Lip Function Research Articles

Lip Histology of the Adult Farmed African Catfish (<i>Clarias gariepinus</i>)

The lip histology of the adult farmed African catfish was investigated to fill the knowledge gap in available literature especially those from commercial concrete tanks. This microanatomy is important as the lip is the principal organ involved in prehension. The lip epidermis was lined by stratified squamous epithelium containing PAS and AB positive mucous cells, and occasional eosinophilic club cells. Some melanocytes were seen at the basal epithelial layer and subepithelium. Pectinate ligament of dense regular connective tissue was seen attaching the epithelium to the deep dermal dense regular connective tissue. This deep dense regular connective tissue was seen ventral to the subepithelial loose areolar connective tissue. In the lower lip, the core contained skeletal muscle fibres in varying directions, elastic cartilage, and bone. This core provides anchorage for the horny pad teeth. Abundant nerve fibres were observed in the deep connective tissue layers. No taste bud was observed. This microanatomical observation suggests an organ involved in prehension and tearing of feed; protractibility and protection but no gustatory function. Keywords : Clarias gariepinus , Pectinate ligament, mucous cells, club cells, Histology, lip function

Lip Reconstruction Using Karapandzic Flap

Reconstruction of the lip may be required after trauma and/or surgical excision of tumor. The lips contribute to form the beginning of the oral cavity, and they are the most common site of oral cancer. Any reconstruction of the lips must include both functional and cosmetic considerations. This case report presents a female patient, aged 22 years old, who was exposed to severe road traffic accident resulting in lower lip loss with both functional and cosmetic disturbances. Surgical reconstruction using Karapandzic flap was carried out at the Maxillofacial Surgery Department at Ramadi Teaching Hospital, Anbar Province, Iraq. A dynamic reconstruction with remaining lip tissue can provide superior results in terms of lip appearance and function.

Total Lower Lip Reconstruction With a Double Mental Neurovascular V-Y Island Advancement Flap

To assess the effectiveness of double mental V-Y island advancement flaps for total lower lip reconstructions. During a 6-year period, from 2006 to 2012, total lower lip reconstruction was performed in 12 patients using double mental V-Y island advanced flaps. The resulting lip function and superiority of each flap were analyzed. To assess any cosmetic implications, patients were asked to answer the Appearance Domain section from the University of Washington Quality of Life Questionnaire at least 12 months after discharge from the hospital. All flaps survived completely and no short-term postoperative complications occurred. The mean follow-up time was 34.5 months (range, 15 to 69 months) and there was no recurrence of disease. All patients were capable of consuming a regular oral diet and no patients complained of an inability to eat in a public setting, drooling, or microstomia. The mean preoperative and postoperative open-mouth widths were 4.1 and 3.7 cm, respectively, and the mean reduced open-mouth width was 10%. The intercommissural width varied from 4.6 to 6.8 cm (mean, 5.5 cm). The mean postoperative 2-point discrimination was 11.2 mm (range, 9 to 13 mm). The mean score for the Appearance Domain section was 93.8 (range, 75 to 100). The mental V-Y island advancement flap reconstruction is a reliable procedure for total lower lip reconstruction.

Tailoring Folded-Fasciocutaneous Flap for the Restoration of Oral Commissure Morphology

The reconstruction of a through-and-through cheek defect with oral commissure involvement can be challenging. When attempting to reconstruct its seam-like structure or to replace its supple lip tissue, postoperative morbidities such as drooling, microstomia, and poor aesthetic appearance can often occur and be difficult to correct. After inspecting the oral commissure, one can observe that the morphology of the upper lip acts as a "drape" hanging over the upper teeth, whereas the lower lip functions similarly to a "dam" holding the constant pour of saliva within the oral cavity. We noted that if we tailored a single fasciocutaneous flap to satisfy these morphologies during reconstruction, not only were the mentioned morbidities of reconstruction greatly diminished, but the reconstructed oral commissure could also spontaneously mimic the contralateral side in form. We presented 10 consecutive patients with cheek defects with concomitant oral commissure involvement, which underwent reconstruction by using a single-folded fasciocutaneous flap. We described how the flaps are tailored to suit the mentioned upper and lower lip morphology. For certain defects, such as a cheek defect with oral commissure involvement, the loss of functional morphology greatly outweighs its anatomical or tissue losses. Our method provides a simple and straightforward surgical option in this area, which was previously perceived as a challenging reconstruction site.

Botulinum toxin type A: implications in wound healing, facial cutaneous scarring, and cleft lip repair

Botulinum toxin is a neurotoxin that has been utilized to induce chemo-denervation of muscles. Cutaneous wounds represent a special situation in which the tensile forces applied by these muscles on wound edges might have deleterious effects on the healing process. The aim of this review was to investigate such an effect and to review other mechanisms this toxin might have on the healing process. We also reviewed the role of botulinum toxin in the management of hypertrophic scars and cleft lip repair.

Sufficient conditions for the Lebesgue integrability of double Fourier transforms

We consider complex-valued functions \(\widehat{f}\) for some 1 > p = 2 and give sufficient conditions for its Fourier transform f to belong to \(\widehat{f}\epsilon L^{r}(\mathbb{R}^2)\), where 0 > r > q and 1/p + 1/q = 1. Under additional conditions, we also give sufficient conditions, under which we have f Lr(R2). These sufficient conditions are in terms of the Lp-integral modulus or the ordinary modulus of continuity of f. Our theorems apply for functions in the Lipschitz classes Lip(α{in1}, α{in2}), where 0 > α{in1}, α{in2} ≤ 1 as well as for functions of bounded {its}-variation on R2, where 0 > {its} > {itp}. The results of this paper can be considered to be the nonperiodic versions of those results proved in [5] for double Fourier series, and the latter ones were in turn the two-dimensional extensions of the classical theorems of Bernstein, Szász and Zygmund on the absolute convergence of single Fourier series.

Tessier 30 symphyseal mandibular cleft: Early simultaneous soft and hard tissue correction – A case report

A symphyseal mandibular facial cleft (Tessier 30) is a rare congenital abnormality. Nonunion of bone in the symphysis of the mandible, median cleft of the lower lip and tongue adherence in the midline to the floor of the mouth are the principle features of the anomaly. A satisfactory result can be achieved with early surgical correction of both hard and soft tissue defects in the age of 6 months. More than 3 years follow-up shows total bony fusion of the symphysis and normal lower lip function. There were only left deciduous central incisor and the ipsilateral tooth bud of the permanent central incisor missing.

Effects of Lip Closure Training on Lip Functions and Brain Hemodynamic Responses in Healthy Female Subjects

Effects of Lip Closure Training on Lip Functions and Brain Hemodynamic Responses in Healthy Female Subjects

Double rhomboidal flap for reconstruction of large surgical defect of the labial commissure

Closure of perioral surgical defects involving the oral commissures is highly challenging. We describe a 69-year-old male patient with a large basal cell carcinoma of the right perioral region, extending to the right oral commissure. This lesion was radically excised, and the resulting surgical defect was closed using a homolateral double opposing rhomboidal flap. The final result was esthetically very satisfactory, with total preservation of lip function. Double opposing rhomboidal flaps are viable surgical options for the reconstruction of surgical defects involving the perioral area and oral commissures. In this relatively simple procedure, donor skin is obtained from the nearby cheek and mandibular areas, under low risk of surgical complications, preserving lip function without distortion of the labial anatomy.

Double Mental Neurovascular V-Y Island Advancement Flaps Combined With Tongue Flaps for Functionally Reconstructing Total Lower-Lip Defects

Although several techniques have been described for lower-lip reconstruction, functional reconstruction of total lower-lip defects remains a challenge. This study investigated a functional reconstruction technique for total lower-lip defects. Nine lower-lip defects were reconstructed after cancer ablation using double mental V-Y island advancement flaps, based on mental neurovascular bundle combined with tongue flaps. All flaps survived completely. The patients were followed up for 6 to 20 months. The lip function and sensation were normal, and aesthetic appearance was satisfactory. No patient developed local recurrence or lymphatic metastasis. The technique of combining a double mental neurovascular V-Y island advancement flap with a lingual mucosal membrane flap is ideal for the functional repair of total lower-lip defects after cancer ablation.

Spacefilling curves and phases of the Loewner equation

Similar to the well-known phases of SLE, the Loewner differential equation with Lip(1/2) driving terms is known to have a phase transition at norm 4, when traces change from simple to non-simple curves. We establish the deterministic analog of the second phase transition of SLE, where traces change to space-filling curves: There is a constant C>4 such that a Loewner driving term whose trace is space filling has Lip(1/2) norm at least C. We also provide a geometric criterion for traces to be driven by Lip(1/2) functions, and show that for instance the Hilbert space filling curve and the Sierpinski gasket fall into this class.

RETALHO ROMBOIDAL DUPLO PARA ENCERRAMENTO DE DEFEITO CIRÚRGICO DA COMISSURA LABIAL

Os lábios, enquanto estruturas anatómicas móveis da face, apresentam crucial importância em termos funcionais e cosméticos. A abordagem de defeitos cirúrgicos da região perioral é um desafio importante na prática cirúrgica dermatológica, atendendo ao risco de distorção da anatomia local. Apresentamos o caso de um doente do sexo masculino, de 69 anos, com extenso carcinoma basocelular ulcerado da região perioral direita, com envolvi- mento da comissura labial. Foi realizada excisão radical da lesão e encerramento do defeito cirúrgico com retalho romboidal duplo das regiões geniana e mandibular homolaterais. Não houve complicações pós-operatórias e o re- sultado cosmético final foi bastante satisfatório, com preservação da funcionalidade das estruturas labiais. O retalho romboidal duplo é uma alternativa viável para o encerramento de defeitos cirúrgicos da comissura labial, utilizando pele das regiões geniana e mandibular adjacentes. É uma técnica de execução relativamente simples, com baixo risco de complicações, que oferece óptimos resultados funcionais e cosméticos.PALAVRAS-CHAVE – Procedimentos Cirúrgicos Reconstrutivos; Retalhos Cirúrgicos; Comissura Labial; Carcinoma Basocelular; Neoplasias do Lábio.

Mandibular Distraction Osteogenesis in 23 Patients With Juvenile Idiopathic Arthritis

Statement of the Problem: Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease occurring before the age of 16. The temporomandibular joint is frequently involved and this can result in growth impairment of the mandible with an asymmetric growth in cases of unilateral involvement. In severe cases, conventional orthognathic surgery has a risk of relapse, and in an attempt to avoid this we have used distraction osteogenesis (DO) in a group of JIA patients. Only few publications have described the use of DO in JIA patients. Materials and Methods: Twenty-three patients with JIA underwent unilateral distraction osteogenesis. There were 14 females and 9 males. Mean age was 16 years (range 11-34 years). All patients were treated according to a standardized protocol with preoperative orthodontic planning, cephalometric analysis with calculation of distraction vector, and transfer of the vector to the surgical procedure. An occlusal splint was used full-time during distraction. Data from five examinations of symptoms and function were included in this study: T1: before distraction osteogenesis, T2: after removal of distraction device, T3: 6 months after DO, T4: 12 months after DO, and T5: the latest follow-up visit. Radiographic evaluation was performed by comparing the normal and the affected side on frontal and lateral cephalograms and orthopantomograms. Methods of Data Analysis: Data describing the functional status was analyzed by descriptive statistics. The results from the cephalometric analysis before and after treatment were compared by paired t-test by use of SPSS 18.0 for Windows. Results of Investigation: Subjective: TMJ function was good both before and after distraction osteogenesis and nearly all the patients reported normal chewing and opening capacity. Pain related to TMJ arthritis was reduced after treatment (5 patients before, none after) in contrast to muscle pain and muscular headache which were more frequent at long-term follow-up. Objective: The mandibular asymmetry was corrected. The lip function was improved and the respiratory pattern was normalized for most of the patients. A tongue dysfunction was present in eight patients before treatment and in two patients at follow-up. The dental occlusion was normalized for all but 2 patients, who still had a distal molar relationship. The mandibular range of motion before treatment was 47.6 mm with laterotrusion and protrusion within the normal range. In the early post-distraction period the mobility was significantly reduced but throughout the follow-up period it increased to normal range and close to the preoperative values. Cephalometric analysis demonstrated skeletal stability of the treatment result. Conclusion: The use of DO in patients with previous JIA in the TMJ resulted in a good skeletal and occlusal stability. It appears that good function of the joints is preserved at long-term follow-up. The affected joint should be guarded by use of occlusal splint during and after the distraction process.

Further Experience With Permafacial Implants for Lip Augmentation: A Review of 100 Implants

Although fillers and surgical lip lifts are effective ways of treating the perioral area, both have inherent downsides. Fillers lack permanence, and lip lifts do not address the issue of fullness. The authors present the results of a long-term follow-up study of Permafacial implants (SurgiSil LLC, Plano, Texas) for lip augmentation. This report is a follow-up from their first publication. The original publication demonstrated the benefit of the procedure at the time of a facelift. The present study reports a long-term follow-up on all of the authors' first 50 patients. The authors' original publication demonstrated the benefits of inserting Permafacial implants concurrent with a facelift procedure. In this long-term follow-up study, the results of the first 100 implants (50 patients) are presented; this initial group of patients was followed up for one to two years. Implant migration, lip function, implant position, sensation, and patient satisfaction are reviewed. Very few complications were reported; they included migration with revision, along with patient-requested size adjustments or removal. No extrusions were reported. The degree of patient satisfaction with these implants was high. Although the authors initially experienced a significant migration rate, a modification in technique reduced this rate over the long term. Permafacial implants are an effective method of increasing fullness in the lip area, and they are associated with few complications and high patient satisfaction.

Improved Black procedure in microsurgical repair of bilateralcomplete cleft lip

Objective To discuss the effect of cheiloplasty we designed an improved Black procedure that with microsurgical technique the tissue from lateral lips on the bilateral cleft lip were used to reconstruct the skin of anterior lip and the vermilion tubercle. Methods 36 cases of congenital bilateral complete cleft lip deformity were repaired through improved Black procedure and microsurgical method, including 19 patients with very short prolabium tissue, repairing insufficient skin and vermilion tubercle tissue by fissure lateral lip tissue. Results Following-up for 3 months to 3 years after treatment showed that 36 patients were with normal and symmetrical high of anterior lips, the chubby vermilion tubercles, the natural morphous of labial archs, the appropriate strength of labrums and the vermilion tubercles and lips without color difference, and the effects were satisfactory. Conclusion The improved Black procedure redeems the shortages of traditional Black procedure for the case with bilateralcomplete cleft lip and smaller anterior lip, such as the deficient height of anterior lips, eclabium and inadequate vermilion tubercles. By applying microsurgical technique, the procedure gives better upper lip function and aesthetic effect, and therefore it is worthy to be recommended in clinic. Key words: Bilateralcomplete cleft lip; Improved Black procedure; Repair

Correction of the Cleft Lip Lateral Bulge Deformity Using Anatomic Muscle Repair

The lateral bulge deformity may result after primary cleft lip repair. In a pilot study, greater orbicularis oris thickness and levator width underlying the lateral bulge were identified using ultrasound. The purpose of this study was to evaluate postoperative results of anatomic muscle repair for lateral bulge correction. Patients with a lateral bulge after primary unilateral cleft lip repair were prospectively recruited. Oronasal musculature and connective tissue dimensions were measured using ultrasound, preoperatively and postoperatively. Guided by preoperative ultrasound findings in each patient, lateral bulge correction consisted of total lip takedown and anatomic orbicularis oris reapproximation. Within each group, measurements between sides at corresponding landmarks were compared using t-tests. Ratios between sides at corresponding landmarks preoperatively and postoperatively were compared using parametric and nonparametric tests. Repeat measurements were performed to calculate intrarater reliability. Standardized video assessments of dynamic lip function were recorded preoperatively and postoperatively. Average patient age was 17.4 years. Patients were evaluated preoperatively and postoperatively (n=14) at 7.8 months' mean follow-up. Cleft-side orbicularis thickness and levator width were greater preoperatively versus postoperatively (P=0.003 and P=0.018, respectively). Postoperatively, no differences were seen between sides for both orbicularis thickness (P=0.763) and levator width (P=0.626). All patients demonstrated improved lip contour and symmetry, both static and dynamically, on video assessments. Lip contour, function, and aesthetics improved clinically, and lip muscle anatomy normalized postoperatively as assessed using ultrasound. Complete orbicularis oris takedown and anatomic reapproximation effectively addressed the lateral bulge deformity.

Treatment of Class II Division 1 Malocclusion with Myofunctional Trainer System in Early Mixed Dentition Period

Dentofacial growth interferences, caused by abnormal lip and tongue function in the mixed dentition period are a common clinical condition. The main purpose of the treatment in such cases is to eliminate oral dysfunction, establish muscular balance and correct or diminish maxillary incisor protrusion. The position of the teeth is determined by the lip and tongue pressure. Lip function may have been the cause of forcing teeth in to malposition they occupy. The case report is presented where the myofunctional trainer T4K is used during growth phase.

下顎歯肉癌術後患者の舌および下唇の知覚と口腔機能に関する検討

本研究の目的は，下顎歯肉癌術後患者10名の口腔機能と口腔粘膜の知覚（温覚，冷覚，触覚，熱痛覚）を調査し詳細を知ることである。患者の年齢は59歳から82歳であり，口腔機能評価には低粘着性発色チューインガム法，オクルーザルプレスケール法，山本の咬度表，単音節発語明瞭度検査，全口腔法味覚検査を用いた。知覚の検査部位数は下唇が2か所，舌尖と舌背合わせて4か所とした。患者自身で評価する山本の咬度と客観的評価による咀嚼機能の結果は一致していなかった。単音節発語明瞭度では軽度障害が認められた。味覚閾値は患者群と健常者との間に差がなかった。患者群患側において温覚および熱痛覚閾値は冷覚および触覚閾値と比べて回復が遅い傾向にあった。

唇顎口蓋裂児の口唇機能に関する研究

唇顎口蓋裂は発生頻度の高い先天異常であり, 治療や療育にはさまざまな分野からのアプローチが必要とされているが, 摂食や口唇閉鎖などの口腔機能面でのアプローチは未だ十分に行われていない. そこで, 唇顎口蓋裂児の口腔機能の発達を解明するために, 小型圧センサを埋め込んだスプーンを用いて片側性唇顎口蓋裂児の口唇正中部, 口唇側方部 (破裂側および非破裂側) の3点から捕食時垂直的口唇圧の測定を行った. 対象は乳歯列完成期の片側性唇顎口蓋裂児 (Cleft群) 23名で, 健常小児 (N群) 25名を対照群とした. 解析項目は, 捕食時口唇圧, 陰圧, 捕食時作用時間, 捕食時圧積分値とし, それぞれについて検討を行った. 捕食時口唇圧はCleft群がN群と比較して正中部で有意に小さかった. 陰圧はCleft群とN群で殆ど差は認められなかった. 捕食時作用時間は, Cleft群がN群と比較して有意に長い値を示した. また, 捕食時圧積分値は両群で有意差はみられず同程度であった. 以上よりCleft群はN群と比較して弱い口唇圧を捕食時の作用時間の長さで代償していることが示唆された.

Exploring quantitative methods for evaluation of lip function

The objective was to explore quantitative methods for the measurement of lip mobility and lip force and to relate these to qualitative assessments of lip function. Fifty healthy adults (mean age 45 years) and 23 adults with diagnoses affecting the facial muscles (mean age 37 years) participated in the study. Diagnoses were Möbius syndrome (n=5), Facioscapulohumeral muscular dystrophy (n=6) and Myotonic dystrophy type 1 (n=12). A system for computerised 3D analysis of lip mobility and a lip force meter were tested, and the results were related to results from qualitative assessments of lip mobility, speech (articulation), eating ability and saliva control. Facial expressions studied were open mouth smile and lip pucker. Normative data and cut-off values for adults on lip mobility and lip force were proposed, and the diagnostic value of these thresholds was tested. The proposed cut-off values could identify all inviduals with moderate or severe impairment of lip mobility but not always the milder cases. There were significant correlations between the results from quantitative measurements and qualitative assessments. The examined instruments for measuring lip function were found to be reliable with an acceptable measuring error. The combination of quantitative and qualitative ways to evaluate lip function made it possible to show the strong relation between lip contraction, lip force, eating ability and saliva control. The same combination of assessments can be used in the future to study if oral motor exercises aimed at improving lip mobility and strength could have a positive effect on lip function.