The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Zhengwen Zhang - One of the best experts on this subject based on the ideXlab platform.
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reconstruction of Philtrum using partial splitting and folding of orbicularis oris muscle in secondary unilateral cleft lip
Plastic and Reconstructive Surgery, 2015Co-Authors: Lei Li, Zhengwen ZhangAbstract:BACKGROUND: The reconstruction of the Philtrum during unilateral cleft lip repair remains a surgical challenge. The authors introduce a modified surgical technique for the reconstruction of the Philtrum that allows for both the deepening of the philtral dimple and augmentation of the philtral ridge. METHODS: Between January of 2011 and June of 2012, 37 patients, including 22 male and 15 female patients (mean age, 25.6 years), underwent secondary unilateral cleft lip repair. The Philtrum was reconstructed by the partial splitting and folding of the orbicularis oris muscle. The aesthetic outcome of the Philtrum and the scar after the operation was scored to evaluate the effectiveness of the procedure. RESULTS: The patients were evaluated for the appearance of the Philtrum and scar at 12 to 18 months (mean, 14.6 months). Good symmetry of the bilateral philtral ridges was achieved in 35 of the 37 patients, with the postoperative scores for aesthetic outcome being 2 to 4. The postoperative appearance of the scar in almost all cases was also significantly better than that before the operation. Only two patients showed widening of the philtral ridges and less prominent philtral ridges on the reconstructed side than on the normal side. CONCLUSIONS: The authors presented a new technique for the repair of the Philtrum in patients with secondary unilateral cleft lip; the technique afforded good aesthetic outcomes in almost all cases.
Melanie A Manning - One of the best experts on this subject based on the ideXlab platform.
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a south african mixed race lip Philtrum guide for diagnosis of fetal alcohol spectrum disorders
American Journal of Medical Genetics Part A, 2015Co-Authors: Eugene H Hoyme, Derek B Hoyme, Amy J Elliott, Jason Blankenship, Wendy O Kalberg, David Buckley, Omar A Abdulrahman, M P Adam, Luther K Robinson, Melanie A ManningAbstract:The adverse effects of maternal alcohol use during pregnancy represent a spectrum of growth restriction, facial dysmorphology, and neurocognitive challenges in the offspring. The continuum of diagnoses is referred to as fetal alcohol spectrum disorders (FASD). Short palpebral fissures, a smooth Philtrum, and a thin vermilion border of the upper lip comprise the three cardinal facial features of FASD. Early attempts to define a smooth Philtrum and thin vermilion border of the upper lip were subjective. Astley and colleagues introduced a 5-point Likert-scaled lip/Philtrum guide based on Caucasian North American subjects as an objective tool for the evaluation of the facial dysmorphology in FASD. This Caucasian guide has been incorporated into all current diagnostic schemes for FASD. However, broad international clinical experience with FASD indicates racial and ethnic differences with respect to the facial morphology. Because of the substantial number of children with FASD in South Africa among the Cape Coloured (mixed race) population in the Western Cape Province, we developed a specific lip/Philtrum guide for that population. The guide incorporates a 45-degree view of the Philtrum that enables an enhanced 3-dimensional evaluation of philtral height not possible with a frontal view alone. The guide has proven to be a more specific and sensitive tool for evaluation of the facial dysmorphology of FASD in the Cape Coloured population than the use of the previous North American Caucasian guide and points to the utility of racial and ethnic-specific dysmorphology tools in the evaluation of children with suspected FASD.
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A South African mixed race lip/Philtrum guide for diagnosis of fetal alcohol spectrum disorders
American Journal of Medical Genetics Part A, 2015Co-Authors: H. Eugene Hoyme, Derek B Hoyme, Amy J Elliott, Jason Blankenship, Wendy O Kalberg, David Buckley, M P Adam, Luther K Robinson, Omar A. Abdul-rahman, Melanie A ManningAbstract:The adverse effects of maternal alcohol use during pregnancy represent a spectrum of growth restriction, facial dysmorphology, and neurocognitive challenges in the offspring. The continuum of diagnoses is referred to as fetal alcohol spectrum disorders (FASD). Short palpebral fissures, a smooth Philtrum, and a thin vermilion border of the upper lip comprise the three cardinal facial features of FASD. Early attempts to define a smooth Philtrum and thin vermilion border of the upper lip were subjective. Astley and colleagues introduced a 5-point Likert-scaled lip/Philtrum guide based on Caucasian North American subjects as an objective tool for the evaluation of the facial dysmorphology in FASD. This Caucasian guide has been incorporated into all current diagnostic schemes for FASD. However, broad international clinical experience with FASD indicates racial and ethnic differences with respect to the facial morphology. Because of the substantial number of children with FASD in South Africa among the Cape Coloured (mixed race) population in the Western Cape Province, we developed a specific lip/Philtrum guide for that population. The guide incorporates a 45-degree view of the Philtrum that enables an enhanced 3-dimensional evaluation of philtral height not possible with a frontal view alone. The guide has proven to be a more specific and sensitive tool for evaluation of the facial dysmorphology of FASD in the Cape Coloured population than the use of the previous North American Caucasian guide and points to the utility of racial and ethnic-specific dysmorphology tools in the evaluation of children with suspected FASD.
Lei Li - One of the best experts on this subject based on the ideXlab platform.
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reconstruction of Philtrum using partial splitting and folding of orbicularis oris muscle in secondary unilateral cleft lip
Plastic and Reconstructive Surgery, 2015Co-Authors: Lei Li, Zhengwen ZhangAbstract:BACKGROUND: The reconstruction of the Philtrum during unilateral cleft lip repair remains a surgical challenge. The authors introduce a modified surgical technique for the reconstruction of the Philtrum that allows for both the deepening of the philtral dimple and augmentation of the philtral ridge. METHODS: Between January of 2011 and June of 2012, 37 patients, including 22 male and 15 female patients (mean age, 25.6 years), underwent secondary unilateral cleft lip repair. The Philtrum was reconstructed by the partial splitting and folding of the orbicularis oris muscle. The aesthetic outcome of the Philtrum and the scar after the operation was scored to evaluate the effectiveness of the procedure. RESULTS: The patients were evaluated for the appearance of the Philtrum and scar at 12 to 18 months (mean, 14.6 months). Good symmetry of the bilateral philtral ridges was achieved in 35 of the 37 patients, with the postoperative scores for aesthetic outcome being 2 to 4. The postoperative appearance of the scar in almost all cases was also significantly better than that before the operation. Only two patients showed widening of the philtral ridges and less prominent philtral ridges on the reconstructed side than on the normal side. CONCLUSIONS: The authors presented a new technique for the repair of the Philtrum in patients with secondary unilateral cleft lip; the technique afforded good aesthetic outcomes in almost all cases.
Viktor M Grishkevich - One of the best experts on this subject based on the ideXlab platform.
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single stage upper lip and Philtrum reconstruction in burned patients
2018Co-Authors: Viktor M Grishkevich, Max GrishkevichAbstract:The upper lip is an important functional and esthetic feature and it has a defining role in the concept of modern beauty. Therefore, the reconstruction of the upper lip, including all three of its subunits (Philtrum and two laterals), should be carried out with a single-stage procedure. Such a technique, as the literature shows, has not yet been developed. Our new technique of total upper lip restoration with Philtrum reconstruction is based on creating Philtrum columns by preserving thicker and more rigid strips of scar tissue over the intended location of the Philtrum and excising the rest of the scar of the upper lip. A single-flap skin graft covers all of the upper lip and the space between the Philtrum columns. A dedicated tied-over compression dressing allows creation of an anatomical depression between Philtrum columns, restoring proper anatomy of the upper lip.
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post burn Philtrum restoration
Burns, 2010Co-Authors: Viktor M GrishkevichAbstract:Abstract One of the consequences of face burn is upper lip deformation with Philtrum injury. The Philtrum's absence poses severe cosmetic defects. A literature review shows no effective developed technique which allows the surgeon to restore the upper lip and the Philtrum in a single-stage procedure. The article presents a new method for burn-damaged Philtrum restoration. Two scar stripes are deliberately left in place above the upper lip where the normal philtral ridges should be. The width of these two stripes (ridges) should be around 4 mm. The upper lip scars, lateral both ridges and between them, are excised forming the philtral dimple. The wound is covered with a split thickness skin graft. Two U-shaped sutures are led through the skin graft, both scar stripes and deeper through the underlying tissues between stripes. A bolster is plunged between the ridges in order to fill the dimple and is fixed by the tie-over dressing with tension. The skin transplant lying laterally to the ridges is covered with a separate tie-over dressing. The bolster is being kept in place for the duration of 7 days. As a result, the scar ridges preserve their height and the dimple keeps its depth. Good long-time follow-up results (up to 7 years) were observed in all 18 patients. In most cases the dimple can be slightly smoothed with time. The suggested method of Philtrum restoration is an important component of the burned upper lip reconstruction as part of the post-burn facial resurfacing.
Eugene H Hoyme - One of the best experts on this subject based on the ideXlab platform.
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a south african mixed race lip Philtrum guide for diagnosis of fetal alcohol spectrum disorders
American Journal of Medical Genetics Part A, 2015Co-Authors: Eugene H Hoyme, Derek B Hoyme, Amy J Elliott, Jason Blankenship, Wendy O Kalberg, David Buckley, Omar A Abdulrahman, M P Adam, Luther K Robinson, Melanie A ManningAbstract:The adverse effects of maternal alcohol use during pregnancy represent a spectrum of growth restriction, facial dysmorphology, and neurocognitive challenges in the offspring. The continuum of diagnoses is referred to as fetal alcohol spectrum disorders (FASD). Short palpebral fissures, a smooth Philtrum, and a thin vermilion border of the upper lip comprise the three cardinal facial features of FASD. Early attempts to define a smooth Philtrum and thin vermilion border of the upper lip were subjective. Astley and colleagues introduced a 5-point Likert-scaled lip/Philtrum guide based on Caucasian North American subjects as an objective tool for the evaluation of the facial dysmorphology in FASD. This Caucasian guide has been incorporated into all current diagnostic schemes for FASD. However, broad international clinical experience with FASD indicates racial and ethnic differences with respect to the facial morphology. Because of the substantial number of children with FASD in South Africa among the Cape Coloured (mixed race) population in the Western Cape Province, we developed a specific lip/Philtrum guide for that population. The guide incorporates a 45-degree view of the Philtrum that enables an enhanced 3-dimensional evaluation of philtral height not possible with a frontal view alone. The guide has proven to be a more specific and sensitive tool for evaluation of the facial dysmorphology of FASD in the Cape Coloured population than the use of the previous North American Caucasian guide and points to the utility of racial and ethnic-specific dysmorphology tools in the evaluation of children with suspected FASD.
