The Governor Vessel (GV)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
On the philtrum, on the anterior midline, at the junction of the upper third and lower two-thirds of the distance from the nose to the margin of the upper lip.
Oral Cavity Tumours Including Lip Reconstruction
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Superficial defects of the upper lip, with intact orbicularis oris, can often be reconstructed by simple methods. Central defects involving less than half the distance between the philtral columns can either be repaired primarily or with a wedge resection. In all wedge resections, it is essential that the orbicularis muscle be accurately repaired for normal lip movement. If the defect is superficial and involves more than half of the central lip without crossing the philtrum, a full-thickness skin graft can give adequate results. In men, this graft could be taken from hair-bearing preauricular skin to restore hair growth. For superficial lateral defects which are less than half the width of the lateral lip, wedge resection is a good option. When the defect involves more than half the width of the lateral lip, a local flap from the cheek may be a good option ( Figure 12.9 ). Alternatively, a full-thickness graft can be just as acceptable. The management of full-thickness defects of the upper lip depends on their size and location. Defects up to one-third in width can usually be closed directly, often with the aid of perialar crescentic excisions. If primary closure is employed for central defects it can result in a narrow central lip, but this is usually cosmetically acceptable. When a central defect is greater than half of the upper lip, an Abbe-Sabattini flap from the lower lip is indicated ( Figure 12.10 ). In such situations the whole central lip subunit (from philtral column to philtral column) should be excised. The width and height of the flap should equal that of the upper lip defect.
Individual conditions grouped according to the international nosology and classification of genetic skeletal disorders*
Christine M Hall, Amaka C Offiah, Francesca Forzano, Mario Lituania, Michelle Fink, Deborah Krakow in Fetal and Perinatal Skeletal Dysplasias, 2012
Developmental delay and seizures are constant features. Death has often been reported as secondary to infectious disease. Differential diagnosis: other diseases characterised by significant IUGR and prenatal onset microcephaly include MOPD type 2: relatively proportionate head size at birth, postnatal progression to severe microcephaly, progressive skeletal dysplasia, dislocated joints, characteristic facies, dysplastic or missing dentition. No brain abnormalities, but a proportion can show cerebral aneurysms and Moya Moya disease. Patients display a sociable personality and a high squeaky voice. Autosomal recessive, mutations in PCNT2 have been identified. Seckel syndrome: proportionate prenatal onset dwarfism, absence of skeletal dysplasia. Patients develop severe developmental delay and sometimes haematological abnormalities. Autosomal recessive, genetically heterogeneous, three loci identified, SCKL1 is caused by mutations in the gene ATR. Fetal alcohol syndrome: the more severe cases can show intrauterine growth retardation, microcephaly, cardiac abnormalities (septal defects, tetralogy of Fallot), brain abnormalities (microcephaly, agenesis of corpus callosum, cavum septum pellucidum, ventriculomegaly). Facial features are very typical and include short palpebral fissures, smooth and underdeveloped philtrum with a thin upper lip. Epiphyseal stippling has been reported, as well as short distal phalanges and transverse limb defects. Dubowitz syndrome: typical facial features, which consist of telecanthus, ptosis, blepharophimosis, prominent epicanthic folds, broad nasal tip, micrognathia. Ears are often dysplastic; occasionally cleft palate. Other particular features include sparse hair and eczema on the face and flexural areas.
Two Trisomy 22 Live Births in One Hospital in 15 Months: Is It as Rare as We Thought?
Published in Fetal and Pediatric Pathology, 2014
Thirona Naicker, Colleen Aldous
We report two cases of complete non-mosaic trisomy 22 who were born within 15 months of each other in KwaZulu Natal, South Africa. In an effort to consolidate diagnostic criteria to suspect trisomy 22 prior to chromosomal testing, we compare the clinical features of these infants with those of 23 other trisomy 22 live borns presented in the literature. We further compare the clinical phenotype of trisomy 22 with those of trisomies 13 and 18 to delineate a clinical picture to presume possible trisomy 22 soon after birth. Dysmorphic features which distinguish trisomy 22 from trisomy 13 and 18 include hypertelorism, long philtrum, long and thin upper lip, webbing of the neck, low set, wide spread nipples and an abnormal anus. Given the poor prognosis of this disorder and early mortality of most confirmed cases, non-aggressive versus aggressive treatment measures should be weighed up as soon after birth as possible.
A novel electroneurography method in facial palsy
Published in Acta Oto-Laryngologica, 2010
Shin-Ichi Haginomori, Shin-Ichi Wada, Atsuko Takamaki, Atsuko Kanazawa, Ryuzaburo Nonaka, Hiroshi Takenaka, Takayuki Takubo
Conclusion: The novel midline electroneurography (ENoG) method may have advantages over the standard method in terms of ease of electrode setting, and the ENoG value may be a useful prognostic factor. Objective: We compared ENoG performed in patients with facial palsy using two different methods – the new midline method and standard method – in terms of the amplitudes of the compound muscle action potentials (CMAPs) and relationship between the ENoG value and clinical course. Methods: A total of 64 patients with facial palsy were enrolled. CMAPs were recorded using the midline method, in which the recording electrodes were placed on the mental protuberance and philtrum over the orbicularis oris muscle, and the standard method, in which the recording electrodes were set close to the nasolabial fold. Percutaneous electrical stimulation was applied to the main trunk of the facial nerve. The amplitudes of the CMAPs and the relationship between the ENoG value and the period to full recovery from the facial palsy were compared. Results: The midline method had larger CMAP amplitudes on both sides and a stronger negative correlation in the relationship between the ENoG value and period to full recovery from palsy than the standard method statistically.
Ocular Manifestations of Fetal Alcohol Syndrome
Published in American Orthoptic Journal, 1991
Infants born to alcoholic women can have a characteristic pattern of birth defects, the Fetal Alcohol Syndrome (FAS). Clinically, the diagnosis of FAS must include central nervous system dysfunction, linear growth deficiency before and after birth and under development of the mid-face, especially the eyes. These findings are variable and may be subclinical. Microcephaly with microphthalmia, sunken nasal bridge, hypoplasia of the maxilla and philtrum contribute to the unusual facial appearance of FAS children. Ophthalmologic findings in FAS may include ptosis and blepharophimosis, palpebral fissure anomalies, tortuosity of retinal vessels, optic nerve hypoplasia and strabismus. Education about FAS has been shown to decrease alcohol use during pregnancy. Healthcare providers are in the key position to provide this education, and to prevent damage in subsequent siblings of a diagnosed index case.
Related Knowledge Centers
- Cleft Palate
- Gingiva
- Mouth
- Oral Mucosa
- Embryo
- Rhinarium
- Nostril