Clinical Features of the Microform Cleft Lip and The Ultrastructural Characteristics of the Orbicularis Oris Muscle

2009 ◽  
pp. 091202121239062
Author(s):  
Eun Kim ◽  
Shin Khang ◽  
Taik Lee ◽  
Tae Gon Kim
2018 ◽  
Vol 56 (3) ◽  
pp. 390-394
Author(s):  
Yuta Nakajima ◽  
Shunsuke Yuzuriha ◽  
Fumio Nagai ◽  
Kenya Fujita ◽  
Masahiko Noguchi

Objective: In unilateral cleft lip and palate, the reconstructed nasal floor is sometimes uplifted regardless of the reconstructive method used. We used a 5-0 absorbable anchoring suture, the oronasal transfixion suture (ONT suture), to fasten the reconstructed nasal floor to the orbicularis oris muscle to prevent this deformity. This study was performed to evaluate the effects of the ONT suture. Design: Blind retrospective study of photography and chart review. Setting: Shinshu University Hospital, tertiary care, Nagano, Japan. Private practice. Patients: Ninety-three consecutive patients with unilateral complete cleft lip and palate who had undergone primary nasolabial repair in our department and affiliated hospitals between 1999 and 2011 participated in this study. Finally, 45 patients were included. Interventions: The ONT suture was put in place at the time of primary nasolabial repair. Main Outcome Measure: The height of the nasal floor was evaluated on submental view photographs at 5 years old. Results: The ONT suture was applied in 21 patients. The height of the nasal floor on the cleft side was significantly closer to that on the noncleft side with the ONT suture than without the ONT suture ( P = .008). Conclusions: The ONT suture is effective to prevent uplifted nasal floor deformity on the cleft side// in unilateral complete cleft lip and palate at the time of primary nasolabial repair.


2009 ◽  
Vol 17 (3) ◽  
pp. 1-2 ◽  
Author(s):  
Iván Marcelo Cueva Galárraga

Objective To determine if the use of botulinum toxin during cheiloplasty could help in the management of tension at the surgical wound level. Interventions Five children younger than six months of age, who were born with complete cleft lip and palate, were treated with a dose of 10 units of botulinum toxin injected into the upper lip during surgery. Before the surgery, an electromyographic study was carried out on the patients' upper lips. A Millard-type cheiloplasty was performed and 10 days later, a second electromyographic study was performed on the upper lips of all the patients. Results There was a significant change (P<0.039) in the electromyo-graphic tracing obtained after the application of botulinum toxin, especially during rest. Conclusion As confirmed by electromyography, botulinum toxin effectively inhibits the action of the orbicularis oris muscle, especially when at rest; consequently, the tension is decreased at the level of the surgical wound.


2007 ◽  
Vol 44 (3) ◽  
pp. 261-268 ◽  
Author(s):  
Nancy J. M. van Hees ◽  
Johan M. Thijssen ◽  
Rinske W. Huyskens ◽  
Gert Weijers ◽  
Maartje M. Nillesen ◽  
...  

Objective: To investigate the feasibility of echographic imaging of healthy and reconstructed cleft lip and to estimate tissue dimensions and normalized echo level. Methods: Echographic images of the upper lip were made on three healthy subjects and two patients using a linear array transducer (7 to 11 MHz bandwidth) and a noncontact gel coupling. Tissue dimensions were measured using calipers. Echo levels were calibrated and were corrected for beam characteristics, gel path, and tissue attenuation using a tissue-mimicking phantom. Results: At the central position of the philtrum, mean thickness (SD) of lip loose connective tissue layer, orbicularis oris muscle, and dense connective layer was 4.0 (0.1) mm, 2.3 (0.7) mm, and 2.2 (0.7) mm, respectively, in healthy lip at rest; and 4.1 (0.9) mm, 3.8 (1.7) mm, and 2.6 (0.6) mm, respectively, in contracted lip. Mean (SD) echo level of muscle and dense connective tissue layer with respect to echo level of lip loose connective tissue layer was −19.3 (0.6) dB and −10.7 (4.0) dB, respectively, in relaxed condition and −20.7 (1.5) dB and −7.7 (2.3) dB, respectively, in contracted state. Color mode echo images were calculated, showing lip tissues in separate colors and highlighting details like discontinuity of the orbicularis oris muscle and presence of scar tissue. Conclusions: Quantitative assessment of thickness and echo level of various lip tissues is feasible after proper echographic equipment calibration. Diagnostic potentials of this method for noninvasive evaluation of cleft lip reconstruction outcome are promising.


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