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Intravascular papillary endothelial hyperplasia (IPEH) is a benign lesion characterized by reactive proliferation of endothelial cells with papillary formations related to thrombosed blood vessels. IPEH in the oral region is relatively rare, and its clinical picture is not specific. Herein, we report the case of a patient with IPEH of the upper lip who had a favorable outcome. A man in his 40 s presented to our department with a nodule beneath the right upper labial mucosa. Magnetic resonance imaging showed a relatively well-defined mass. Based on the diagnosis of a benign tumor, a total excision with healthy margins was performed. Histopathological and immunohistochemical findings revealed a pure form of IPEH with a Ki-67 labeling index of 20%. No recurrence was observed 1 year postoperatively. Although IPEH in the oral region is relatively rare, and its clinical presentation is nonspecific, based on the clinical diagnosis of benign tumors, adequate excision with clear margins can reduce the risk of recurrence. As Ki-67 can be used to predict the biological behavior and risk of IPEH recurrence, careful follow-up considering the risk of recurrence suggested by the Ki-67 labeling index is needed. Thorough knowledge of IPEH is important for clinicians and pathologists to arrive at a correct diagnosis, which leads to appropriate treatment. [ABSTRACT FROM AUTHOR]

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Objective: To describe 3 cases of midline congenital upper lip sinus (MCULS) and review current literature to inform risk of intracranial involvement in the context of this rare congenital facial anomaly. Materials and Methods: A limited case series with chart review is presented. A literature search was conducted to review proposed theories of the embryology of MCULS and to determine the relative frequency of cephalic extension. Results: Including the 3 new cases presented herein, there have been 42 cases of MCULS described in the literature over the past 53 years. Thirty-nine cases (93%) underwent surgical excision, with 2 of these cases (4.7%) demonstrating cephalic extension of the fistula tract beyond the maxillary crest with termination at the anterior skull base. However, 95% (37/39) of surgically excised MCULS cases demonstrated a more limited depth of extension, with termination of the tract at or below the anterior nasal spine. Conclusions: The MCULS anomaly is rare, with fewer than 50 cases reported in the literature. Only 2 cases have been described with extension of the MCULS superior to the anterior nasal spine and into the nasal septum. It is the authors' opinion that preoperative neuroimaging is not routinely required for MCULS. However, if extension of the sinus tract beyond the anterior nasal spine is noted intraoperatively, the surgeon should consider aborting the case and obtaining appropriate neuroimaging. [ABSTRACT FROM AUTHOR]

Cleft lip and/or primary palate (CL/P) represent a prevalent congenital malformation, the aetiology of which is highly intricate. Although it is generally accepted that the condition arises from failed fusion between the upper lip and primary palate, the precise mechanism underlying this fusion process remains enigmatic. In this study, we utilized transposase‐accessible chromatin sequencing (scATAC‐seq) and single‐cell RNA sequencing (scRNA‐seq) to interrogate lambdoidal junction tissue derived from C57BL/6J mouse embryos at critical stages of embryogenesis (10.5, 11.5 and 12.5 embryonic days). We successfully identified distinct subgroups of mesenchymal and ectodermal cells involved in the fusion process and characterized their unique transcriptional profiles. Furthermore, we conducted cell differentiation trajectory analysis, revealing a dynamic repertoire of genes that are sequentially activated or repressed during pseudotime, facilitating the transition of relevant cell types. Additionally, we employed scATAC data to identify key genes associated with the fusion process and demonstrated differential chromatin accessibility across major cell types. Finally, we constructed a dynamic intercellular communication network and predicted upstream transcriptional regulators of critical genes involved in important signalling pathways. Our findings provide a valuable resource for future studies on upper lip and primary palate development, as well as congenital defects. [ABSTRACT FROM AUTHOR]

Masson’s tumor is a benign intravascular lesion of proliferating endothelial cells that accounts for 2% of vascular and subcutaneous lesions. It manifests clinically as a bluish swelling, resembling a mucocele or hemangioma. Intravascular papillary endothelial hyperplasia (IPEH) was coined by Clearkin and Enzinger in 1976 to describe reactive vascular expansion, following traumatic vascular stasis mimicking angiosarcoma. Clinically, this condition manifests as a bluish enlargement resembling a mucocele or hemangioma. We reported a rare case of IPEH located on the upper lip in an 18-year-old female. A diagnosis of IPEH was reported based on the histopathological findings of papillary proliferating endothelial cells with engorged red blood cells. There was no evidence of recurrence after 6 months of follow-up.

The female upper lip is shorter than its male counterpart. We have recently described a precise direct surface measurement technique of the philtral height. In this study we aim to quantify the difference in philtral height using this same measuring technique between two groups of young male and female Lebanese subjects. The mean philtral height obtained in the young male group was 15.7 ± 1.7 mm. By comparing this result to the previously described mean philtral height of 14.3 ± 1.9 mm in the young female group, we obtained a mean difference of 1.3 ± 1.8 mm between the two groups. This result confirms and quantifies by direct surface measurement the gender difference in upper lip height and should be considered when planning a gender-affirming upper lip shortening surgery.

Masson's tumor is a benign intravascular lesion of proliferating endothelial cells that accounts for 2% of vascular and subcutaneous lesions. It manifests clinically as a bluish swelling, resembling a mucocele or hemangioma. Intravascular papillary endothelial hyperplasia (IPEH) was coined by Clearkin and Enzinger in 1976 to describe reactive vascular expansion, following traumatic vascular stasis mimicking angiosarcoma. Clinically, this condition manifests as a bluish enlargement resembling a mucocele or hemangioma. We reported a rare case of IPEH located on the upper lip in an 18-year-old female. A diagnosis of IPEH was reported based on the histopathological findings of papillary proliferating endothelial cells with engorged red blood cells. There was no evidence of recurrence after 6 months of follow-up. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the changes of reference points on the labial surface of upper incisors (U1) to upper lip (UL) after U1 labial movement between a translation group (TSL) and tipping group (TIP). Correlations between changes in U1 and UL were determined. Methods: Lateral cephalometric radiographs were selected and divided into TSL and TIP groups by pre- and post-treatment superimpositions. Skeletal, dental, and soft tissue of pre- and post-treatment and variables were evaluated. Independent t-test and Mann-Whitney U test were applied for the statistical analysis between TSL and TIP. Spearman's correlation coefficients and multiple linear regression analysis were used to verify the association between lip profile changes and other variables in TSL and TIP group separately. Results: After U1 labial movement, the incisal edge (LaU1e), middle (LaU1m), and cervical (LaU1c) points of TSL moved evenly labially, whereas the TIP group had incisal edge that moved greater labially than the middle and cervical points. UL moved more labially in TSL (0.87–1.05 mm) than the TIP (0.31–0.41 mm). UL changes to the E-line in TSL showed significant positive correlations to all three LaU1(e, m, c)-SnTV changes. In the TIP group, only a positive correlation presented for the LaU1m-SnTV and LaU1c-SnTV changes. Nevertheless, Multiple linear regression analysis indicated the unfeasibility of predicting the upper lip changing. Conclusion: LaU1e in TSL and TIP moved almost equally labially but less labially in TIP at the middle and cervical points. The UL moved more labially in TSL than TIP. Rather than using the incisal edge to estimate upper lip changes, it would be better to use the middle and cervical points of U1, which coincide with Labrale superioris (Ls).

Upper lip lifting is a very popular procedure but there is no objective guidelines on how much skin has to be removed to obtain an optimal result. We have measured and compared the philtral height in two groups of young and old female Lebanese subjects. We have found a mean philtral height of 14.3 ± 1.9 mm in the young group and 19.8 ± 2.4 mm In the old group, with a mean philtral lengthening of 5.5 ± 2.9 mm. We suggest using these results to plan the amount of skin that has to be removed during a lip lift procedure. [ABSTRACT FROM AUTHOR]

Introduction Lips play a fundamental role in facial attractiveness and in decisions pertaining to orthognathic surgery. Objective To assess the upper lip changes following Le Fort I osteotomy for maxillary advancement and/or impaction. Methods In the present retrospective non-randomized clinical trial, we evaluated 3 groups of patients who underwent Le Fort I osteotomy of the maxilla. Group 1 (n = 35) underwent maxillary advancement, group 2 (n = 14), maxillary impaction, and group 3 (n = 11) was submitted to both maxillary advancement and impaction. The lip thickness of all patients was measured preoperatively, and the participants in each group were categorized into two subgroups: thin (< 12 mm) and thick (> 12 mm) lip. The primary (before orthognathic surgery) and final (after orthodontic bracket removal) lateral cephalograms of the patients were analyzed using the Dolphin software. Comparisons were made using the paired t -test and linear regression in the IBM SPSS Statistics for Windows software. Results The length of the upper lip increased by 1 mm (p = 0.012) on average following maxillary advancement, and it decreased by 0.43 mm (p = 0.24) on average following maxillary impaction. In the maxillary advancement group, the change in angulation of the incisors predicted the incisal display (p = 0.03). In the maxillary impaction group, skeletal changes in the vertical dimension predicted changes in upper lip length (p = 0.033). Conclusions Le Fort I osteotomy for maxillary advancement significantly increases the length of the upper lip. The assessment of lip thickness prior to surgery can help predict the postoperative results. Changing the angulation of the incisors can predict the incisal display. In maxillary impaction, skeletal changes in the vertical dimension can predict the changes in the length of the upper lip. [ABSTRACT FROM AUTHOR]

We aimed to determine the width of the levator labii superioris alaeque nasi muscle (LLSAN) at the level of the nasal ala through cadaveric dissections and ultrasonography (US), to provide essential anatomical information for use during both invasive and noninvasive procedures in the nasal ala region. The LLSAN was investigated in the 40 hemifaces of 20 Korean cadavers, comprising 10 males and 10 females with a mean age of 73.6 years. The LLSAN width of the 40 specimens at the level of the midpoint of the nasal ala was 5.02+2.35 mm (mean+standard deviation), and ranged from 1.45 mm to 10.11 mm. The LLSAN widths were 5.96+2.36 mm and 3.93+1.89 mm in males and females, respectively, with ranges of 2.40-10.11 mm and 1.45-6.96 mm, respectively. The LLSAN widths on the left and right sides were 4.77+2.72 mm and 5.26+1.99 mm, respectively. The proportions of the LLSAN fibers inserting into the nasal ala and upper lip were similar in 13 specimens (32.5 %), while more fibers inserted into the nasal ala in 11 specimens (27.5 %) and more fibers inserted fibers of the LLSAN into the upper lip in 16 specimens (40 %). When clinicians need to target or avoid the LLSAN, the present width and range data can be helpful for ensuring the efficacy and safely of both invasive and noninvasive procedures. In addition, the possibility of asymmetry in the width of the LLSAN in the nasal ala region should be confirmed by US before performing such procedures. [ABSTRACT FROM AUTHOR]

Background: The traditional nasolabial V-Y advancement flap is widely used for midface reconstruction, particularly for the lower third of the nose and upper lip, as its color and texture are similar to these areas. However, it provides insufficient tissue to cover large defects and cannot restore the nasal convexity, nasal ala, and adjacent tissues. The purpose of this study is to investigate the modified nasolabial V-Y advancement flap with extension limbs the along alar crease for the reconstruction of complex midface defects. Methods: A retrospective analysis of 18 patients, who underwent reconstruction with the modified nasolabial V-Y advancement flap, was performed between September 2014 and December 2022. An extension limb was added along the alar crease, adjacent to the defect area, and was hinged down as a transposition flap at the end of the advancement flap. Results: The extension limb along the alar crease successfully covered large and complicated defects, including those of the ala, the alar rim, the alar base, the nostrils, and the upper lip, with minor complications. Conclusion: The alar crease is a good donor site for the reconstruction of large and complex nasal and upper lip defects. [ABSTRACT FROM AUTHOR]

Jihad Alrehaili Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi ArabiaCorrespondence: Jihad Alrehaili, Tel +966-112037100, Email jaalrehaili@imamu.edu.saAbstract: Pleomorphic adenoma (PA) is a common benign tumor of the salivary glands, but its occurrence in the minor salivary glands of the upper lip is rare. In the a case report of a 24-year-old female with PA of the minor salivary glands in the upper lip, exhibiting unique histological characteristics such as features resembling schwannoma, keratinization, myxolipomatous, oncocytic, and mucinous traits resembling mucoepidermoid carcinoma. The main symptom of this condition is a gradual painless enlargement of the affected area. Histopathological analysis confirmed the diagnosis of PA. This case highlights the importance of public education in recognizing and treating painless masses. Further research is needed to explore PA’s histological and molecular characteristics to establish prognostic factors such as the risk of recurrence.Keywords: pleomorphic adenoma, salivary glands, upper lip, painless mass

Introduction Lips play a fundamental role in facial attractiveness and in decisions pertaining to orthognathic surgery.

Adenocarcinoma, not otherwise specified (NOS) exhibits ductal differentiation without the diagnostic histomorphological features of other defined salivary carcinomas. Adenocarcinoma, NOS rarely occurs in the lip, and when adenocarcinomas occurs in more than one organ, it is often difficult to identify the primary site. We report a case of adenocarcinoma of the left-upper lip occurring in a 67-year-old woman, which need to clearly identify the type of tumor required collaboration with Department of Respiratory Surgery to identify the primary origin site. The woman was referred to our department because of a painless mass in the upper lip. The clinical diagnosis was a benign tumor or mucous cyst and we performed a biopsy. The histopathological diagnosis was adenocarcinoma, NOS. Chest computed tomography demonstrated a mass in the lower-right-lung lobe. We suspected lung metastases and histopathologically attempted to identify the primary lesion. Immunohistochemical analysis showed positive staining for cytokeratin 7 and negative staining for thyroid transcription factor 1 and napsin A. The analysis identified the primary lesion as a salivary adenocarcinoma, NOS. We performed a full-thickness resection of the left-upper lip and reconstructive surgery of the upper lip. Postoperative computed tomography at the 3-month follow-up showed no mass in the lower-right-lung lobe. Follow-up examinations have shown no evidence of recurrence for 4 years after the surgery. [ABSTRACT FROM AUTHOR]

Abstract Background Broken tooth fragments that get lodged post trauma in oral cavity lacerations should not go unnoticed during primary care of the patient. Tooth fragments can act as a biological foreign body. Unnoticed foreign bodies can give rise to granulomas, sepsis, and fistula formation. Aim This article stresses on the need for all primary contact medical staff and residents to pay additional attention on patients with a loose/broken tooth and a laceration. Early removal of tooth fragment is key to avoiding granuloma formation and thus the need to excise the surrounding tissue. Case presentation A 70-year-old female presented with a post traumatic upper lip swelling. A broken tooth fragment was studied on plain CT scan and removed under local anesthesia. A speedy restoration of normal anatomy was seen due to early diagnosis and removal. Conclusions Dental traumas, being the commonest maxillofacial injuries, have a significant impact on the physical, cosmetic, and emotional health of the patient. Careful assessment of a patient with history of trauma and a missing/broken tooth is mandatory.

To investigate the clinical effects of surgical treatment to improve the lip morphology for a smile-like appearance (joy and happiness) in East-Asian women. From October 2016 to April 2020, 63 patients who had received surgery to lift the commissure of the mouth and adjust the shape of the upper red lip to form a smile-like shape were analyzed and evaluated. The lip shape of enrolled patients was improved to a certain extent after surgery without any obvious scar hyperplasia, and the satisfaction rate of people after the surgery was 85.71%. For East-Asian women with thin and flat lips, surgical approach can be used to improve the shape of lip, such that the appearance of the lip is in a smile-like shape, which can enhance affinity and also exhibit the aesthetic characteristics of East-Asian women. This treatment can be used for clinical reference. Level IV. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the width of the fibers that extend from the orbicularis oculi muscle (OOc) to the upper lip, and the lateral and inferior lengths of the OOc at the lateral canthus level. Methods: The OOc was investigated in the 40 hemifaces of 20 Korean cadavers. The lateral fibers of the OOc (OOc lat) were traced to determine whether or not these fibers extended to the upper lip. Results: The OOc lat extended to the upper lip at the lateral canthus level in 31 of the 40 specimens (77.5%), whereas some inferolateral fibers of the OOc that extended to the upper lip were observed near the level of the lower margin of the OOc in the other 9 specimens (22.5%). The mean ± SD and maximum widths of the OOc lat that extended to the upper lip at the lateral canthus level were 6.9 ± 3.3 mm and 14.3 mm, respectively. Conclusion: The obtained data will be helpful to distinguish the muscles that underly the wrinkles around the lateral canthus for safer and more-efficient BoNT-A treatments for crow's feet. [ABSTRACT FROM AUTHOR]

In this case report, we present a pleomorphic adenoma that presented as a hard nodule on the upper lip in a man in his 30s. Differential diagnosis is necessary, as there are multiple causes of a nodule in the lip. The nodule was excised extracapsularly and a histopathological examination was performed. Although the tumor was found to be benign, there is a risk of late malignant conversion, which underscores the importance of prompt treatment.

A myoepithelioma is a type of salivary gland tumor composed entirely of myoepithelial cells. Previously, this was considered a subtype of pleomorphic adenoma. Here, we report an extremely rare case of myoepithelioma of the upper lip. A 33-year-old female patient presented with a painless mass on her upper lip. Magnetic resonance imaging revealed a 23 mm × 18 mm well-defined tumor. We clinically suspected a benign minor salivary gland tumor and the patient underwent complete resection of the tumor under general anesthesia. Since the tumor was diagnosed as a myoepithelioma by rapid pathological examination, it was resected with a safety margin of approximately 5 mm. Pathologically, this tumor showed mild to moderate cell atypia, and focal invasion into the capsule. Immunohistochemical findings showed that the tumor was positive for the S-100 protein and vimentin. The Ki-67 labeling index was less than 1%, and there were no malignant findings. The postoperative clinical course has been good for approximately 5 years, and satisfactory results were obtained both functionally and esthetically. Herein, we also discussed the clinical and immunohistochemical features of myoepitheliomas.

Abstract Background Non-infectious granulomatous disorders of the upper lip represent a special chapter of oral and maxillofacial pathology. In this work we report a case-series of this process, to analyse its main clinicopathological features and find differential data that allow us improve its diagnosis and understand its pathogenesis. Methods We present 11 cases of non-infectious granulomatous disorders of the upper lip, 8 women and 3 men with an age range of 29–84 years, who have been attended at the Oral Medicine Department of the IUCT (France) and the Oral Medicine Unit of the UPV/EHU (Spain). All clinicopathological data were collected in a specific protocol. Results We recognized 4 different subtypes of non-infectious granulomatous disorders of the upper lip: (1) associated with Crohn’s disease (1 case), (2) associated with foreign body (2 cases), (3) associated with gingivitis lichenoid-like (4 cases), (4) idiopathic (4 cases). Conclusions Clinicopathological differences were identified between these subtypes. A good differential diagnosis is necessary in all cases to rule out the presence of local or systemic etiopathogenic factors.

Le Fort I osteotomy causes nasolabial alterations that may be unattractive, such as expansion of the alae and alar bases and thinning of the upper lip. After maxillary impaction, there is a propensity for the tip to elevate, and in some circumstances, this may even become excessive. The nasolabial angle closes and similar alterations are observed with maxillary advancement. When Le Fort I impaction or maxilla advancement occurs, the alar base cinch suture is frequently utilised to reduce the unfavourable rise in nasal width. There are significant changes in the nasolabial morphology associated with Le Fort I osteotomy. Numerous changes occur after the surgical intervention in the maxilla namely- widening of the alar base of the nose, upturning of the nasal tip, flattening and thinning of the upper lip and down turning of the commissures. Widening of the alar bases of the nose appears to be the most common undesirable outcome. Some people may benefit aesthetically from nasal widening. For instance, the long face syndrome is frequently characterised by a narrow nose with a large dorsum. In these situations, superior maxillary relocation typically improves the look of the nose by enlarging the bases of the arches. However, excessive alar base broadening and superior retraction would cause the alar-facial groove to aesthetically deepen, giving the patient an older appearance, and may cause asymmetry in the alas. It is crucial for the surgeon to comprehend the preoperative aesthetic facial linkages and anticipate any potential impact the surgical operation may have on the nasolabial region before performing maxillary surgery. To control the width of the alar base after maxillary osteotomy clinicians have advocated the placement of cinch sutures, reduction of the anterior nasal spine and use of V-Y closure technique. There are inconstant opinions on the effect of the cinch suture.

Merkel cell carcinoma (MCC) is a highly aggressive tumor (WHO, 2018), primarily affecting elderly individuals with a history of chronic sun exposure. Researchers link factors such as ultraviolet radiation, immunosuppression, and infection with the Merkel cell polyomavirus (MCPyV) to its etiology. Despite ongoing debate over its cell origin, MCC's immunohistochemical profile and morphological characteristics resemble those of native Merkel cells found in the skin. We present a case observed in the pathology department at the Mohamed VI University Hospital Center in Marrakech. This case study involves a 79-year-old patient without any specific medical history who presented with a rapidly enlarging mass on the upper lip. Merkel cell carcinoma is a highly aggressive skin tumor associated with various causative factors, including UV radiation, immunosuppression, and MCPyV infection. Its diagnosis relies on careful histopathological examination and immunohistochemical profiling. Differential diagnosis considerations are crucial to ensure accurate classification and appropriate management of this challenging malignancy. [ABSTRACT FROM AUTHOR]

Trauma to the lips is the most common type of facial injury. The prominence of the lips and the close correlation with the teeth, make it a vulnerable aesthetic unit. We here report the case of a 20-year-old student presenting two hours after maxillofacial trauma following a traffic accident involving a head-on collision between two motorcyclists. The student had fallen on the handlebars of his motorbike injuring his upper lip. Maxillofacial examination showed involvement of the nasogenial sulcus with elevation of the right nasal wing, a notch in the right upper hemi-lip, well colored, and whose endo-buccal extension was embedded in the vestibule, giving an appearance of "right unilateral cleft lip". Radiological evaluation showed air-fluid levels with solution of continuity of the medial wall of the right maxillary sinus. The diagnosis of traumatic incarceration of the right upper hemi-lip with no displaced fracture of the right maxilla was retained. This can cause unilateral or incomplete right upper cleft lip, or a wound with loss of substance involving the right upper hemi-lip. It is a very uncommon lesion of the upper lip requiring urgent repair, given the risk of ischemia and labial necrosis. The patient was operated under locoregional anesthesia. The right upper hemi-lip was embedded with incarceration due to nondisplaced fracture at the level of the nasal notch. Disincarceration was performed, resulting in minimal labial loss with a vestibular detachment, repaired by direct suture. The patient's outcome was good. [ABSTRACT FROM AUTHOR]

The nasolabial cyst is a rare non-odontogenic cyst that develops between the upper lip and nasal vestibule. It has unsure pathogenesis. It has a history of slow-growing lesions, and clinically on palpation gives a floating touch. Usually, there is an elevation of the upper lip. The swelling usually, in most cases, is asymptomatic produces a localised swelling along with varying degrees of nasal obstruction. We present a case of a nasolabial cyst which was clinically diagnosed as a lipoma because of its unusual location in the upper lip in a 46-year-old man, which slowly increased in size over a period of 6 months with the association of slight pain on palpation and facial disfigurement. Our objective is to alert the dental professionals about the unusual presentation of nasolabial cyst in the upper lip, which may become a hurdle in clinical diagnosis.

Introduction: One of the most common maxillofacial malformations is mandibular advancement, a class II malformation or malocclusion. One treatment is mandibular advancement surgery. This research aimed to investigate the effect of mandibular advancement surgery on upper lip length in class II patients. Methods: This retrospective study was conducted with 16 patients having class II malformations who underwent mandibular advancement surgery. Data analysis was conducted using SPSS 19. Results: Results showed that although height of philtrum increased after surgery, there was no significant difference in the height of the philtrum from before to after the mandibular advancement surgery (p > 0.05). Evaluation of the patients showed that although commissure height and vermilion height decreased after surgery, this difference was not statistically different(p > 0.05). However, there was a statistically significant difference between before and after commissure height (p

Background: Non-infectious granulomatous disorders of the upper lip represent a special chapter of oral and maxillofacial pathology. In this work we report a case-series of this process, to analyse its main clinicopathological features and find differential data that allow us improve its diagnosis and understand its pathogenesis. Methods: We present 11 cases of non-infectious granulomatous disorders of the upper lip, 8 women and 3 men with an age range of 29–84 years, who have been attended at the Oral Medicine Department of the IUCT (France) and the Oral Medicine Unit of the UPV/EHU (Spain). All clinicopathological data were collected in a specific protocol. Results: We recognized 4 different subtypes of non-infectious granulomatous disorders of the upper lip: (1) associated with Crohn's disease (1 case), (2) associated with foreign body (2 cases), (3) associated with gingivitis lichenoid-like (4 cases), (4) idiopathic (4 cases). Conclusions: Clinicopathological differences were identified between these subtypes. A good differential diagnosis is necessary in all cases to rule out the presence of local or systemic etiopathogenic factors. [ABSTRACT FROM AUTHOR]

Background: The perioral region is the most important area for facial expression, after the periocular structures. For the reconstructions of this region, an aesthetic outcome is as important as functional results in terms of the patient's social life. The purpose of this study was to discuss the functional and aesthetic outcomes achieved with transversely advanced V–Y flaps in reconstructions of the perioral region. Methods : The study included 17 patients in whom transverse V–Y advancement flaps were used to repair full-thickness perioral defects resulting from malignant tumor resection. The patients were evaluated in terms of functional and aesthetic outcomes, complications, and need for revision surgery. To evaluate postoperative outcomes, a control group with no history of surgical interventions to the lips or perioral region was selected. Measurements of the lower and upper lips, mouth opening height, and mouth opening width were obtained from the controls and postoperatively from the patients. Results: Lower lip reconstruction was performed in 13 patients (76.4%) and upper lip reconstruction was performed in 4 patients (23.5%). Total lower lip reconstruction was performed in 3 patients. Postoperative measurements were statistically equivalent to those of individuals with no surgical history. No cosmetic deformity formation or microstomia which require surgical treatment were observed in any of our patients. Conclusions: This technique is a simple, useful, functional method with short procedure time and satisfying aesthetic outcomes for patients with total or partial lower and upper lip defects. Level of evidence: Level IV, therapeutic study. [ABSTRACT FROM AUTHOR]

Resumen: La reconstrucción del labio superior tras la cirugía de Mohs supone, en ocasiones, un reto para el cirujano dermatológico. Presentamos una serie de 15 pacientes (7 hombres y 8 mujeres; edad media de 65,6 años) con cáncer cutáneo (10 carcinomas basocelulares, 2 melanomas y 3 carcinomas escamosos) localizados en el labio superior intervenidos mediante cirugía de Mohs con defectos resultantes de 3-7,6 cm. Para la reconstrucción se empleó un colgajo en isla del labio superior diseñado escondiendo las incisiones en el pliegue nasolabial, en la línea de unión del bermellón con la piel y en las líneas de tensión de la piel relajada. Se explican las claves del diseño y la cirugía, enfatizando en la importancia de sacrificar en ocasiones pequeñas zonas de tejido sano. Se alcanzaron resultados satisfactorios cosméticos y funcionales, sin complicaciones posquirúrgicas en todos los pacientes. Abstract: Upper-lip reconstruction after Mohs micrographic surgery is challenging for dermatologic surgeons. We describe a series of 15 patients (7 men and 8 women; mean age, 65.6 years) with skin cancer on the upper lip treated with Mohs surgery: 10 were basal cell carcinomas, 2 were melanomas, and 3 were squamous cell carcinomas. The resulting defects measured between 3 and 7.6 cm. We used island flaps to reconstruct the defects in all cases, hiding the incisions in the nasolabial fold, at the line where the skin meets the vermillion border of the lip, and in the relaxed skin tension lines. We explain key aspects of the surgeries and design of the reconstructions, with emphasis on the importance of occasionally sacrificing small areas of healthy skin. Cosmetic and functional outcomes were satisfactory in all patients, and there were no postsurgical complications.

Reconstruction of critical-sized defects of composite facial units is a challenging one. This is amplified when facial hair-bearing areas are included. A case of reconstruction of multiple midfacial defects is presented. Initially, defective jaws were addressed. Later, appropriate modification of existing extended paramedical forehead flap to sequentially reconstruct defective lip, moustache, and parts of alae are described. The flap design was such that hair-bearing areas were used to reconstruct moustache while the nasal alar defect was reconstructed using the non-hair-beating forehead skin. Finally, dental implants were also placed. The technique was reliable, giving minimal donor site deformity but with maximum result. However, it is a multi-stage procedure. The paper also describes the challenges of midfacial unit reconstruction as handled in this case.

Polymorphous adnenocarcinoma (PAC) is a less aggressive malignant tumour, mainly occurs in the minor salivary glands. It is less frequently seen in the upper lip. As there aren't any specific features to differentiate PAC from other benign tumours of the minor salivary glands of the upper lip, PAC must be considered in the differential diagnosis of the minor salivary gland tumours of the upper lip.

The aim of this study is to evaluate the changes in nasolabial soft tissues following Le Fort I osteotomies, focusing on the impact of maxillary vertical repositioning. This retrospective study included 39 patients with a history of Le Fort 1 osteotomy between 2013 and 2021. Patients were grouped based on their maxillary movement into three categories: pure advancement (group A), advancement with impaction (group B), and advancement with downward repositioning (group C). Preoperative and postoperative CBCT (Cone Beam Computed Tomography) data were analyzed to measure the changes in nasolabial soft tissues. The current study utilized Mimics Suite 20.0 for measuring linear and angular variables. The evaluated variables included intercanthal distance, nasal dorsal length, tip protrusion, mouth width, alar width, upper lip height, nostril dimensions, and angles of nasolabial, alar base, and upper lip. Among them intercanthal distance, nasal dorsal length, or tip protrusion showed no statistical difference (p > 0,05). Mouth width, alar width, alar base angle were increased and upper lip angle was decreased significantly (p < 0.001). Changes in upper lip height and nasolabial angle differed among the groups of the study. While upper lip height increased significantly in groups A and C (p < 0.05), there was a slight decrease in Group B with no significance (p > 0.05). Nasolabial angle decrased significantly on Groups A and B (p < 0.05). The results of this study revealed changes in several soft tissue parameters, some of which occurred regardless of vertical repositioning of the maxilla. Within the limitations of the study, maxillary advancement surgery can affect the aesthetics of the nasolabial region and cause specific changes in related soft tissues. Understanding these changes is essential to establish realistic patient expectations and achieve optimal functional and aesthetic outcomes., (Copyright © 2024 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

The female upper lip is shorter than its male counterpart. We have recently described a precise direct surface measurement technique of the philtral height. In this study we aim to quantify the difference in philtral height using this same measuring technique between two groups of young male and female Lebanese subjects. The mean philtral height obtained in the young male group was 15.7 ± 1.7 mm. By comparing this result to the previously described mean philtral height of 14.3 ± 1.9 mm in the young female group, we obtained a mean difference of 1.3 ± 1.8 mm between the two groups. This result confirms and quantifies by direct surface measurement the gender difference in upper lip height and should be considered when planning a gender-affirming upper lip shortening surgery., Competing Interests: None., (© 2024 The Author(s).)

Background: Salivary gland tumors are relatively rare. Most minor salivary gland tumors are malignant with benign tumors accounting for 18% of the tumors. Pleomorphic adenoma (PA) is the most common salivary gland tumor. Lip PA is uncommon with 9.8% occurring in the upper lip. We are adding on the knowledge of the rare upper lip PA (benign mixed tumor)., Case Summary: We report an upper lip PA (benign mixed tumor) in a 28-year-old man. His complaint was a painless swelling on the upper lip. A painless, non-tender, well-circumscribed, slightly mobile, sessile, nodular, and rubbery (in consistency) tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip. The overlying skin was not fixed and of normal color. There was no ulceration, and palpation did not elicit pain or bleeding. There was no history of trauma. Blunt dissection was used to completely excise the nodular, whitish, and encapsulated tumor. Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion, with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells, well-formed tubules containing eosinic secretion, and nests of myoepithelial cells. A diagnosis of PA (benign mixed tumor) was confirmed., Conclusion: Blunt dissection is indicated to preserve the cosmesis and function of the upper lip., Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Le Fort I osteotomy causes nasolabial alterations that may be unattractive, such as expansion of the alae and alar bases and thinning of the upper lip. After maxillary impaction, there is a propensity for the tip to elevate, and in some circumstances, this may even become excessive. The nasolabial angle closes and similar alterations are observed with maxillary advancement. When Le Fort I impaction or maxilla advancement occurs, the alar base cinch suture is frequently utilised to reduce the unfavourable rise in nasal width. There are significant changes in the nasolabial morphology associated with Le Fort I osteotomy. Numerous changes occur after the surgical intervention in the maxilla namely-widening of the alar base of the nose, upturning of the nasal tip, flattening and thinning of the upper lip and down turning of the commissures. Widening of the alar bases of the nose appears to be the most common undesirable outcome. Some people may benefit aesthetically from nasal widening. For instance, the long face syndrome is frequently characterised by a narrow nose with a large dorsum. In these situations, superior maxillary relocation typically improves the look of the nose by enlarging the bases of the arches. However, excessive alar base broadening and superior retraction would cause the alar-facial groove to aesthetically deepen, giving the patient an older appearance, and may cause asymmetry in the alas. It is crucial for the surgeon to comprehend the preoperative aesthetic facial linkages and anticipate any potential impact the surgical operation may have on the nasolabial region before performing maxillary surgery. To control the width of the alar base after maxillary osteotomy clinicians have advocated the placement of cinch sutures, reduction of the anterior nasal spine and use of V-Y closure technique. There are inconstant opinions on the effect of the cinch suture. [ABSTRACT FROM AUTHOR]