Cleft Lip and Palate
John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed in Paediatrics, The Ear, Skull Base, 2018
Integrity of the lip and oral sphincter is important for normal function of the mouth. A defect in the lip results in abnormal insertion of orbicularis oris and loss of continuity of the vermilion border, both of which have to be addressed in cleft lip repair in order to allow long-term return to form and function. The mucocutaneous area of the lip is well defined into three regions: there is the cutaneous skin of the upper lip and philtrum, an intermediate area of dry mucosa known as the vermilion and an internal area of moist mucosa.27 The orbicularis oris normally forms a full sling under the mucosal covering, however aberrant muscle due to the cleft results in insertion of the orbicularis oris into the dermis and nasal ala on the cleft side and insertion into the columella on the non-cleft side (Figure 18.6).
Fetal Alcohol Syndrome
Merlin G. Butler, F. John Meaney in Genetics of Developmental Disabilities, 2019
One advantage of the Washington Criteria is the attempt to define the facial phenotype of FAS in an objective manner. Astley and Clarren (9) have created a pictorial “lip/philtrum guide” to aid in the objective assessment of the structure of the upper lip and philtrum (Fig. 3). This guide depicts five categories, ranging from normal to those observed in classical FAS. In order to use the guide for the diagnosis of FAS, the upper lip thinness and the philtrum smoothness are assessed separately by comparing the patient’s face to the guide. A rank of 1 is considered completely normal while a rank of 5 is most suggestive of FAS. Medical practitioners who evaluate patients with in utero exposure to alcohol should be encouraged to use this objective lip/philtrum guide even if they do not employ the full diagnostic system proposed by Astley and Clarren.
Dermal filler complications and management
Michael Parker, Charlie James in Fundamentals for Cosmetic Practice, 2022
Tiny lumps may not be noticeable at the time of augmentation due to localised oedema and will become visible once the swelling has settled down a few days post-treatment. They are often seen when a patient smiles, laughs or talks in a manner which stretches out overlying tissues. They are most problematic and cosmetically displeasing within the lips, where their off-white colour is demonstrated in stark contrast to the normal pinky-red hues of the lips themselves. If your patient notices these lumps within two weeks of treatment, then you can yet again advise them to massage the area. It is advisable for you to make an urgent appointment to see them to massage the area and teach them to how to do this in person. A face-to-face assessment is also often useful to allow you to exclude these lumps from being a more worrisome condition, such as an infection or abscess. If the lumps do not settle, then you have three realistic choices. The first of which is to wait a few weeks and then re-augment the area in question with the aim of burying the lumps within the new filler. The second is to do nothing and wait for them to dissolve naturally, and the third is to actively remove the lumps which can be via hyaluronidase administration or incision and manual removal of lumps under local anaesthesia.
Cell culture models of oral mucosal barriers: A review with a focus on applications, culture conditions and barrier properties
Published in Tissue Barriers, 2018
Lisa Bierbaumer, Uwe Yacine Schwarze, Reinhard Gruber, Winfried Neuhaus
The external anatomical borders of the oral cavity are lips and cheeks. The internal anatomical borders are (i) the anterior pillars of the fauces, (ii) the palate, (iv) the mylohyoid muscle, (iv) the cheeks and (v) the retromandibular region. The oral cavity is covered by three kinds of mucosa: lining, masticatory and specialized mucosa. Lining mucosa is red, consists of non-keratinized stratified squamous epithelium covering the loosely fibrous lamina propria and the submucosa containing fat deposits. This kind of mucosa covers the soft palate, the ventral surface of the tongue, the floor of the mouth, the internal surface of the lips, the cheeks and the alveolar process excluding the masticatory mucosa. Masticatory mucosa is keratinized or parakeratinized and located at the palate, the papilla free dorsal part of the tongue, and the upper part of the alveolar process. In the region of the upper part of the alveolar process and the raphe of the palate, the mucosa is firmly bund to the underlying bone and called gingival mucosa or gingivae, which appears pale pink. The specialized mucosa is the part where the tongue is dorsally covered by numerous papillae.11
Targeted therapy of rheumatoid arthritis via macrophage repolarization
Published in Drug Delivery, 2021
Xu Zhou, Dandan Huang, Runkong Wang, Mingquan Wu, Liyang Zhu, Wei Peng, He Tu, Xuangeng Deng, He Zhu, Zhong Zhang, Xinming Wang, Xi Cao
The in vivo biodistribution of the Lips is shown in Figure 4(A). No obvious fluorescence was observed in the DiD group. Both Lips/DiD and FA-Lips/DiD exhibited strong fluorescence in the rear limbs of AIA rats compared to that of the DiD solution. Importantly, FA-Lips/DiD more selectively accumulated in the inflamed joints than Lips/DiD at 2 h, 6 h, and 24 h. The ex vivo biodistribution in major organs is shown in Figure 4(B,D), and the liver and lung had the greatest fluorescence after 24 h in the DiD solution group. In contrast, more Lips seemed to accumulate in the spleen compared to the DiD solution. There was massive fluorescence accumulation in the limbs in the FA-Lips/DiD group after 24 h compared with the DiD solution group and Lips/DiD group (Figure 4(C,D)), indicating a prolonged circulation time and increased inflamed joint targeting efficiency.
Q-switched 532 nm Nd:YAG laser therapy for physiological lip hyperpigmentation: novel classification, efficacy, and safety
Published in Journal of Dermatological Treatment, 2022
Saad Altalhab, Mohammed Aljamal, Thamer Mubki, Naief AlNomair, Shoug Algoblan, Ammar Alalola, Mohammed I. AlJasser, Ahmed Alissa
Lip hyperpigmentation is commonly seen in practice. Many conditions are known to be associated with lip hyperpigmentation. Some of those conditions are very common and benign while others are rare and can be associated with serious systemic findings (1). Physiological lip hyperpigmentation (PLH) or dark lips is considered a very common cause of diffuse lip hyperpigmentation. It is a frequently encountered cosmetic concern in individuals with dark skin including in the Middle East. The color ranges from light brown to black and typically has symmetric distribution over both lips (2). It can be limited to the lips or associated with gingival and/or other oral mucosal hyperpigmentation (1). Melanocytes in PLH are normal in number but have increased melanin production. This can be enhanced further with age and some environmental factors such as smoking (2).
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