Ultrastructural Changes of Cleft Lip Muscle Following Primary Cheiloplasty

The cleft lip is the most common congenital craniofacial anomaly, the anatomical difference in operated patient and normal person by several authors. Authors deserved the ultrastructural changes in secondary cleft lip patients treated with primary cheiloplasty. We obtained eighteen muscle specimens from the upper lip of 18 patients during the time of secondary lip revision. It was stained with Hematoxylin Eosin, Epon-toluidine blue and histochemical method, and examined by light microscope. Also it was examined by electron microscope with various stain and several steps. We found the extensive collagenous fibrosis with various atrophy of muscles by light microscope, and the myofibroblast with rER, mitochondria, and abundant intermediate filaments by electron microscope in 14 cases. We also found muscular atrophy characterized with variable size of muscle fibers by light microscope, and marked variation of muscle fiber size with sarcoplasmic vacuoles, myocytolysis and internal migration of nuclei by electron microscope in 4 cases. In conclusion, in the most cases the major part of the tissues were surrounded by progressive fibrosis, the mild muscular atrophy was seen at some cases.

Surgical Correction of Rare Craniofacial Clefts

Facial clefts are uncommon congenital deformities in comparison to the clefts of the lip and palate. the clinical expression of the craniofacial clefts is highly variable. the face can be marred by a faint expression of the cleft or be disfigured by a full representation of the defect. the extent of the soft tissue and skeletal components is also variable, and they are seldom affected to an equal degree. Generally, discription of the clefts are based on the bony malformation, since the skeletal landmarks tend to be more constant. I report six cases of rare craniofacial clefts that I recently experienced. the soft tissue repair was accomplished with local flaps from cheek, eyelid and nose. Additional vertical length was obtained from the lower Z-plasty flaps in the sutures. the coloboma was corrected with local flaps and a cartilage graft, the depression of cheek with a dermofat graft, and the macrostomia with the repositioning of orbicularls oris muscle and a Z-plasty. the results were cosmetically acceptable.