Reconstruction of the Corner of the Mouth

Anderson, Robin; Kurtay, Mine

doi:10.1097/00006534-197105000-00008

Cited by 24 publications

(3 citation statements)

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“…Several authors have considered the natural shape of the oral angle to be a smooth curve rather than a corner. 10,20,21 Some are concerned that positioning scars on the commissure may result in further scarring and distortion of the commissural shape. 3,4,7 For these reasons, many surgeons have used vermilion flaps to create oral commissures with the development of several modifications.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Long-Term Outcomes of Transverse Facial Cleft Repair

Kim,

Lim

2023

The Cleft Palate Craniofacial Journal

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Objective To evaluate the long-term outcomes of linear commissuroplasty and linear skin closure with a focus on commissural migration. Design Retrospective study. Patients Individuals who underwent transverse facial cleft repair at a single institution between 2004 and 2021. Interventions The disrupted orbicularis oris muscle was reoriented and sutured. A simple linear commissuroplasty technique was used, and the cheek skin was closed linearly without Z-plasty. Main outcome measures The distances from Cupid's bow peak to the oral commissure were measured bilaterally, and the difference between the normal and cleft sides was obtained. Finally, its proportional value as a percentage of the total lip length was calculated from short- and long-term follow-up photographs. Cheek scarring and its effects on melolabial fold breakage were evaluated. Results Of the 18 patients who underwent transverse facial cleft repair, 12 were included in this study. The mean follow-up period based on medical photographs was 1773.5 days. The average proportional difference was 4.6%, demonstrating no observable commissural migration. There were no consistent trends in the direction of migration, either on the cleft or normal side. In patients with a transverse cleft crossing the melolabial fold, the folds appeared broken before and after the cleft repair surgery. Conclusions No significant long-term commissural migration was observed after transverse facial cleft repair with simple linear commissuroplasty and linear skin closure. Deliberate positioning of the new oral commissure, proper myoplasty, and meticulous skin closure with minimal scar burden can be considered key procedures for successful transverse cleft repair.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Long-Term Outcomes of Transverse Facial Cleft Repair

Kim,

Lim

2023

The Cleft Palate Craniofacial Journal

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“…However, these methods of reconstruction have their scars located at the angle. Because the corner of the normal mouth is not a corner but rather a smooth and continuous segment of the vermilion [26], it is difficult to achieve a natural contour of the corner of the mouth when the scar is located at the angle.…”

Section: Discussionmentioning

confidence: 99%

Repair for Congenital Macrostomia: Vermilion Square Flap Method

Dhingra

Dhingra²,

Munjal

2014

Case Reports in Dentistry

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Transverse facial clefts (macrostomia) are rare disorders that result when the embryonic mandibular and maxillary processes of the first branchial arch fail to fuse due to failure of mesodermal migration and merging to obliterate the embryonic grooves between the maxillary and mandibular processes to form the angle of the mouth at its normal anatomic position. Macrostomia may be seen alone or in association with other anomalies. It may be unilateral, extending along a line from the commissure to the tragus or bilateral. It is usually partial but rarely complete. Transverse facial clefts are more common in males and more common on the left side when unilateral. The goal of macrostomia reconstruction is to achieve functional, symmetrical, and accurate oral commissure with minimal scar. In this paper, we present a six-year-old girl with unilateral macrostomia with preauricular skin tags and malformation of pinna on ipsilateral side treated with vermillion-square flap method. The scar is placed at the upper lip. At two-month followup, the oral commissures are symmetric, the scars are inconspicuous, and the overall balance of facial contour and lip is excellent. We recommend this method for patients with mild to moderate macrostomia.

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“…Several authors have noted that the normal commissure is not a corner, but rather a smooth and continuous segment of vermilion. 21,48 Verheyden noted that the rugae, present on the more exposed labial Volume 120, Number 3 • Repair of Transverse Facial Cleft vermilion, are absent in the commissure, and that vermilion in the commissure more closely imitates mucosa. 28 Onizuka described the outermost edge of the upper and lower lip vermilion as two small opposing triangles that appear to be noncontiguous with the mouth closed.…”

Section: Discussionmentioning

confidence: 99%