scholarly journals Functional Outcomes of Cleft Lip Surgery. Part II: Quantification of Nasolabial Movement

2007 ◽  
Vol 44 (6) ◽  
pp. 607-616 ◽  
Author(s):  
Carroll-Ann Trotman ◽  
Julian J. Faraway ◽  
H. Wolfgang Losken ◽  
John A. van Aalst
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mouth Opening ◽  
Upper Lip ◽  
Vertical Movements ◽  
Lower Lip ◽  
Lower Jaw ◽  
Lip Movement ◽  
The Asymmetry

Objective: To explore nasolabial movements in participants with repaired cleft lip and palate. Design: A parallel, three-group, nonrandomized clinical trial. Subjects: Group 1 = 31 participants with a cleft lip slated for revision surgery (revision), group 2 = 32 participants with a cleft lip who did not have surgery (nonrevision), and group 3 = 37 noncleft control participants. Methods: Three-dimensional movements were assessed using a video-based tracking system that captured movement of 38 landmarks placed at specific sites on the face during instructed maximum smile, cheek puff, lip purse, mouth opening, and natural smile. Measurements were made at two time points at least 1 week and no greater than 3 months apart. Summary measurements were generated for the magnitude of upper lip, lower lip, and lower jaw movements and the asymmetry of upper lip movement. Separate regression models were fitted to each of the summary measurements. Results: Lateral movements of the upper lip were greater than vertical movements. Relative to the noncleft group, the revision and nonrevision groups demonstrated 6% to 28% less upper lip movements, with the smiles having the most restriction in movement and greater asymmetry of upper lip movement. Having an alveolar bone graft further increased the asymmetry, while a bilateral cleft lip decreased the asymmetry. Lower jaw movement caused a small increase in upper lip movement. Conclusions: The objective measurement of movement may be used as an outcome measure for cleft lip surgery.

A Cephalometric Evaluation of Lower Lip in Patients with Unilateral Cleft Lip and Palate

2004 ◽  
Vol 41 (5) ◽  
pp. 485-489 ◽  
Author(s):  
T. Ufuk Toygar ◽  
M. Okan Akçam ◽  
Ayça Arman
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Normal Subjects ◽  
Middle Part ◽  
Class I ◽  
Control Group ◽  
Upper Lip ◽  
Lower Lip ◽  
Normal Individuals ◽  
Lateral Cephalograms

Objective The aim of this study was to evaluate cephalometrically the lower lip position and area of patients with unilateral cleft lip and palate (UCLP) comparatively with Class I skeletodental normal subjects. Patients Lateral cephalometric and hand-wrist radiographs obtained from 24 patients with UCLP (mean age 12.86 years), along with 20 normal individuals (mean age 12.33 years) used as a control group, were examined. Design In addition to standard cephalometric dentofacial variables, lower lip area (superior, middle, inferior) was also measured using a digital planimeter on the lateral cephalograms. Results The superior and middle part of the lower lip areas were significantly smaller (p < .05) in the UCLP group, compared to the control group. The inferior and total lower lip areas of patients with UCLP were found to be significantly smaller than controls. The labiomental angle was also smaller (38.79 degrees). Conclusions The results suggest that the lower lip of patients with UCLP is smaller, retruded, and curved, with a deep labiomental sulcus, compared with normal individuals during puberty. Therefore, practitioners should focus not only on the upper lip of patients with UCLP but also should consider the lower lip as it was found distinct from normal individuals during puberty.

Lip Movement in Patients with a History of Unilateral Cleft Lip

2001 ◽  
Vol 38 (5) ◽  
pp. 468-475 ◽  
Author(s):  
Christel A. W. Rutjens ◽  
Paul H. M. Spauwen ◽  
Pascal H. H. M. van Lieshout
Keyword(s):  
Cleft Lip ◽  
Relative Phase ◽  
Cleft Lip And Palate ◽  
General Increase ◽  
Lower Lip ◽  
History Of ◽  
Lip Movement ◽  
Cleft Lip Repair ◽  
Palate Repair ◽  
The Stability

Objective: The influence of a repaired cleft lip on the stability of coordination between upper and lower lip in nonspeech and speech tasks was investigated. Design: First, we looked at the effects of a secondary cleft lip repair in three individuals. Second, we compared subjects with a history of repaired unilateral cleft lip and subjects with no history of cleft lip (controls). Lip coordination was measured using continuous estimates of relative phase. Participants: Subjects were nine children and adolescents with a primary unilateral cleft lip and palate repair and 4 participants without cleft matched for age across different age categories. Results: In general, the averaged relative phase angle (RPA) angle values were smaller than 180 degrees, indicating an upper lip lead for lip closure. Controls showed a tendency toward a more symmetric type of coordination (close to 180 degrees), compared with subjects with a repaired unilateral cleft lip. The controls also showed less variation in coordination between the lips. For the more complex speech tasks, a general increase in variability of the RPA values for all subjects was observed, most likely suggesting a more flexible type of coordination. Regarding the effect of a secondary cleft lip repair, only one of the three patients showed a clearly less symmetric and less stable type of coordination, compared with preoperation results. Conclusions: There appear to be differences in lip coordination between speakers without and speakers with a repaired unilateral cleft lip. Furthermore, it seems that the stability of lip coordination tends to increase with age.

Dynamic Analysis of the Effects of Upper Lip Pressure on the Asymmetry of the Facial Skeleton in Patients with Unilateral Complete Cleft Lip and Palate

2009 ◽  
Vol 46 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Tomohisa Nagasao ◽  
Junpei Miyamoto ◽  
Eri Konno ◽  
Hisao Ogata ◽  
Tatsuo Nakajima ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Computer Aided Design ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Nasal Bone ◽  
Facial Asymmetry ◽  
Upper Lip ◽  
Facial Skeleton ◽  
Alveolar Bone Grafting

Objective: Our purpose was to assess quantitatively the effect of increased upper-lip pressure on asymmetry of the facial bones in patients with unilateral complete lip-alveolar-palatal clefts. Methods: We collected computed tomographic images from 16 patients with unilateral complete lip-alveolar-palatal clefts and classified them into two groups based on absence/presence of alveolar bone grafting. We categorized eight patients (9.6 ± 2.0 years old) who had not been treated with alveolar bone grafting as the ABG(−) group and the other eight patients (9.3 ± 1.6 years old) who had received alveolar bone grafting as the ABG(+) group. After producing a computer-aided design model for each patient, we applied a uniform load on the anterior aspects of the maxilla, alveolus, and teeth of the model to simulate the upper-lip pressure. Then we calculated the degree of distortion each model presented using the finite element method. We compared the distortion pattern between the ABG(−) and ABG(+) groups. Results: In the ABG(−) patients, asymmetry of distortion between the cleft and noncleft sides was present in wide areas involving the orbit, nasal bone, piriform margin, and anterior wall of the maxillary sinus. In the ABG(+) patients, asymmetry of distortion was limited to rather small areas. Conclusions: In unilateral complete lip-alveolar-palatal clefts patients, the upper-lip pressure works to dislocate the cleft-side segment to a more posterior position than the noncleft-side segment. This finding implies that the increased lip pressure exacerbates facial asymmetry of these patients. The exacerbating effect on facial asymmetry is alleviated by alveolar bone grafting.

The Dynamics of Interlip Coupling in Speakers With a Repaired Unilateral Cleft-Lip History

2002 ◽  
Vol 45 (1) ◽  
pp. 5-19 ◽  
Author(s):  
P. H. H. M. van Lieshout ◽  
C. A. W. Rutjens ◽  
P. H. M. Spauwen
Keyword(s):  
Cleft Lip ◽  
Coordination Dynamics ◽  
Spatiotemporal Pattern ◽  
Upper Lip ◽  
Lower Lip ◽  
Kinematic Data ◽  
Movement Characteristics ◽  
Lip Movement ◽  
The Individual ◽  
Selection Of

In this paper, data are presented on individual movement characteristics of the upper and lower lip and on interlip coordination in speakers with a repaired unilateral cleft upper lip history and age-matched control participants. The data were acquired using the AG100 EMMA system while the participants produced a selection of nonspeech and speech tasks. The participants with a repaired unilateral cleft upper lip history showed reduced upper-lip movement ranges and peak velocities and a more variable spatiotemporal pattern for individual upper-lip movement cycles, in addition to a more variable interlip coupling. The latter difference also proved to be more pronounced for the younger speakers with a repaired cleft upper lip. Overall, for both groups, the linguistically more complex task showed more variability in the individual upper- and lower-lip movement cycles and their coupling. In the discussion, we address the potential relationships between the kinematic data for upper lip in the repaired-cleft-lip speakers and the findings on movement and coordination stability as they might fit within current notions of coordination dynamics theory.

scholarly journals Evaluation of Lip Morphology and Nasolabial Angle in Non-Syndromic Cleft Lip and/Palate and Non-Cleft Individuals

2021 ◽  
Vol 12 (1) ◽  
pp. 357
Author(s):  
Mohammad Khursheed Alam ◽  
Ahmed Ali Alfawzan ◽  
Fatema Akhter ◽  
Haytham Jamil Alswairki ◽  
Prabhat Kumar Chaudhari
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Upper Lip ◽  
Lateral Cephalogram ◽  
Lower Lip ◽  
Nasolabial Angle ◽  
Bilateral Cleft Lip ◽  
Different Types ◽  
The Mean ◽  
Two Parameters

Objective: To investigate the variation between the non-syndromic cleft lip and/or palate (NSCLP) and non-cleft (NC) subjects in relation to the lip morphology (LM) and nasolabial angle (NLA). Materials and Methods: Lateral cephalogram (Late. Ceph.) of 123 individuals (92 NSCLP [29 = bilateral cleft lip and palate (BCLP), 41 = unilateral cleft lip and palate (UCLP), 9 = unilateral cleft lip and alveolus (UCLA), 13 = unilateral cleft lip (UCL)], and 31 NC) who did not undergo any orthodontic treatment were investigated. By WebCeph, an artificial intelligence- (A.I.) driven software, 2 (two) parameters of LM, namely upper lip to E line (LM-1) and lower lip to E line (LM-2), and NLA analysis was carried out for each individual. Multiple tests were carried out for statistical analysis. Results: The mean ± SD observed for LM-1, LM-2, and NLA for NC individuals were 1.56 ± 2.98, 0.49 ± 3.51, and 97.20 ± 16.10, respectively. On the other hand, the mean ± SD of LM-1, LM-2, and NLA for NSCLP individuals were 4.55 ± 4.23, 1.68 ± 2.82, and 82.02 ± 14.66, respectively. No significant variation was observed with respect to gender and side. NSCLP (different types) and NC individuals showed significant disparities in LM-1 and NLA. Conclusion: It can be concluded that parameters of lip morphology such as LM-1, LM-2, and NLA vary among NSCLP and NC individuals.

scholarly journals Rare Expression Of Van Der Wound Syndrome: A Case Report Revisited

2017 ◽  
Vol 3 (2) ◽  
pp. 61-65
Author(s):  
Kristaninta Bangun ◽  
Nurina Widayanti ◽  
Gentur Sudjatmiko
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mouth Opening ◽  
Careful Examination ◽  
Van Der Woude Syndrome ◽  
Lower Lip ◽  
Genital Abnormality ◽  
Craniofacial Syndrome ◽  
Oral Abnormalities ◽  
Left Eyelid

Background: Van der Woude syndrome (VWS) is a rare developmental malformation, characterized by pits in the lower lip. Van der Woude syndrome is an autosomal dominant craniofacial syndrome with various expression: lower lip pits, cleft lip with or without cleft palate, syngnathia, hypoodontia, and ankyloglossia. Extra-oral abnormalities findings can be found: syndactily, corpus callosum dysgenesis, megacolon, ventricular septal defect and genital abnormality. Methods: We reported a case of 5-month-old male with rare expression of VWS: bilateral cleft lip and palate, syngnathia, lower lip pits, ptosis of upper left eyelid and macropenis. Results: We perform surgery to release the fibrous band to achieve satisfactory maximum mouth opening. Next we perform cheiloplasty and lower lip pit removal. Conclusion: Proper surgical intervention in VWS patients can improve feeding and prevent further temporomandibular complications. Careful examination of patients with cleft lip and lower lip pit should be done to avoid misdiagnosis.

scholarly journals Association between Subjective and Objective Measures of Lip Form and Function: An Exploratory Analysis

2003 ◽  
Vol 40 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Carroll-Ann Trotman ◽  
Ceib Phillips ◽  
Julian J. Faraway ◽  
Kelly Ritter
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Objective Measures ◽  
Upper Lip ◽  
Form And Function ◽  
Subjective Assessments ◽  
The Face ◽  
Lip Movement ◽  
Analysis System ◽  
And Function

Objective In patients with cleft lip and palate, the aims of this study were to generate objective measures of different attributes of lip movement and to explore the utility of these objective measures by examining the association between examiners’ subjective assessments with the objective measures. Patients and Participants Thirteen patients with unilateral cleft lip and palate with varying degrees of cleft scar severity were selected. All patients had a previously repaired complete unilateral cleft lip and palate. Interventions Photographs and videotape recordings were made of the patients with cleft at rest and during smiling. Measurements of lip movement were obtained by means of a motion analysis system. Main Outcome Measures The study sought to obtain rankings of cleft scar severity and impairment on a 6-point Likert scale by a lay and professional panel and measurements of displacement, asymmetry, speed, and velocity of upper lip during smiling. Results Displacement was the most consistent and valid objective measurement. An objective analysis of the entire upper lip provided the most information. In general, there was a decrease in the objective measures of upper lip movement as examiners’ perceptions of facial appearance or disfigurement at rest and impairment during movement became worse. This relationship was stronger for the at-rest perceptions, implying that subjective assessments should be made with the face at rest. Conclusions Objective measures provided the promise for differentiation of the components of movement and should be used to supplement subjective evaluations of lip appearance at rest and during movement.

Vestibuloplasty after Secondary Alveolar Bone Grafting

2001 ◽  
Vol 38 (6) ◽  
pp. 551-559 ◽  
Author(s):  
Mitsuyoshi Iino ◽  
Masayuki Fukuda ◽  
Kaho Murakami ◽  
Toshikatsu Horiuchi ◽  
Kouta Niitsu ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Surgical Procedure ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Scar Tissue ◽  
Upper Lip ◽  
Alveolar Bone Grafting ◽  
Periosteal Surface ◽  
Secondary Alveolar Bone Grafting

Objective: This paper introduces a surgical technique for vestibuloplasty after secondary alveolar bone grafting of patients with cleft lip and palate (CLP). This paper also reports on the patients who underwent this modified vestibuloplasty. Surgical Procedure: The vestibuloplasty technique described in this paper consists of: (1) reduction of submucosal scar tissue of the upper lip, (2) V-Y plasty of the superficial mucosa, (3) placement of horizontal mattress sutures between nostril floor skin and freed marginal mucosa, (4) application of artificial skin to cover the exposed periosteal surface, and (5) use of a removable retention splint. Conclusion: This surgical procedure appears to be very useful for patients with CLP. The technique enables the surgeon to obtain an adequate sulcus depth around the graft area. In addition, this technique releases the mucosal scar contraction and improves the shape and mobility of the upper lip.

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