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Erschienen in: Surgical and Radiologic Anatomy 11/2017

13.03.2017 | Original Article

Digitalized analysis of philtral anatomy for planning individual treatment

verfasst von: Hassan Bagheri, Suzan Sirinturk, Figen Govsa, Yelda Pinar, Mehmet Asim Ozer

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 11/2017

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Abstract

Objective

Restoration of the philtral region following traumatic, cleft, and tumor surgeries is often difficult due to influence of this feature to whole facial beauty. The aim of this study is to investigate the types and measurements of the philtrum and its relationship with the upper lip using a software.

Methods

Standard personal photographs of the philtral region were obtained from 200 young adults participated in this study. Linear analyses (the lengths of philtral column and dimple; the philtral width) and angular analyses (apex and central angles of Cupid’s bow) were measured as reference points. As for the shape of the philtral column, it was categorized as four distinct types: parallel, triangular, concave, and unclear type.

Results

The philtral width was 11.37 ± 1.9 mm in males, 10.21 ± 1.80 mm in females. The length of the philtral dimple was 18.16 ± 3.6 mm in males, 18.16 ± 3.6 mm in females. Compared with women, both of the measured average philtral reference lengths displayed a significantly greater value in men. In the meanwhile, compared to women, the angular measurements of Cupid’s bow (i.e., the apex and central angle of Cupid’s bow) were smaller in men. It was 127.47 ± 12.74° mm in males, 134.1 ± 11.38° mm in females. The triangular and concave types were associated with a substantial fraction in men, whereas the triangular and parallel types were predominant in women. There were significant gender differences in the esthetic rankings of philtral column shapes.

Conclusions

These results suggest digitalized reference values relative to the philtral column which may increase the success of the individual reconstructive treatment of the surgical procedures and reduce possible asymmetrical appearance. With the help of certain software, this research has made possible to investigate the ideal parameters of philtral construction in defining the best surgical solution for the patient.
Literatur
1.
Zurück zum Zitat Alley TR, Cunningham MR (1991) Averaged faces are attractive, but very attractive faces are not average. Psychol Sci 2:123–125CrossRef Alley TR, Cunningham MR (1991) Averaged faces are attractive, but very attractive faces are not average. Psychol Sci 2:123–125CrossRef
2.
Zurück zum Zitat Baik HS, Jeon JM, Lee HJ (2007) Facial soft-tissue analysis of Korean adults with normal occlusion using a 3-dimensional laser scanner. Am J Orthod Dentofac Orthop 131:759–766CrossRef Baik HS, Jeon JM, Lee HJ (2007) Facial soft-tissue analysis of Korean adults with normal occlusion using a 3-dimensional laser scanner. Am J Orthod Dentofac Orthop 131:759–766CrossRef
3.
Zurück zum Zitat Bo C, Ningbei Y (2014) Reconstruction of upper lip muscle system by anatomy, magnetic resonance imaging, and serial histological sections. J Craniofac Surg 25(1):48–54CrossRefPubMed Bo C, Ningbei Y (2014) Reconstruction of upper lip muscle system by anatomy, magnetic resonance imaging, and serial histological sections. J Craniofac Surg 25(1):48–54CrossRefPubMed
4.
Zurück zum Zitat Briedis J, Jackson IT (1981) The anatomy of the philtrum: observations made on dissections in the normal lip. Br J Plast Surg 34(2):128–132CrossRefPubMed Briedis J, Jackson IT (1981) The anatomy of the philtrum: observations made on dissections in the normal lip. Br J Plast Surg 34(2):128–132CrossRefPubMed
5.
Zurück zum Zitat Carey JC, Cohen MM, Curry CJR, Devriendt K, Holmes LB, Verloes A (2009) Elements of morphology: standard terminology for the lips, mouth, and oral region. Am J Med Genet A 149A:77–92CrossRefPubMed Carey JC, Cohen MM, Curry CJR, Devriendt K, Holmes LB, Verloes A (2009) Elements of morphology: standard terminology for the lips, mouth, and oral region. Am J Med Genet A 149A:77–92CrossRefPubMed
6.
Zurück zum Zitat Cho BC (2006) Formation of the philtral column using vertical interdigitation of orbicularis oris muscle flaps in the secondary cleft lip. Plast Resconstr Surg 117:1992–2000CrossRef Cho BC (2006) Formation of the philtral column using vertical interdigitation of orbicularis oris muscle flaps in the secondary cleft lip. Plast Resconstr Surg 117:1992–2000CrossRef
7.
Zurück zum Zitat Choi HN, Kim SR, Han YS (2013) A new method for creating a definite philtrum by theflipping of an orbicularis oris muscle flap in a patient with an indistinct philtrum. Arch Plast Surg 40(1):62–65CrossRefPubMedPubMedCentral Choi HN, Kim SR, Han YS (2013) A new method for creating a definite philtrum by theflipping of an orbicularis oris muscle flap in a patient with an indistinct philtrum. Arch Plast Surg 40(1):62–65CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Farkas LG, Hajnis K, Posnick JC (1993) Anthropometric and anthroposcopic findings of the nasal and facial region in cleft patients before and after primary lip and palate repair. Cleft Palate Craniofac J 30:1–12CrossRefPubMed Farkas LG, Hajnis K, Posnick JC (1993) Anthropometric and anthroposcopic findings of the nasal and facial region in cleft patients before and after primary lip and palate repair. Cleft Palate Craniofac J 30:1–12CrossRefPubMed
9.
Zurück zum Zitat Fisher DM (2005) Unilateral cleft lip repair: an anatomical subunit approximation technique. J Plast Reconstr Surg 116(1):61–71CrossRef Fisher DM (2005) Unilateral cleft lip repair: an anatomical subunit approximation technique. J Plast Reconstr Surg 116(1):61–71CrossRef
10.
Zurück zum Zitat Fukui N, Amano A, Akiyama S, Daikoku H, Wakisaka S, Morisaki I (2000) Oral findings in DiGeorge syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 89:208–215CrossRef Fukui N, Amano A, Akiyama S, Daikoku H, Wakisaka S, Morisaki I (2000) Oral findings in DiGeorge syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 89:208–215CrossRef
11.
Zurück zum Zitat Garcia de Mitchell CA, Pessa JE, Schaverien MV, Rohrich RJ (2008) The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg 122(6):1756–1760CrossRefPubMed Garcia de Mitchell CA, Pessa JE, Schaverien MV, Rohrich RJ (2008) The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg 122(6):1756–1760CrossRefPubMed
12.
Zurück zum Zitat Germec-Cakan D, Canter HI, Nur B, Arun T (2010) Comparison of facial soft tissue measurements on three-dimensional images and models obtained with different methods. J Craniofac Surg 21:1393–1399CrossRefPubMed Germec-Cakan D, Canter HI, Nur B, Arun T (2010) Comparison of facial soft tissue measurements on three-dimensional images and models obtained with different methods. J Craniofac Surg 21:1393–1399CrossRefPubMed
13.
Zurück zum Zitat Haramoto U, Kamiji T, Takagi S, Kubo T, Yoshioka N, Hosokawa K (2000) Philtrum construction by composite skin muscle rotation and orbicularis oris muscle advancement in secondary cleft lip deformity. Ann Plast Surg 45:485–490CrossRefPubMed Haramoto U, Kamiji T, Takagi S, Kubo T, Yoshioka N, Hosokawa K (2000) Philtrum construction by composite skin muscle rotation and orbicularis oris muscle advancement in secondary cleft lip deformity. Ann Plast Surg 45:485–490CrossRefPubMed
14.
Zurück zum Zitat Hennekam RC, Cormier-Daire V, Hall JG, Méhes K, Patton M, Stevenson RE (2009) Elements of morphology: standard terminology for the nose and philtrum. Am J Med Genet A 194A:61–76CrossRef Hennekam RC, Cormier-Daire V, Hall JG, Méhes K, Patton M, Stevenson RE (2009) Elements of morphology: standard terminology for the nose and philtrum. Am J Med Genet A 194A:61–76CrossRef
15.
Zurück zum Zitat Hood CA, Hosey MT, Bock M, White J, Ray A, Ayoub AF (2004) Facial characterization of infants with cleft lip and palate using a three-dimensional capture technique. Cleft Palate Craniofac J 41:27–35CrossRefPubMed Hood CA, Hosey MT, Bock M, White J, Ray A, Ayoub AF (2004) Facial characterization of infants with cleft lip and palate using a three-dimensional capture technique. Cleft Palate Craniofac J 41:27–35CrossRefPubMed
16.
Zurück zum Zitat Jones LR, Tatum SA (2008) Pearls for aesthetic reconstruction of cleft lip and nose defects. Facial Plast Surg 24(1):146–151CrossRefPubMed Jones LR, Tatum SA (2008) Pearls for aesthetic reconstruction of cleft lip and nose defects. Facial Plast Surg 24(1):146–151CrossRefPubMed
17.
Zurück zum Zitat Kishi N, Tanaka S, Iida S, Kogo M (2012) The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg 40(3):215–222CrossRefPubMed Kishi N, Tanaka S, Iida S, Kogo M (2012) The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg 40(3):215–222CrossRefPubMed
18.
Zurück zum Zitat Kishi N, Tanaka S, Iida S, Kogo M (2011) Comprehensive evaluation of three-dimensional philtral morphology. J Craniofac Surg 22(5):1606–1611CrossRefPubMed Kishi N, Tanaka S, Iida S, Kogo M (2011) Comprehensive evaluation of three-dimensional philtral morphology. J Craniofac Surg 22(5):1606–1611CrossRefPubMed
19.
Zurück zum Zitat Latham RA, Deaton TG (1976) The structural basis of the philtrum and the contour of the vermilion border: a study of the musculature of the upper lip. J Anat 121:151–160PubMedPubMedCentral Latham RA, Deaton TG (1976) The structural basis of the philtrum and the contour of the vermilion border: a study of the musculature of the upper lip. J Anat 121:151–160PubMedPubMedCentral
20.
Zurück zum Zitat Mulliken JB, Pensler JM, Kozakewich HP (1993) The anatomy of Cupid’s bow in normal and cleft lip. Plast Reconstr Surg 92(3):395–403 (discussion 404) CrossRefPubMed Mulliken JB, Pensler JM, Kozakewich HP (1993) The anatomy of Cupid’s bow in normal and cleft lip. Plast Reconstr Surg 92(3):395–403 (discussion 404) CrossRefPubMed
21.
Zurück zum Zitat Nakajima T, Tamada I, Miyamoto J, Nagasao T, Hikosaka M (2008) Straight line repair of unilateral cleft lip. J Plast Reconstr Aesthet Surg 61:870–878CrossRefPubMed Nakajima T, Tamada I, Miyamoto J, Nagasao T, Hikosaka M (2008) Straight line repair of unilateral cleft lip. J Plast Reconstr Aesthet Surg 61:870–878CrossRefPubMed
22.
Zurück zum Zitat Nakamura N, Suzuki A, Takahashi H, Honda Y, Sasaguri M, Ohishi M (2005) A Longitudinal study on influence of primary facial deformities on maxillofacial growth in patients with cleft lip and palate. Cleft Palate Craniofac J 42:633–640CrossRefPubMed Nakamura N, Suzuki A, Takahashi H, Honda Y, Sasaguri M, Ohishi M (2005) A Longitudinal study on influence of primary facial deformities on maxillofacial growth in patients with cleft lip and palate. Cleft Palate Craniofac J 42:633–640CrossRefPubMed
23.
Zurück zum Zitat Pepper JP, Shan RB (2013) Local flaps: cheek and lip reconstruction. JAMA Facial Plast Surg 15(5):374–382CrossRefPubMed Pepper JP, Shan RB (2013) Local flaps: cheek and lip reconstruction. JAMA Facial Plast Surg 15(5):374–382CrossRefPubMed
24.
Zurück zum Zitat Peret DI, Lee KJ, Penton-Voak I, Rowland D, Yoshikawa S, Burt DM, Henzi SP, Castles DL, Akamatsu S (1998) Effects of sexual dimorphism on facial attractiveness. Nature 394:884–887CrossRef Peret DI, Lee KJ, Penton-Voak I, Rowland D, Yoshikawa S, Burt DM, Henzi SP, Castles DL, Akamatsu S (1998) Effects of sexual dimorphism on facial attractiveness. Nature 394:884–887CrossRef
25.
Zurück zum Zitat Pinar YA, Bilge O, Govsa F (2005) Anatomic study of the blood supply of perioral region. Clin Anat 18(5):330–339CrossRefPubMed Pinar YA, Bilge O, Govsa F (2005) Anatomic study of the blood supply of perioral region. Clin Anat 18(5):330–339CrossRefPubMed
26.
Zurück zum Zitat Raphael P, Harris R, Harris SW (2013) Analysis and classification of the upper lip aesthetic unit. Plast Reconstr Surg 132(3):543–551CrossRefPubMed Raphael P, Harris R, Harris SW (2013) Analysis and classification of the upper lip aesthetic unit. Plast Reconstr Surg 132(3):543–551CrossRefPubMed
27.
Zurück zum Zitat Rogers CR, Meara JG, Mulliken JB (2014) The philtrum in cleft lip: review of anatomy and techniques for construction. J Craniofac Surg 25(1):9–138CrossRefPubMed Rogers CR, Meara JG, Mulliken JB (2014) The philtrum in cleft lip: review of anatomy and techniques for construction. J Craniofac Surg 25(1):9–138CrossRefPubMed
28.
Zurück zum Zitat Tirone L, Moscatiello F, Molea G (2006) Reconstruction of the upper lip and philtrum. J Plast Reconstr Aesthet Surg 59(8):865–866CrossRefPubMed Tirone L, Moscatiello F, Molea G (2006) Reconstruction of the upper lip and philtrum. J Plast Reconstr Aesthet Surg 59(8):865–866CrossRefPubMed
29.
Zurück zum Zitat Zimmerer KS, Chaitidis D, Boerner I, Kovacs L, Schwenzer NF, Holberg C, Zeilhofer HF (2008) Systematic contact-free 3D topometry of the soft tissue profile in cleft lips. Cleft Palate Craniofac J 45:607–613CrossRef Zimmerer KS, Chaitidis D, Boerner I, Kovacs L, Schwenzer NF, Holberg C, Zeilhofer HF (2008) Systematic contact-free 3D topometry of the soft tissue profile in cleft lips. Cleft Palate Craniofac J 45:607–613CrossRef
30.
Zurück zum Zitat Zimmerer KS, Chaitidis D, Boerner I, Krol Z, Kovacs L, Schwenzer NF, Zimmerer S, Holberg C, Zeilhofer HF (2008) Quantitative 3D soft issue analysis of symmetry prior to and after unilateral cleft lip repair compared with non-cleft persons (performed in Cambodia). J Craniomaxillofac Surg 36:431–438CrossRefPubMed Zimmerer KS, Chaitidis D, Boerner I, Krol Z, Kovacs L, Schwenzer NF, Zimmerer S, Holberg C, Zeilhofer HF (2008) Quantitative 3D soft issue analysis of symmetry prior to and after unilateral cleft lip repair compared with non-cleft persons (performed in Cambodia). J Craniomaxillofac Surg 36:431–438CrossRefPubMed
Metadaten
Titel
Digitalized analysis of philtral anatomy for planning individual treatment
verfasst von
Hassan Bagheri
Suzan Sirinturk
Figen Govsa
Yelda Pinar
Mehmet Asim Ozer
Publikationsdatum
13.03.2017
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 11/2017
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-017-1840-0

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