trauma to the lips is the most common type of facial injury. The prominence of the lips and the close correlation with the teeth, make it a vulnerable aesthetic unit. We here report the case of a 20-year-old student presenting two hours after maxillofacial trauma following a traffic accident involving a head-on collision between two motorcyclists. The student had fallen on the handlebars of his motorbike injuring his upper lip. Maxillofacial examination showed involvement of the nasogenial sulcus with elevation of the right nasal wing, a notch in the right upper hemi-lip, well colored, and whose endo-buccal extension was embedded in the vestibule, giving an appearance of "right unilateral cleft lip". Radiological evaluation showed air-fluid levels with solution of continuity of the medial wall of the right maxillary sinus. The diagnosis of traumatic incarceration of the right upper hemi-lip with not displaced fracture of the right maxilla was retained. This can cause unilateral or incomplete right upper cleft lip, or a wound with loss of substance involving the right upper hemi-lip. It is a very uncommon lesion of the upper lip requiring urgent repair, given the risk of ischemia and labial necrosis. The patient was operated under locoregional anesthesia. The right upper hemi-lip was embedded with incarceration due to non-displaced fracture at the level of the nasal notch. Disincarceration was performed, resulting in minimal labial loss with a vestibular detachment, repaired by direct suture. Patient's outcome was good.