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Sleilati F, Chalhoub R. Quantifying female upper lip lengthening with age by direct surface measurement: A guide for the lip lifting procedure. J Plast Reconstr Aesthet Surg 2024; 93:55-57. [PMID: 38643687 DOI: 10.1016/j.bjps.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/11/2024] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
Upper lip lifting is a very popular procedure but there is no objective guidelines on how much skin has to be removed to obtain an optimal result. We have measured and compared the philtral height in two groups of young and old female Lebanese subjects. We have found a mean philtral height of 14.3 ± 1.9 mm in the young group and 19.8 ± 2.4 mm In the old group, with a mean philtral lengthening of 5.5 ± 2.9 mm. We suggest using these results to plan the amount of skin that has to be removed during a lip lift procedure.
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Affiliation(s)
- Fadi Sleilati
- Plastic Surgery Department, Hotel Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon.
| | - Ralph Chalhoub
- Plastic Surgery Department, Hotel Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
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2
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Yauchi K, Kitano D, Omori M. Cheiloplasty for False Median Cleft Lip Associated With Holoprosencephaly: The Use of Skin Graft for Philtrum Reconstruction, the Risk of Simultaneous Columella Reconstruction. Eplasty 2024; 24:e4. [PMID: 38476519 PMCID: PMC10929068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
A false median cleft lip is a congenital malformation associated with holoprosencephaly. Cheiloplasty is an effective treatment for false median cleft lip. In the past, holoprosencephaly had a poor prognosis with extremely low survival rates; consequently, cheiloplasty was rarely performed. However, with the recent improvement in survival and prognosis with advances in medical care, patients survive and can now undergo cheiloplasty. We report a case of cheiloplasty performed using a skin graft for philtrum reconstruction. The lip contour was satisfactory because the insufficient tissue was resolved by filling the skin graft, which could not be resolved by midline suture closure. We did not perform columella reconstruction considering the safety; however, oxygenation temporarily destabilized owing to postoperative airway stenosis. Careful postoperative management is necessary even if the columella is not reconstructed.
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Affiliation(s)
- Kaori Yauchi
- Department of Plastic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Daiki Kitano
- Department of Plastic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Makoto Omori
- Department of Plastic Surgery, Yodogawa Christian Hospital, Osaka, Japan
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Park HJ, Park JS, Iwanaga J, Tubbs RS, Hur MS. Positional relationships of the origin and course of zygomaticus major with the nasal ala, tragus, philtrum, and lateral canthus for aesthetic treatments and surgeries. Surg Radiol Anat 2024; 46:27-32. [PMID: 38091037 DOI: 10.1007/s00276-023-03271-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/17/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE The aim of this study was to characterize the origin and course of the zygomaticus major muscle (Zmj) with its topographic relationships with the nasal ala, tragus, philtrum, and lateral canthus. METHODS The Zmj was examined in 50 specimens of 25 embalmed adult Korean cadavers. Facial muscles were dissected to expose the origin and course of the Zmj in 48 specimens of 24 cadavers. The 25th cadaver was sectioned to obtain images of the Zmj. RESULTS The positional relationships of the Zmj origin with the nasal ala and the tragus were classified into three categories. A horizontal line through the center of the Zmj origin and the nasal ala passed through the tragus in 20 of 48 specimens (41.7%), the intertragic notch in 18 specimens (37.5%), and above the tragus in 10 specimens (20.8%). In a horizontal section of the head, the Zmj origin was located near the level of the nasal ala and tragus. In a coronal section of the head, the fibers of the Zmj arising at its origin were located close to the zygomatic bone, lateral to the zygomaticus minor muscle. CONCLUSION By combining dissection with the analysis of sectioned images and ultrasound images of the Zmj, this study has yielded positional information for easily predicting the location of the origin and the course of the Zmj and its related structures underlying the skin.
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Affiliation(s)
- Hyun Jin Park
- Department of Anatomy, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Jin Seo Park
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, Korea
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Anatomical Sciences, St. George's University, St. George's, West Indies, Grenada
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- University of Queensland, Brisbane, Australia
| | - Mi-Sun Hur
- Department of Anatomy, Daegu Catholic University School of Medicine, Daegu, Korea.
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Li Z, Yu R, Li C, Li Z, Shen X. A new cut-hidden cosmetic surgery for definite philtrum creation by suturing skin and orbicularis oris muscle. J Plast Reconstr Aesthet Surg 2023; 80:1-3. [PMID: 36931005 DOI: 10.1016/j.bjps.2023.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023]
Affiliation(s)
- Ze Li
- Department of Plastic Surgery, Chengshang Medical Cosmetology Clinic, Chongqing 400000, China
| | - Rentao Yu
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
| | - Caihong Li
- Department of Plastic Surgery, Chengshang Medical Cosmetology Clinic, Chongqing 400000, China
| | - Zhe Li
- Department of Plastic Surgery, Southwest Hospital, Army Medical University, Chongqing 400000, China.
| | - Xiao Shen
- Department of Burns and Plastic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China.
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Fernandes DD, Hussain SA. A Normative Observational Study of the Relationship of the Philtral Ridges to the Columellar Base in South-Indian Population and its Significance on Cleft Lip Repair. Indian J Plast Surg 2021; 54:334-337. [PMID: 34667520 PMCID: PMC8515340 DOI: 10.1055/s-0041-1734571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction
The philtral ridges form a prominent visual landmark in the upper lip. An aesthetically pleasing cleft lip repair should restore this preferably without any scars cutting across it. Although there are several scientific publications on morphology of this structure and its variations, very few studies on the Indian population have been published.
Aim
To study the morphology of the philtral ridges and their relationship to the columellar base in normal Indian children and its significance in cleft lip repair.
Methods
115 normal healthy children from southern India aged between one and 12 years were studied based on direct observation of the relationship of the superior end of the philtral ridge to the columellar base and nasal sill. In type A, the philtral ridge terminates at the nasal sill just lateral to the columellar base, and in type B, it either reaches or fades before reaching the columellar base. All observations were performed by the first author by examining standardized two-dimensional (2D) photographs of the upper lip-nose complex.
Results
In this study, 74% of the subjects had the philtral column extending lateral to the columellar base.
Conclusion
These finding assume a significance since, in a substantial proportion of the studied population, techniques of cleft lip repair such as the rotation advancement method, place a scar that crosses the upper third of the philtral ridge which may be undesirable.
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Affiliation(s)
- Deyonna Deepthi Fernandes
- The Department of Plastic Surgery, The Cleft and Craniofacial Center, Sri Ramachandra University Hospital, Chennai, Tamil Nadu, India
| | - Syed Altaf Hussain
- The Department of Plastic Surgery, The Cleft and Craniofacial Center, Sri Ramachandra University Hospital, Chennai, Tamil Nadu, India
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Wei J, Deng N, Herrler T, Zhang Y, Li Q, Hua C, Dai C. Short term results of philtrum reconstruction with an orbicularis oris muscle flap in cleft patients. J Craniomaxillofac Surg 2020; 48:569-573. [PMID: 32340907 DOI: 10.1016/j.jcms.2020.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 01/15/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022] Open
Abstract
PURPOSE In the treatment of philtral ridge deficiency in cleft lip patients, optimal results are difficult to obtain due to visible scarring following surgery. The purpose of this article is to introduce a novel strategy for philtrum reconstruction along with an evaluation of postoperative outcomes of this technique. METHOD All patients with a deficiency of the philtrum underwent reconstruction of the philtral ridge and upper lip using an orbicularis oris muscle flap with a specific re-suturing technique in our study. The convexity of the philtral ridge was evaluated pre- and postoperatively at rest and while puckering using patient photography as well as three-dimensional simulation technology. Postoperative outcomes and complications were assessed during follow-up, including a patient satisfaction survey. RESULTS Thirty cleft lip patients underwent treatment in this study using a specific orbicularis oris muscle re-suturing technique. The average age of the 13 male and 17 female patients was 31.5 years. The follow-up period ranged from 6 months to 3.5 years with an average of 10.3 months. Postoperative results showed an aesthetic reconstructed philtral ridge with stable outcome. Complications included acute infection (1 case) and temporary stiffness of smile (3 cases). No systemic complications occurred. All patients were satisfied with their results, and none required further surgery. CONCLUSION We propose a simple, effective, and reproducible technique involving an orbicularis oris muscle flap for the creation of the philtral column in secondary cleft lip deformity. Our approach allowed aesthetically pleasing and stable outcomes. Although the short-term results of the philtrum reconstruction seem to be adequate there is no information on the long-term situation, and therefore no general recommendation to adopt this method can be given.
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Affiliation(s)
- Jiao Wei
- Department of Plastic & Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, 639 Zhi Zao Ju Rd. Shanghai, 200011, PR China
| | - Ning Deng
- Department of Breast Surgery, LiaoNing Cancer Hospital & Institute, PR China
| | - Tanja Herrler
- Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany
| | - Yi Zhang
- Department of Plastic & Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, 639 Zhi Zao Ju Rd. Shanghai, 200011, PR China
| | - Qingfeng Li
- Department of Plastic & Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, 639 Zhi Zao Ju Rd. Shanghai, 200011, PR China
| | - Chenqing Hua
- Department of Plastic & Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, 639 Zhi Zao Ju Rd. Shanghai, 200011, PR China
| | - Chuanchang Dai
- Department of Plastic & Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, 639 Zhi Zao Ju Rd. Shanghai, 200011, PR China.
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Jeong TK, Park SH. Perioral Ruler in Routine Esthetic Surgery: Convenient and Exact. Aesthetic Plast Surg 2020; 44:93-6. [PMID: 31822963 DOI: 10.1007/s00266-019-01564-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/28/2019] [Indexed: 10/25/2022]
Abstract
Lip and perioral surgery, like any other esthetic surgery, requires an exact and convenient measurement tool to ensure reliable and reproducible outcomes. Although three-dimensional measuring equipment has proven its effectiveness in measuring facial parameters over the past two decades, it has some drawbacks, including high cost, long scanning times, and non-portability. Thus, digital photography remains the standard tool of measurement in esthetic surgery to date. Many authors have presented evaluation and measurement methods using digital photography in combination with different tools. However, there are no specific tools for the perioral region. Therefore, we devised a specific ruler for perioral measurements. The ruler has differently colored lines for length and angle measurements and a reference point for correct positioning. It can be used in preoperative consultation, intraoperative orientation, and postoperative evaluation.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Joh Y, Park HS, Yang HJ, Hwang SJ. Horizontal change of philtrum after orthognathic surgery in patients with facial asymmetry. Maxillofac Plast Reconstr Surg 2019; 41:48. [PMID: 31799219 DOI: 10.1186/s40902-019-0232-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/09/2019] [Indexed: 11/24/2022] Open
Abstract
Background Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.
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Mole B. [Lip lifting and philtral restoration with a mustache flap]. ANN CHIR PLAST ESTH 2019; 65:100-105. [PMID: 31791555 DOI: 10.1016/j.anplas.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/07/2019] [Indexed: 11/30/2022]
Abstract
The restoration of the philtrum is an often neglected aspect in the technique of labial lifting with a perinasal scar, or it is secondarily resorted to by simple injections of hyaluronic acid. We are not in favor of the classic continuous bull's horn scar because, on the one hand, we consider that most of the labial shortening is due to the nasal floor resection -the internal excursion of which determines the final result-, and on the other hand that the approximation of 2 skins of very different nature (columella and lip) may cause a visible scar. The base of the columella is particularly well vascularized by the anastomosis of branches derived from the external carotid artery via the superior labial artery and septal branches distributed from the internal carotid system. We therefore consider that this zone on each side of the base of the columella constitutes the vascular pivot of our "mustache flap" drawn according to the classic peri nasal incision: this flap is desepidermized and then totally elevated from the orbicularis muscle except for its internal part where it is simply discarded so as not to compromise its vascularity; it is then rotated at 90° and inserted into a tunnel fitted in the subcutaneous plane down to the red lip corresponding to the restoration of the 2 philtral crests. Thus, all of the superior labial deformations observed over time (elongation and convexity of the white lip, flattening of the philtrum are corrected in a long lasting manner. The intervention is carried out under local anesthesia and, if necessary, the other elements of aging (loss of volume of the red lip, vertical wrinkles, defect of pigmentation etc.) can be corrected without risk at the same time.
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Affiliation(s)
- B Mole
- 15, avenue de Tourville, 75007 Paris, France.
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Bagheri H, Sirinturk S, Govsa F, Pinar Y, Ozer MA. Digitalized analysis of philtral anatomy for planning individual treatment. Surg Radiol Anat 2017; 39:1183-1189. [PMID: 28289871 DOI: 10.1007/s00276-017-1840-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/27/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Restoration of the philtral region following traumatic, cleft, and tumor surgeries is often difficult due to influence of this feature to whole facial beauty. The aim of this study is to investigate the types and measurements of the philtrum and its relationship with the upper lip using a software. METHODS Standard personal photographs of the philtral region were obtained from 200 young adults participated in this study. Linear analyses (the lengths of philtral column and dimple; the philtral width) and angular analyses (apex and central angles of Cupid's bow) were measured as reference points. As for the shape of the philtral column, it was categorized as four distinct types: parallel, triangular, concave, and unclear type. RESULTS The philtral width was 11.37 ± 1.9 mm in males, 10.21 ± 1.80 mm in females. The length of the philtral dimple was 18.16 ± 3.6 mm in males, 18.16 ± 3.6 mm in females. Compared with women, both of the measured average philtral reference lengths displayed a significantly greater value in men. In the meanwhile, compared to women, the angular measurements of Cupid's bow (i.e., the apex and central angle of Cupid's bow) were smaller in men. It was 127.47 ± 12.74° mm in males, 134.1 ± 11.38° mm in females. The triangular and concave types were associated with a substantial fraction in men, whereas the triangular and parallel types were predominant in women. There were significant gender differences in the esthetic rankings of philtral column shapes. CONCLUSIONS These results suggest digitalized reference values relative to the philtral column which may increase the success of the individual reconstructive treatment of the surgical procedures and reduce possible asymmetrical appearance. With the help of certain software, this research has made possible to investigate the ideal parameters of philtral construction in defining the best surgical solution for the patient.
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Affiliation(s)
- Hassan Bagheri
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey
| | - Suzan Sirinturk
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey
| | - Figen Govsa
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey.
| | - Yelda Pinar
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey
| | - Mehmet Asim Ozer
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey
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Fisahn C, Montalbano MJ, Iwanaga J, Moisi M, Loukas M, Chapman JR, Oskouian RJ, Tubbs RS. A new superficial landmark for the odontoid process: a cadaveric study. Anat Sci Int 2018; 93:203-6. [PMID: 28176269 DOI: 10.1007/s12565-017-0390-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/20/2017] [Indexed: 10/20/2022]
Abstract
When image guidance is not available or when there is a need to confirm the findings of such technology, superficial landmarks can still play a role in providing surgeons with estimations of the position of deeper anatomical structures. To our knowledge, surface landmarks for the position of the odontoid process have not been investigated. We have therefore performed an anatomical study to investigate such a landmark. One-centimeter metallic rods were placed on the philtrum of the upper lip of 20 cadaveric head specimens. To assess the position relative to the odontoid process, we took lateral and anteroposterior radiographs and recorded the measurements. Descriptive findings from radiographic observations indicated a reasonable approximation between the philtrum and the midpoint of the odontoid process. Based on our results, we suggest that the philtrum of the upper lip can serve as a first line estimation of the position of the odontoid process and can assist in verifying this bony structure following the use of image guidance.
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Dong C, Zheng S. Immunohistochemical analysis of orbicularis oris muscle fiber distribution at the philtrum in healthy infants. Int J Pediatr Otorhinolaryngol 2015; 79:2208-12. [PMID: 26527071 DOI: 10.1016/j.ijporl.2015.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To characterize the fiber-type distribution of the orbicularis oris muscle at the philtrum in healthy infants by immunohistochemistry and examine the relationship between orbicularis oris and philtrum structure. METHODS Samples of the upper lip were obtained from two infant cadavers. Serial sagittal sections were obtained at the midline of the philtral dimple, unilateral philtral ridge, and the lateral side. Three sections from each site were prepared for immunohistochemical staining using myosin heavy chain fast fiber (MHCf) and myosin heavy chain slow fiber (MHCs) antibodies to determine the ratio of fast to slow skeletal muscle fibers. RESULTS The ratio of fast to slow muscle fibers differed significantly among the superficial orbicularis oris muscle (98.30%:1.13%), deep pars peripheralis (95.30%:3.14%), and deep pars marginalis (91.31%:5.74%), with a significantly higher percentage of slow fibers in the pars marginalis compared to pars peripheralis (P=0.002) and fast fibers in the superficial muscle compared to pars marginalis and peripheralis (both P=0.000). Similarly, the fast:slow fiber ratio differed among the superficial philtral dimple (95.88%:2.41%), superficial philtral ridge (98.52%:1.11%), and superficial midlateral philtral ridge (99.07%:0.66%), with a higher percentage of fast fibers higher on the lateral side of the superficial philtral ridge than at the philtral ridge (P=0.030) and higher at the philtral ridge than the philtral dimple (P=0.001). The fast:slow fiber ratio did not differ within the pars peripheralis at the philtral dimple (93.94%:4.19%), philtral ridge (94.49%:3.84%), and lateral philtral ridge (95.79%:2.70%) (all P>0.05). CONCLUSIONS Philtum structure is likely determined in part by the distribution of muscle fiber types among philtral dimple, ridge, and lateral side. These differences should be considered in cleft lip repair.
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Affiliation(s)
- Chenbin Dong
- Department of Plastic Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Shan Zheng
- Department of Plastic Surgery, Children's Hospital of Fudan University, Shanghai 201102, China.
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Rahpeyma A, Khajehahmadi S. Unilateral one stage nasolabial flap for reconstruction of the lips. J Maxillofac Oral Surg 2015; 14:234-9. [PMID: 26028840 DOI: 10.1007/s12663-013-0615-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 12/28/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Nasolabial flap (NLF) is one of the oldest described soft tissue flaps. Despite the great advances in maxillofacial reconstruction it still has a stable location in the reconstructive ladder of the face and oral cavity. Reconstruction of the lips, which are important structures that connect the oral cavity to the facial skin, with this flap is the interest of the surgeons. PATIENTS AND METHODS Experience of the authors for reconstruction of the upper lip philtrum, correction of lower lip contracture and subtotal reconstruction of the lower lip with emphasis on simultaneous correction of the red lip (volume and color) is explained in five cases. RESULTS Satisfactory functional and aesthetic results were obtained. Iatrogenic epidermoid cyst occurred in one patient. CONCLUSION One stage reconstruction of lateral lower lip defects with/without commissural involvement in full or partial thickness defects is possible by NLF. Supplementary flaps are needed when the vermilion needs simultaneous reconstruction.
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