Lower Lip Research Articles

The aggressive face of melasma: unveiling the influence of upper lip pigmentation on social perception.

Although melasma leads to emotional distress and quality-of-life reduction, indigenous cultures practice female facial tattooing. Facial cues influence personality trait inferences and attractiveness ratings. Skin lesions have been shown to alter gaze patterns, emotion perception, and social evaluations. This study aimed to evaluate melasma's impact on visual attention, perceived attractiveness, and social evaluations, considering distinct anatomical areas. Additionally, we sought to compare perceptions of traditional facial tattoos due to their purposeful placement. Gaze fixation patterns were examined via eye-tracking, and image-based personality questionnaires were completed for psychological trait assessment. Visual stimuli showcased anatomic melasma variants and tattoo patterns. Traditional tattoos often follow midline patterns, sparing the upper lip. Both melasma and tattoos significantly affected visual attention (p < 0.001), with chin and upper lip melasma garnering increased attention. Upper lip melasma decreased gaze to the ocular area (p ≤ 0.002). while increasing perioral fixations (p < 0.001) compared to healthy faces. Upper lip tattoos conveyed increased perceived aggressiveness (p = 0.004). Ratings for attractiveness and personality traits were lower for centrofacial melasma than other variants, with no significant difference between centrofacial and isolated upper lip melasma. The global avoidance of upper lip pigmentation underscores its perceptual burden. Upper lip pigmentation directs gaze towards anger-signalling regions, increasing perceived aggression and reducing attractiveness. Centrofacial melasma's impact parallels an isolated upper lip pattern, underscoring the disproportionate role of upper lip pigmentation. These findings warrant considering upper lip melasma's significant influence when evaluating quality of life and establishing treatment goals.

Histological, Clinical Assessment, and Treatment of a Permanent Filler Complication in the Upper Lip: A Case Report with 16-Year Follow-Up

There is a considerable increase in the use of substances and medical procedures aimed at changing the esthetics of the face, particularly the appearance of the lips. Permanent fillers such as polydimethylsiloxane, also called liquid silicone, are widely used, but their application for facial esthetics is currently obsolete. Silicone belongs to this polymer family; its viscosity is determined by its degree of polymerization. Liquid injectable silicone is odorless, colorless, non-volatile, and oily to the touch. The substance is not altered by storage at room temperature and is not carcinogenic or teratogenic. However, the long-term complications remain a reality, as they can occur decades after the application. Thus, the goal of this case report was to present a complication after 16 years of treatment using liquid silicone. This case report involved a 52-year-old male with a complication of bilateral permanent filler in the upper lip performed 16 years ago, its surgical removal, and histological analysis. The patient had the first appointment at the University Dental Clinic—Universidade Católica Portuguesa (Viseu, Portugal) in April 2022, dissatisfied with his upper lip’s esthetic appearance and shape. He was not a smoker or diabetic but had hypertension and hypercholesterolemia and was medicated with Losartan, Hydrochlorothiazide, and Pitavastatin. No relevant findings were observed in the extraoral examination; he had bruxism and a good periodontal condition. The patient had an asymptomatic bilateral mass, hard to palpation, located on the upper lip due to permanent lip filling performed to increase its volume in 2006 associated with non-related generalized granules of Fordyce. The treatment options presented just observation or complete material removal in two surgical steps, which was the patient’s choice. Then, the first surgical procedure was performed under local anesthesia on the right side of the lip, one carpule of Lidocaine 2% with adrenaline 1:100,000, with a chalazion clamp, a diode laser for hemorrhagic control, and a simple suture. In this procedure, three fragments were biopsied: a cuboid measuring 1 × 1 × 0.8 cm and an irregular one consisting of two fragments that at one end of the piece were in continuity with each other, one measuring 1.6 × 0.5 × 0.4 cm and the other 2.5 × 0.6 × 0.5 cm. A similar macroscopic appearance in all the material, white in color, irregular surface, elastic, white section surface, or slightly fasciculate. The patient was medicated with Tylenol 500 mg thrice a day for two days. With 20-day intervals, the sutures from the first surgery were removed, as well as the foreign body from the upper lip on the left side, following the same surgical technique and medication. Histologically, it was possible to identify a chronic inflammatory, lymphoplasmacytic, and granulomatous reaction, with foreign body giant cells’ reaction, in relation to non-polarizable exogenous material due to the reaction to silicone. The most common complications are granulomas’ appearance and material displacement. The case report shows these granulomas are characterized as chronic low-caliber inflammation around the silicone. They have an unknown etiology but are probably multifactorial, from continuous trauma, friction or irritation, iatrogenic factors, infection, immunological mechanisms, and genetic and molecular variations, and can be highly related to the impurity of the injected material. This case brings the opportunity for health professionals to increase awareness of the long-term adverse effects of the silicone material used to fill the lip in order to make its application more predictable and conscious.

Does Upper Incisors Procline following Rapid Maxillary Expansion Facemask Therapy?

Background: The present study is intended to evaluate the changes in upper incisor angulation, skeletal and dental parameters, soft-tissue and airway dimensions following rapid palatal expansion and maxillary protraction. Materials and Methods: Twenty class III subjects (mean age 11.3 years) were given bonded rapid maxillary expansion (RME) and facemask (FM) for 6 months. Pre- and posttreatment cephalogram were compared and dental, skeletal, soft-tissue, and airway changes were quantified. Results: The mean increase in SNA was 1.85° (P &lt; 0.001) while SNB decreased by 1.85° (P &lt; 0.001). Upper and lower face height increased (UFH 1.1 mm, P &lt; 0.05; LFH 2.92 mm, P &lt; 0.001). Upper lip moved forward (E line U/lip 1.27 mm, P &lt; 0.001; S line U/lip 1.3 mm, P &lt; 0.01). 1-SN decreased by 4.35° and 1-NA decreased by 4.50° with P &lt; 0.01. Overjet improved by 3.07 mm (P &lt; 0.001). Conclusion: RME and FM therapy resulted in maxillary forward movement; mandible rotated downward and backward; UFH and LFH increased. The upper lip exhibited forward movement, resulting in a less concave profile. Upper incisor retroclined and there was increase in overjet and no changes in airway dimensions. The upper incisors following RME and FM does not always procline; it is decided by the interaction of four factors – mesial dental movement, rotation of maxillary/occlusal plane, amount of expansion with RME (expansion effect), and reverse twin block if incorporated with FM.

Clinicopathologic Evaluation and Management of Twenty Cases of Oral Mucoceles

Background: Oral mucoceles are benign minor salivary gland lesions characterized by a single or multiple, soft, fluctuant nodule, ranging from normal oral mucosal color to deep blue depending upon the extent of the swelling in deeper layers. This study evaluated clinicopathological features, including the etiology and management of oral mucoceles. Methods: Twenty cases of oral mucoceles were diagnosed, and parameters such as age, gender, etiology, site, clinical presentation, including size, any symptoms, and treatment mode underwent evaluation. Results: In 20 cases, the lesions were found to be more common in males compared to females (16:4). The most common site was the lower lip, and the etiology of mucocele was lip biting, with 80% of cases normal in color and size ranging between 5 mm and 10 mm. The most common type based on histopathology evaluation was the extravasation type in almost all cases. Conclusion: The non-neoplastic benign lesions of minor or major salivary glands pose a diagnostic challenge because of their close resemblance to other pathologies and iatrogenic responses. Thus, the clinical knowledge and pathogenesis of these lesions are necessary for the correct diagnosis and appropriate treatment.

Mucous extravasation phenomenon: A clinicopathologic evaluation of 68 cases.

A mucocele is a benign, mucus-containing cystic lesion of the minor salivary gland also called a sialocele and ptyalocele. Two types are recognized as mucus extravasation cyst and the other is retention type. To evaluate the clinicopathologic features of oral mucocele cases. The archival blocks which were signed out as mucocele were taken for the study. The following parameters such as age, gender, history of trauma, site, histological features, and clinical presentations were taken into consideration. 68 cases of mucous extravasation cysts were analysed, among which 58% were males and 42% were females. Age of the patients ranged from 4 to 70 years with an average of 20 years. The most common locations were the lower lip (87%), tongue (5%) and buccal mucosa (8%). Almost 53% of cases are seen on the left side of the oral cavity. Most of the cases presented a history of trauma. Histopathologically 23% of cases presented with muciphages in the lumen and connective tissue. The commonly encountered benign salivary lesion of the oral cavity is the mucus extravasation phenomenon of the mucocele. Various histopathological features were discussed in this study to avoid misdiagnosis of this common lesion in dental practice.

Cross Lip Vermilion Flap and Traumatic Upper Lip Avulsion: Reducing Donor Site Morbidity.

Using a cross lip vermilion flap for upper red lip reconstruction in cases other than whistle deformity in patients with cleft lip can lead to donor site morbidity. If the practitioner performs primary closure of the mucosa in lower vermilion after flap harvesting, the width and height of lower lip are reduced, which results in an increased lower incisor tooth show. Using free fat grafting is an effective method for reducing donor site morbidity in the lower lip following cross lip vermilion flap harvest.

Analysis of total lip score system and total groove score for gender identification: A cross-sectional study.

Endless ink and pixel space have been spent to validate the use of cheiloscopy classification systems in the field of identification. It is becoming evident that lip-print patterns may provide indications about an individual's gender, race, occupation, habits, blood type, and paternity. Over the course of time, much data have been collected on a substantial population in this field. In the present study, we strive to see how well a noble total lip scoring (TLS) system works in identifying a person's gender among the College of Dentistry students. We also quantified the total groove score (TGS) and compared it with each quadrant for better authentication of the set study design. A cross-sectional descriptive study was conducted among 60 dental students (30 males and 30 females), with an age range of 18-30 years. Lip prints were recorded using the writing pad method and subsequently digitalized by capturing the images using Adobe Photoshop CS 6 Extended Version, counted and summed up, quadrant-wise, in both upper and lower lips. The TLS and TGS between males and females were statistically calculated using the Jamovi project. The mean value for TLS for males (n = 402; SD ± 92.1) is higher than that for females (n = 348; SD ± 86.1). The correlation matrix applying a non-parametric test for non-continuous data using Spearman's ratio inferred a statistically significant correlation (-0.354) with a P-value of 0.005 for TLS, whereas a correlation (-0.162) of TGS with gender was not so significant with a P-value of 0.217. Our study proved the uniqueness of applying TLS as a novel approach to gender identification. The study revealed that males had a statistically higher lip score than females. Being unique, our study inferred the importance of TLS, which needs to be explored in detail for applying, evaluating, and validating its accuracy in forensic research that can help for errorless investigations as full-proof evidence in court.

A new sliding rotation flap for functional lip reconstruction after cancer ablation: A technical note

ObjectiveTo establish a new technique for ensuring preservation of orbicularis oris muscle continuity and facial nerve for the lip reconstruction after moderate lower lip cancer ablation. MethodsThe surgical procedure consists of three steps. First, a Z-shaped skin flap is created around the nasolabial groove. The incision is made on the skin and muscular side, but not down to the oral mucosa. The angle of the mouth, orbicularis oris muscle, and facial nerve are not affected by this approach. Next, a careful obtuse dissection is performed to preserve the facial artery, facial nerve and mental nerve and to allow freedom of the flap. Finally, changing of the flap allows sliding rotation of the perioral tissue to reconstruct the lip defect. ResultsThe replaced flap pulled new mouth angle outward, and a good morphology was formed. Opening the mouth was sufficiently to wear the dentures. The sphincter movement of the lips was good, and the patient's pronunciation and eating were good. ConclusionThis method may be a useful option for the reconstruction of lower lip after cancer ablation because the resection with safety margins creates a large lip defect.

Chewing gum insulation for upper lip hair reduction.

Chewing gum insulation for upper lip hair reduction.

Brittle cornea syndrome—A rare genetic disease

To report a case of an 8-year-old girl who presented with bluish discoloration of sclera, keratoconus, and progressive high myopia. She had a history of recurrent shoulder dislocation. A general physical examination showed a midfacial hypoplasia, upturned nares, thick and tented upper lip, and hyperextensible joints. The genetic analysis showed ZNF469 mutation suggestive of Brittle cornea syndrome 1 (BCS-1). We aim to highlight the importance of timely diagnosis and early provision of protective glasses seems to be the most important step in treating BCS.

Efficacy of Topical Application of Chum Salmon (Oncorhynchus keta) Skin-derived Collagen Extracts in Improving Oral Traumatic Ulcer Healing

Background: Traumatic ulcer is a wound on the oral mucosa that often causes pain and impaired eating function. Healing of these wounds takes a long time and can interfere with an individual’s daily activities. One therapeutic approach that is being developed is the use of topical application of chum salmon skin-derived collagen extract. Collagen is the main component of the extracellular matrix and plays a major role in wound healing. The skin of chum salmon (Oncorhynchus keta) contains collagen that is effective for the treatment of wounds. Aim: The aim of this study was to evaluate the effectiveness of topical applications of chum salmon (O. keta) skin-derived collagen extracts in improving the healing of traumatic ulcers through analysis of neutrophil and macrophage numbers and collagen density. Materials and Methods: Twenty-four male Wistar rats were randomly divided into four groups consisting of six rats each. The labial mucosa of the lower lips of the rats was injured with heated amalgam stoppers to create oral traumatic ulcers. Group 1 was a control group; in Groups 2, 3, and 4, 25%, 50%, and 75% of collagen extracts from chum salmon (O. keta) skin were applied topically once a day for 7 days, respectively. The neutrophil and macrophage numbers were observed by hematoxylin and eosin staining. Masson’s Trichrome staining was used to analyze the collagen density. Data were analyzed using one-way analysis of variance and continued with post hoc least significant difference tests. Significance is considered if P &lt; 0.05. Results: The oral traumatic ulcers gradually healed until day 7. The number of neutrophils and macrophages was significantly decreased in the treatment groups, and collagen density was increased, compared to the control group (P &lt; 0.05). The decrease of neutrophil and macrophage numbers occurred significantly with the increased collagen extract concentrations (P &lt; 0.05). Collagen density also increased significantly with the increased collagen extract concentrations (P &lt; 0.05). Conclusion: Topical applications of chum salmon (O. keta) skin-derived collagen extracts accelerate the healing process of oral traumatic ulcers by decreasing neutrophil and macrophage numbers and increasing collagen density.

Non-surgical management of paresthesia induced by calcium hydroxide extrusion – a case report with a 4-year follow-up

The present case report describes the non-surgical treatment of alveolar inferior nerve paresthesia caused by the extrusion of calcium hydroxide as intracanal medicament. A 45-year-old female patient had a chief complaint of numbness and pain in the left lower lip region for 2 months. Radiographic examination revealed calcium hydroxide overflow into the mandibular canal. Irrigation of the root canal system with saline using a 27-gauge needle was done to remove as much calcium hydroxide as possible but proved ineffective in removing material from the outside tissues. Root canal treatment was completed in 1 week, and non-surgical paresthesia treatment with steroids and pregabalin was done for one month. In the 1-year follow-up control, the paresthesia had reduced significantly. In a 4-year follow-up visit, there was a complete resolution of paresthesia, and the radiographic analysis showed that calcium hydroxide was completely resorbed.

FULL MOUTH REHABILITATION AS AN EFFECTIVE TOOL FOR ANTIAGING. CASE REPORT

It is a well-known fact that white teeth, harmonically located in the dental rows, with no defects, wear signs and pathology in the periodontium, are a sign of youthfulness and some kind of a mirror of overall body health. Actually, the dentist can be the first one to detect the first manifestations of any somatic diseases or deficiencies during examination of the patient. Modern digital technologies can offer high quality and aesthetics of the dental procedures, that also benefits in the time of dental sessions, which is less stressful for the patient, the dentist and the laboratory. This study presents a clinical case of complex functional and aesthetical dental rehabilitation of a 34-year-old patient.&#x0D; The main complaint of the patient was a change of the face image, tooth wear and unsatisfactory appearance of the teeth, as well as discomfort during the jaw movements and occlusion. Since the patient had clear time limits, namely 3 months, rehabilitation, was carried out according to a fast protocol. It included increase of the vertical dimension, using botulinum therapy of the masticatory muscles, temporary prosthetic crowns and final full zirconia crowns. Also, splint therapy for the treatment of temporomandibular disorder was included to the protocol, as this problem hasn`t been treated in time. During the rehabilitation process, cone-beam computed tomography of the jaws and joints, an intraoral scanner, and the most modern digital workflow for prosthetics were performed.&#x0D; As a result of the rehabilitation, the lost chewing function and aesthetics of the teeth were restored. The tone of the masticatory muscles and the range of the jaw movements were harmoniously corrected, the cheek pits, the upper and lower lips increased in volume, therefore the shape and size of the lower part of the face increased and the patient’s smile became snow-white. The patient’s general condition and mood improved, he gained a new younger look.

Functional and esthetic reconstruction of composite lower lip defects with a motor-innervated chimeric facial artery buccinator myomucosal-submental island flap

ObjectiveThis study aimed to assess the functional and esthetic outcomes of a chimeric innervated buccinator myomucosal-submental island flap (BMM-SIF) for large composite lower lip reconstruction. MethodsThis retrospective study included five patients who underwent lower lip tumor resection and BMM-SIF reconstruction at the Hospital of Stomatology, Sun Yat-sen University, between August 2021 and February 2023. Lip function was evaluated using water leakage, cheek puffing tests, and superficial electromyography. Lip appearance was observed using photographs and evaluated through subjective interviews. Donor-site conditions, including facial symmetry and mouth opening, were monitored. ResultsAll the BMM-SIFs survived. Drooling was the main complication observed shortly after surgery. The water leakage test showed complete oral competence for liquid holding in the 7th month; however, moderate air leakage was present in two patients. Electromyography revealed myoelectric signals from the innervated buccinator at the recipient site. Facial expression and food intake were typically managed. The shape and projection of the vermilion were harmonious and satisfactory for each patient. Neither microstomia nor mouth opening limitation was observed, with an average inter-incisor distance of 37.25±4.4 mm. ConclusionChimeric motor-innervated BMM-SIF effectively reconstructed large full-thickness lower-lip defects with satisfactory functional and esthetic outcomes.

COMBINED TREATMENT OF DIGEORGE SYNDROME

Background. DiGeorge syndrome is a rare congenital disease associated with a deletion of chromosome 22q11.2, which is characterized by the occurrence of various anomalies, such as hypo/aplasia of the thymus and parathyroid glands, which leads to T-cell immunodeficiency and hypoparathyroidism; this syndrome is also characterized by congenital heart disease (tetralogy of Fallot), anomalies in the development of craniofacial structures are observed, in the form of non-fusion of the hard palate and upper lip (cleft palate and cleft lip). Results. This article will examine a clinical case of DiGeorge syndrome in a child, with the classic triad characteristic of this condition (immunodeficiency, hypoparathyroidism and congenital heart disease). The patient underwent the first stage of correction of a combined heart defect against the background of constant (monthly) immunocorrection. Due to the COVID-19 pandemic, our patient was unable to receive scheduled hospitalization for blood replacement and immunocorrective therapy in a timely manner. The key to increasing the survival rate of patients with DiGeorge syndrome is prenatal screening, timely correction of the anomaly and immunoreplacement therapy, which are actively used in foreign countries. Also, incomplete treatment of DiGeorge syndrome can subsequently lead to various other manifestations, such as autoimmune diseases, infectious diseases, etc. Conclusion. The prognosis of DiGeorge syndrome is that this disease has various clinical manifestations, is combined with other variants of the anomaly that are incompatible with life and lead to delayed psychomotor development and have an unfavorable prognosis

Miescher’s cheilitis granulomatosa: a case report

Miescher’s cheilitis granulomatosa (MCG) is a rare idiopathic chronic persistent painless lip swelling with granulomatous infiltrate. It is often associated with orofacial granulomatosis and Melkersson—Rosenthal syndrome. Sometimes cheilitis granulomatosa is attributed to sarcoidosis (Besnier—Boeck—Schaumann disease) without systemic lesions. Although there is a possibility that it is a separate disease. Secondary causes include a reaction in response to infection with Mycobacterium tuberculosis, as well as to the introduction of tissue fillers.The publication presents a clinical case of Miescher’s cheilitis, the probable cause of which were the following infectious agents: long­term untreated caries of many teeth and COVID­19.Patient K., 46 years old, complained of swelling and enlargement of the lower lip, a feeling of numbness and discomfort. She fell ill a week ago. Swelling formed gradually over 6—7 days without disturbing the general condition; the body temperature was within the normal range. The lips were swollen, increased in size, slightly hyperemic, the lower one was turned outwards. The lips had a soft­elastic consistency and were not painful to palpate. Pain, tactile and temperature sensitivity were preserved. Dermoscopy was performed. White­grey, structureless areas forming a reticular pattern were observed on the entire surface of the examined area. The vessels were not clear, full­blooded, visualised in the surrounding skin at a considerable distance from the lip edge. The patient was prescribed systemic and topical corticosteroids, hydroxychloroquine, and hyaluronidase. The oral cavity was sanitised. During the month of treatment, the swelling of the lips gradually decreased. At the control examination in two months, the patient’s lip size decreased by 2—2.5 times. There was no relapse of the disease.Conclusions. In our opinion, Miescher’s cheilitis granulomatosa is a separate type of cheilitis, probably of autoimmune nature, in the implementation of which bacterial and viral infectious agents play an important role (focal infection, caries, maxillary sinusitis, frontitis, etc.). The recovery of our patient after the sanitation of the infection foci and complex anti­inflammatory therapy is a convincing proof.

A CONCEPTUAL REVIEW OF VYANGA (MELASMA) DUE TO LIFESTYLE CHANGES

Melasma is a common skin problem in which brown to grey–brown patches usually appear on the face. The most common areas are cheeks, bridge of the nose, forehead, chin and above the upper lip. It is caused due to the changing lifestyle, unhealthy dietary habits, sleep disturbances, systemic diseases, medi-cation and stressful life. In the Ayurvedic classics, Vyanga is mentioned, described under Kshudraroga under Twak roga, which can be compared with melasma. As per the Ayurvedic classics, Vyanga is a condition where vata pitta dosha as well as Mansika nidana, such as krodha, shoka, and ayasa, are the main culprits. In Ayurveda, several remedies are described for the treatment of this disease. The drugs for internal purposes and the drugs for external purposes with Raktaprasadak, Twakprasadaka, and Varnakarak properties are helpful in managing Vyanga, which, on the other hand, helps in rakta shodhan (blood purification).

Evaluation of the External Soft Tissue Changes Following the Correction of Class II Skeletal Malocclusion in the Adolescence Period Using Removable and Fixed Functional Appliances: A Systematic Review and Meta-Analysis.

In this systematic review, we aimed to assess the current evidence regarding the effectiveness of functional treatment with both removable and fixed appliances to normalize the external soft tissue for skeletal class II adolescent individuals. We performed a broad electronic search to retrieve relevant studies from nine databases to identify randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that investigated soft tissue changes following functional treatment and evaluated the changes using 2D lateral cephalometric radiographsand 3D-optical surface laser scanning. A total of three RCTs and eight CCTs were included. Ages ranged from 11 to 16 years with the fixed functional appliances, and from eight to 12 years with the removable ones, including 689 skeletal class II patients. Version 2 of Cochran's risk-of-bias (RoB2), and the risk of bias in non-randomized studies of interventions (ROBIN-I) were used to assess the risk of bias for the included papers. Of the 11 eligible studies, three studies were included in the meta-analysis to assess the upper and lower lip position in relation to the E-line (Ricketts's aesthetic line) in addition to the nasolabial angle. The meta-analysis showed that the upper lip retracted after functional treatment with Twin-block in relation to E-line (mean difference (MD) = -1.93; 95% CI: -2.37, -1.50; p < 0.00001; χ² = 5.43; p = 0.07; I2 = 63%), while the lower lip position did not change after functional treatment with Twin-block in relation to E-line (MD = 0.03; 95% CI: -0.56, 0.61; p = 0.92; χ² = 1.74; p = 0.42; I2 = 0%). The nasolabial angle increased after Twin-block treatment (MD = 5.75; 95% CI: 4.57, 6.93;p < 0.00001; χ² = 6.77; p = 0.03; I2 = 70%). The mentolabial angle and Z-angle also increased after functional therapy, where the facial convexity angle decreased, regardless of the functional devices used. On the other hand, using the 3D-optical surface laser scanning showed that the upper lip length and the commissural width did not change following therapy, but the lower lip increased in length, as well as the total face height. More high-quality RCTs are required to obtain accurate evidence in this field.

Mucocele Treatment in Pediatric Patient at RSGM UMY

Background : Mucoceles is minor salivary gland lession. The extravasation mucocele, commonly referred to as a "mucous retention cyst," does not have an epithelial lining or a well-defined boundary. An extravasation mucocele is believed to be caused by damage to a tiny salivary gland excretory duct. Saliva accumulates in the adjacent submucosal tissue due to a tear in the duct, leading to swelling. Retention type mucocele occurs when a small salivary gland duct is blocked, often by a sialolith, periductal scarring, or tumor. Salivary flow blockage leads to the accumulation of saliva and the enlargement of the duct. Objective : To provide treatment for mucocele in a pediatric patient at RSGM UMY Case Report : A 9-year-old patient came to RSGM UMY accompanied by his mother, complain he has swelling on lower lip. He often bite the lower lip for a long time. It is painless and sometimes increases in size. His experiencing discomfort due to the bump. Method : The mucocele was excised using infiltration anesthetic and a blade no. 15. Surgical sutured silk braided was utilized for postoperative wound closure. The patient was provided with post-operative instructions and prescribed antibiotics and analgesics. The patient was scheduled for a follow-up appointment after one week to have the sutures removed. Result : No complaints after control 1 month and 3 months after treatment Conclusion : Surgical removal remains the optimal choice for treating mucoceles due to its simplicity and cost-effectiveness compared to laser ablation, cryosurgery, and electrocautery

The Diagnostic Value of Sub-mental Fat Measurement for Prediction of Difficult Laryngoscopy and Intubation: A Randomized Prospective Study

Background: Difficult airway management poses a high-risk procedure, potentially leading to patient mortality. Despite significant advancements in modern anesthesia over the years, there remains a lack of a single reliable tool for predicting difficult airways. Objectives: This study aims to examine neck fat diameter as a potential predictor of airway difficulty. Methods: Two hundred fifty patients participated in the study. Airway parameters, including Mallampati score, mandibular protrusion, upper lip bite test, thyromental distance, neck movements, and neck fat diameter, were documented. Results: Among our study population, 48 patients experienced difficult intubation. The Mann-Whitney test revealed that submental fat was significantly greater in the difficult intubation group (P-value &lt; 0.001). Based on the best subset variable selection, submental fat, thyromental distance (model 1), and age (model 2) were selected to participate in the multivariate regression model. Each one mm increase in neck fat was associated with a 30% increase in the odds of difficult intubation (P-value &lt; 0.001) in the univariate logistic model. After adjusting for thyromental distance, age, and gender, the odds of difficult intubation were approximately 2 times higher in patients with 1 mm more neck fat (P-value 0.007). The area under the curve of the Receiver Operating Characteristics curve and McFadden's pseudo-R squared of the multivariate model were 0.998 and 0.91, respectively. Conclusions: Neck fat diameter serves as a reliable and straightforward predictor of airway difficulty and can be used alone or in conjunction with other predictors for the prediction of difficult airway management.