Pathophysiology
In a study of 20 patients, pedigrees revealed a hereditary predisposition for weakness in the first branchial arch fusion, often more prevalent in males, which can lead to the development of median lip fissures [PMID:1891226].
Clinical Presentation
The study indicated that median lip fissures often remain asymptomatic until they become infected, prompting clinical presentation [PMID:1891226].
Management
The authors introduced the use of a functioning gracilis free flap to achieve good functional and aesthetic outcomes in two cases of lower lip reconstruction [PMID:17415241].
Dynamic sphincter capacity was restored through the coaptation between the motor branch of the gracilis muscle and the marginal branch of the facial nerve in the described cases [PMID:17415241].
Among the patients studied, excision alone was performed in 10 cases, while the other 10 underwent excision combined with Z-plasty at the center of the lesion; the latter approach demonstrated a better prognosis [PMID:1891226].
Prognosis & Follow-up
Both cases demonstrated nearly perfect color matching of scalp skin grafts with the reconstructed area, leading to excellent aesthetic outcomes [PMID:17415241].
References
1 Ninkovic M, di Spilimbergo SS, Ninkovic M. Lower lip reconstruction: introduction of a new procedure using a functioning gracilis muscle free flap. Plastic and reconstructive surgery 2007. link 2 Rosenquist B. Median lip fissure: etiology and suggested treatment. Oral surgery, oral medicine, and oral pathology 1991. link90180-k)
2 papers cited of 3 indexed.