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252 results for

Orbicularis Oris

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101. Scar Revision (Diagnosis)

in the RSTL direction. Often, these scars cross from an oblique lateral to a more horizontal orientation and require a combination of lateral Z-plasty and running W-plasty over the mentum. Scar revision. W-plasty in scar parallel to orbicularis oris. Forehead The underlying frontalis muscle creates unusually prominent forehead RSTLs. These well-defined lines run horizontally in the central forehead, with their lateral ends projecting obliquely inferior over the temple region. Pay particular attention (...) of the cutaneous, or white lip, and the vermilion, or red lip. Key external landmarks include the Cupid’s bow, the philtral columns, the tubercle, the vermilion border, the white roll, and the red line. The white roll is the ridge formed by the insertion of the orbicularis oculi just superior to the vermilion border. The red line of the vermilion is the transition between the wet and dry mucosal lining of the lip. The lip can be further divided into three aesthetic units: the lateral upper lip, the medial

2014 eMedicine.com

102. Botulinum Toxin (Diagnosis)

- Crow's feet Mark the lateral canthal line 1 cm lateral to the canthus. Then, the patient should be asked to squint, and the squint lines above and below the lateral canthal line are marked. The injections are symmetrically placed into the muscle on both sides of the face. To avoid problems with eyelid closure, do not inject too close to the eyelids. Orbicularis oris and mentalis muscles - Excessive lip pursing The injection site is the point halfway between the vermilion border of the lower lip (...) canthal lines associated with orbicularis oculi activity in adults. It is also indicated for the temporary improvement in the appearance of moderate-to-severe forehead lines associated with frontalis muscle activity in adults. Dysport® ( ) is indicated for the treatment of adults with cervical dystonia, lower limb spasticity, and spasticity. The cosmetic indication is for the temporary improvement in the appearance of moderate-to-severe glabellar lines associated with procerus and corrugator muscle

2014 eMedicine.com

103. Bell Palsy (Diagnosis)

of the eighth cranial nerve. The facial nerve passes through the stylomastoid foramen in the skull and terminates into the zygomatic, buccal, mandibular, and cervical branches. These nerves serve the muscles of facial expression, which include the frontalis, orbicularis oculi, orbicularis oris, buccinator, and platysma muscles. Other muscles innervated by the facial nerve include the stapedius, stylohyoid, posterior belly of the digastric, occipitalis, and anterior and posterior auricular muscles. All

2014 eMedicine.com

104. Bell Palsy (Diagnosis)

of the eighth cranial nerve. The facial nerve passes through the stylomastoid foramen in the skull and terminates into the zygomatic, buccal, mandibular, and cervical branches. These nerves serve the muscles of facial expression, which include the frontalis, orbicularis oculi, orbicularis oris, buccinator, and platysma muscles. Other muscles innervated by the facial nerve include the stapedius, stylohyoid, posterior belly of the digastric, occipitalis, and anterior and posterior auricular muscles. All

2014 eMedicine.com

105. Lip Reconstruction (Diagnosis)

of cutaneous lip (C), orbicularis oris muscle (D), lamina propria of mucosal lip with salivary glands (E), mucosa of mucosal lip (F), labial artery (G). Anatomy of the lip region. Cosmetic units of the lip. The Cupid's bow is the downward projection of the philtral unit, which gives the lip its characteristic appearance. The white roll is the light linear projection that circumferentially outlines the upper and lower lip at the border of the cutaneous and vermilion lip. Reconstruction of the Cupid's bow (...) and are perpendicular to the fibers of the orbicularis oris muscle. The vermilion portion is the most cosmetically apparent portion of the lip. This portion is a modified mucosal membrane that lacks pilosebaceous units, eccrine glands, and salivary glands. The pink-to-red color of the vermilion lip is due to the extensive superficial vasculature in this area. The wet, or mucosal, lip abuts the teeth and contains minor salivary glands, which empty onto its surface. The red line is where the upper and lower lips meet

2014 eMedicine.com

106. Anatomy in Cutaneous Surgery (Diagnosis)

tightly. This complex lies superficially in the eyelid skin and is encountered with even a shallow incision. The dominant muscle of the nose is the nasalis muscle, which consists of nasal and alar components. Its function is to compress and dilate the nares. Mouth muscles The has the most extensive network of facial musculature and accounts for much of an individual's capability of facial expression. The orbicularis oris encircles the mouth and is the major component of the lips. The major functions (...) of the orbicularis oris muscle are to pull the lips against the teeth, to draw the lips together, to pull the corners of the mouth together, and to pucker the mouth. This muscle is also extremely important for the phonation of sounds that rely on the lips, such as the pronunciation of the letters M , V , F , and P . A group of 6 muscles, collectively known as the quadratus labii superioris muscle, controls the upper mouth. The 6 muscles are as follows: Zygomaticus major muscle - Starts from the posterolateral

2014 eMedicine.com

107. Surgical Complications (Treatment)

or ptosis (the orbicularis oculi muscle has a coexisting supply from the zygomatic branch). The zygomatic branch of the facial nerve is less vulnerable as it crosses the zygoma because of its deep plane; it exits the parotid gland prior to its entry into the orbicularis oculi muscle. Injury to this nerve results in ectropion and in the unilateral inability to close the eyelid. Transection of the buccal branch of the facial nerve along its course from the parotid gland to the orbicularis oris muscle (...) , especially in elderly patients with thin skin. Transection of the temporal branch to the frontalis muscle results in unilateral eyebrow ptosis and loss of the normal forehead furrows (see images below). Injury to the temporal branch of the facial nerve causing eyebrow droop and loss of normal forehead furrows. Injury to the temporal branch of the facial nerve causing an inability to raise the eyebrow. Injury to the branches supplying the orbicularis oculi muscle may result in difficulty closing the eye

2014 eMedicine.com

108. Scar Revision (Overview)

in the RSTL direction. Often, these scars cross from an oblique lateral to a more horizontal orientation and require a combination of lateral Z-plasty and running W-plasty over the mentum. Scar revision. W-plasty in scar parallel to orbicularis oris. Forehead The underlying frontalis muscle creates unusually prominent forehead RSTLs. These well-defined lines run horizontally in the central forehead, with their lateral ends projecting obliquely inferior over the temple region. Pay particular attention (...) of the cutaneous, or white lip, and the vermilion, or red lip. Key external landmarks include the Cupid’s bow, the philtral columns, the tubercle, the vermilion border, the white roll, and the red line. The white roll is the ridge formed by the insertion of the orbicularis oculi just superior to the vermilion border. The red line of the vermilion is the transition between the wet and dry mucosal lining of the lip. The lip can be further divided into three aesthetic units: the lateral upper lip, the medial

2014 eMedicine.com

109. Anatomy in Cutaneous Surgery (Treatment)

tightly. This complex lies superficially in the eyelid skin and is encountered with even a shallow incision. The dominant muscle of the nose is the nasalis muscle, which consists of nasal and alar components. Its function is to compress and dilate the nares. Mouth muscles The has the most extensive network of facial musculature and accounts for much of an individual's capability of facial expression. The orbicularis oris encircles the mouth and is the major component of the lips. The major functions (...) of the orbicularis oris muscle are to pull the lips against the teeth, to draw the lips together, to pull the corners of the mouth together, and to pucker the mouth. This muscle is also extremely important for the phonation of sounds that rely on the lips, such as the pronunciation of the letters M , V , F , and P . A group of 6 muscles, collectively known as the quadratus labii superioris muscle, controls the upper mouth. The 6 muscles are as follows: Zygomaticus major muscle - Starts from the posterolateral

2014 eMedicine.com

110. Botulinum Toxin (Treatment)

region are too close to the eyelid. Asymmetry of the face can occur because of differences in injection techniques or doses between the 2 sides of the face. Drooling can occur when injections of the orbicularis oris muscle are too close to the lip. [ ] Systemic complications are possible. Headache has been reported and is usually transient. Hypersensitivity reactions have not been described. Antibody development is described in patients receiving high doses of botulinum toxin (eg, for the treatment (...) injection. With the latter method, which is used primarily in the platysma, the preferred injection site is identified with EMG. The needle is then inserted parallel to the plane of the muscle, and the injection is performed while the needle is carefully withdrawn. Orbicularis muscle/periorbital crow's feet injection. Frontalis muscle injections. Corrugator muscle injections. Procerus muscle injections. Next: Preoperative Details Preoperative details include the following: identifying contraindications

2014 eMedicine.com

111. Human Bite Infections (Treatment)

may be reconstructed with mucosal advancement flaps. Wounds measuring up to a third of the length of the lip may be closed by using a wedge or chevron excision and approximating the 2 cut edges. [ ] Perform muscular reapproximation of the orbicularis oris with interrupted, buried, absorbable sutures to assure continuity of the sphincteric muscular ring. Small (< 1.5 cm 2 ) lip segments have been successfully replanted as composite grafts when a segment of lip has been amputated and is available

2014 eMedicine.com

112. Scar Revision (Treatment)

in the RSTL direction. Often, these scars cross from an oblique lateral to a more horizontal orientation and require a combination of lateral Z-plasty and running W-plasty over the mentum. Scar revision. W-plasty in scar parallel to orbicularis oris. Forehead The underlying frontalis muscle creates unusually prominent forehead RSTLs. These well-defined lines run horizontally in the central forehead, with their lateral ends projecting obliquely inferior over the temple region. Pay particular attention (...) of the cutaneous, or white lip, and the vermilion, or red lip. Key external landmarks include the Cupid’s bow, the philtral columns, the tubercle, the vermilion border, the white roll, and the red line. The white roll is the ridge formed by the insertion of the orbicularis oculi just superior to the vermilion border. The red line of the vermilion is the transition between the wet and dry mucosal lining of the lip. The lip can be further divided into three aesthetic units: the lateral upper lip, the medial

2014 eMedicine.com

113. Surgical Complications (Overview)

or ptosis (the orbicularis oculi muscle has a coexisting supply from the zygomatic branch). The zygomatic branch of the facial nerve is less vulnerable as it crosses the zygoma because of its deep plane; it exits the parotid gland prior to its entry into the orbicularis oculi muscle. Injury to this nerve results in ectropion and in the unilateral inability to close the eyelid. Transection of the buccal branch of the facial nerve along its course from the parotid gland to the orbicularis oris muscle (...) , especially in elderly patients with thin skin. Transection of the temporal branch to the frontalis muscle results in unilateral eyebrow ptosis and loss of the normal forehead furrows (see images below). Injury to the temporal branch of the facial nerve causing eyebrow droop and loss of normal forehead furrows. Injury to the temporal branch of the facial nerve causing an inability to raise the eyebrow. Injury to the branches supplying the orbicularis oculi muscle may result in difficulty closing the eye

2014 eMedicine.com

114. Botulinum Toxin (Overview)

- Crow's feet Mark the lateral canthal line 1 cm lateral to the canthus. Then, the patient should be asked to squint, and the squint lines above and below the lateral canthal line are marked. The injections are symmetrically placed into the muscle on both sides of the face. To avoid problems with eyelid closure, do not inject too close to the eyelids. Orbicularis oris and mentalis muscles - Excessive lip pursing The injection site is the point halfway between the vermilion border of the lower lip (...) canthal lines associated with orbicularis oculi activity in adults. It is also indicated for the temporary improvement in the appearance of moderate-to-severe forehead lines associated with frontalis muscle activity in adults. Dysport® ( ) is indicated for the treatment of adults with cervical dystonia, lower limb spasticity, and spasticity. The cosmetic indication is for the temporary improvement in the appearance of moderate-to-severe glabellar lines associated with procerus and corrugator muscle

2014 eMedicine.com

115. Bell Palsy (Overview)

of the eighth cranial nerve. The facial nerve passes through the stylomastoid foramen in the skull and terminates into the zygomatic, buccal, mandibular, and cervical branches. These nerves serve the muscles of facial expression, which include the frontalis, orbicularis oculi, orbicularis oris, buccinator, and platysma muscles. Other muscles innervated by the facial nerve include the stapedius, stylohyoid, posterior belly of the digastric, occipitalis, and anterior and posterior auricular muscles. All

2014 eMedicine.com

116. Bell Palsy (Overview)

of the eighth cranial nerve. The facial nerve passes through the stylomastoid foramen in the skull and terminates into the zygomatic, buccal, mandibular, and cervical branches. These nerves serve the muscles of facial expression, which include the frontalis, orbicularis oculi, orbicularis oris, buccinator, and platysma muscles. Other muscles innervated by the facial nerve include the stapedius, stylohyoid, posterior belly of the digastric, occipitalis, and anterior and posterior auricular muscles. All

2014 eMedicine.com

117. Hemifacial Spasm (Overview)

of the orbicularis oculi and spreads over years to other facial muscles (corrugator, frontalis, orbicularis oris, platysma, zygomaticus). [ , ] Clonic movements progress to sustained tonic contractions of involved musculature. Chronic irritation of the facial nerve or nucleus, the near-universal cause of hemifacial spasm, may arise from numerous underlying conditions. Facial musculature is subject to the same movement disorders as muscles of the limbs or trunk. Myoclonus, dystonia, and other movement disorders

2014 eMedicine.com

118. Lip Reconstruction (Overview)

of cutaneous lip (C), orbicularis oris muscle (D), lamina propria of mucosal lip with salivary glands (E), mucosa of mucosal lip (F), labial artery (G). Anatomy of the lip region. Cosmetic units of the lip. The Cupid's bow is the downward projection of the philtral unit, which gives the lip its characteristic appearance. The white roll is the light linear projection that circumferentially outlines the upper and lower lip at the border of the cutaneous and vermilion lip. Reconstruction of the Cupid's bow (...) and are perpendicular to the fibers of the orbicularis oris muscle. The vermilion portion is the most cosmetically apparent portion of the lip. This portion is a modified mucosal membrane that lacks pilosebaceous units, eccrine glands, and salivary glands. The pink-to-red color of the vermilion lip is due to the extensive superficial vasculature in this area. The wet, or mucosal, lip abuts the teeth and contains minor salivary glands, which empty onto its surface. The red line is where the upper and lower lips meet

2014 eMedicine.com

119. Lip Reconstruction (Treatment)

, full-thickness lip resections should be repaired in 4 layers. Small-caliber 5-0 or 6-0 sutures placed with reverse-cutting needles are preferred in this delicate area. First, the submucosa is repaired by using a small-caliber, soft, nonirritating suture such as silk or braided polyglactin (Vicryl). The surgeon should take special care to bury the knots to prevent irregular wound contours and suture spitting. Second, the orbicularis oris is repaired by using an absorbable suture such as braided (...) polyglactin (Vicryl), braided polyglycolic acid (Dexon), or polydioxanone (PDS). Careful and meticulous reapproximation of the orbicularis oris is necessary to maintain competence of the oral sphincter. Third, the vermilion-cutaneous border should be realigned with an epidermal vertical mattress suture. Proper and exact restoration of this border is crucial for a good aesthetic outcome. Next, the dermis and subcutaneous tissue of the cutaneous lip is closed with absorbable sutures. Fourth, the surgeon

2014 eMedicine.com

120. Lip Reconstruction (Follow-up)

, full-thickness lip resections should be repaired in 4 layers. Small-caliber 5-0 or 6-0 sutures placed with reverse-cutting needles are preferred in this delicate area. First, the submucosa is repaired by using a small-caliber, soft, nonirritating suture such as silk or braided polyglactin (Vicryl). The surgeon should take special care to bury the knots to prevent irregular wound contours and suture spitting. Second, the orbicularis oris is repaired by using an absorbable suture such as braided (...) polyglactin (Vicryl), braided polyglycolic acid (Dexon), or polydioxanone (PDS). Careful and meticulous reapproximation of the orbicularis oris is necessary to maintain competence of the oral sphincter. Third, the vermilion-cutaneous border should be realigned with an epidermal vertical mattress suture. Proper and exact restoration of this border is crucial for a good aesthetic outcome. Next, the dermis and subcutaneous tissue of the cutaneous lip is closed with absorbable sutures. Fourth, the surgeon

2014 eMedicine.com

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