Congenital bilateral macrostomia is a very rare deformity of the mouth, and it is still rarer to see Bilateral macrostomia, muscle repair, straight line closure. Congenital macrostomia is a relatively rare deformity. A number of different methods for its correction have been reported in the past. Here, we report our refined. Congenital macrostomia (transverse facial cleft) is a relatively rare anomaly. Surgical methods used to correct this anomaly include commissuroplasty.
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Problems associated with macrostomia include aesthetic disharmony and functional problems like feeding difficulties, drooling, speech incoherence, and difficulty in blowing.
Discussion Rfpair cleft of macrostomia includes a three layered defects of the skin, muscle and mucosa. Midpoint of the upper lip is noted at the middle of the peaks of the cupids bow. Surgical technique for the correction of macrostomia should address skin, muscle, and mucosa. A review of the literature for surgical solutions revealed various techniques, but no cases in which a bilateral straight line repair was described and adopted.
Schwarz made a similar observation with regard to the Z-plasty repair. We report a case of macrostomia corrected with Z-plasty closure for skin, overlapping muscle closure, and triangular mucosal flap for commissure, with a review on existing techniques.
To receive news and publication updates for Case Reports in Dentistry, enter your email address in the box below. Preoperative macrotomia with right side ill-formed commissure.
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The goal of surgical correction of these clefts includes good aesthetics and better function of orbicularis oris muscle. Charles N Verheyden Annals of plastic surgery Macrostomia may be seen alone or in association with other anomalies. The skin is closed with small Z-plasty as the defect is minimal and the limbs of Z-plasty also aligned satisfactorily into the nasolabial and mentolabial folds giving satisfactory healing. The deep component has a sphincteric function.
The severity of these clefts also differs. However, the choice of technique should be based on the subclassification of defect in order to disguise the scar in the natural skin lines.
Muscle fibers of upper lip are overlapped on to the lower lip at the commissure. Subscribe to Table of Contents Alerts.
Macrostomia: A Review of Evolution of Surgical Techniques
Triangular mucosal flaps will result in a natural looking commissure and can avoid transposition of the skin. Bilateral macrostomia in macrosfomia of monozygotic twins.
The upper muscle fibers of the deep layer decussate into the lower lip, and the lower muscle fibers decussate into the upper lip. Various surgical techniques have been proposed for the correction of macrostomia defects.
Modified technique in surgical correction of macrostomia. Various surgical techniques have been described in the literature for the correction of these defects.
Defects might range from mild to severe. In this case there was no history of medication, use of traditional medications, illnesses or nutritional deficiencies in pregnancy, and no evidence of attempted abortion was established [ 17 ].
Straight line closure for correction of congenital isolated bilateral macrostomia
Various techniques were described in the literature for surgical correction. Introduction Transverse facial or Tessier No. See all authors and affiliations.
Incision is carried out along the marking. 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 madrostomia the scar is located at the angle. View at Google Scholar J. Scar on the lower lip becomes more conspicuous over time because of the macrosgomia that is created when the mouth is opened.
This is an open access article distributed under the Creative Commons Attribution Licensewhich jacrostomia unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Straight line muscle closure or overlapping myoplasties are used for muscle reconstruction.
Osamu FukudaHiroshi Takeda Annals of plastic surgery Incisions were made after infiltration maxrostomia adrenaline solution in concentration 1 inand the excess tissue is excised. Open Access Case Report. Transverse clefts develop either due to failure of the maxillary and mandibular processes to fuse or a disruption in the processes after fusing.