[Sensibility changes of the infraorbital nerve after primary surgery on patients with unilateral cleft lip according to J. Delaire]. / Évaluation à long terme de la sensibilité du nerf infraorbitaire chez les patients porteurs de fente labiale unilatérale complète après traitement primaire selon la technique de J. Delaire.

OBJECTIVE: The aim was to determine the overall sensibility changes in the area of the infraorbital nerve on patients with unilateral clefts lips and unilateral clefts lips and palate who had undergone primary surgical correction according to the principles of Delaire. PATIENTS AND METHOD: Twenty patients (7-20years) with unilateral cleft lips (and palate) who had undergone surgery in infancy according to Delaire were included. Cutaneous sensibilities of the nasolabial fold and of the upper lip were tested using four cutaneous modalities. A tactil superficial sensibility light touch test, a two-point discrimination test (McKinnon-Dellon Disk-Criminator), and the determination of cold and warm detection thresholds (Quantitative Sensory Testing, Medoc Thermal Sensory Analyser). The possible difference of the sensibility between operated and controlateral sides of the face were compared. Results were finally compared to a control group of twenty healthy volunteers. RESULTS: No significant difference could be found between the operated and non-operated side of the cleft group. There was also no difference between the cleft and the control group. Specific difference of perception between nasolabial fold and lip encountered in the literature were confirmed by the experiments. CONCLUSION: The large subperiostal approach according to Delaire during the primary surgical procedure have not affected long term infraorbital sensibility of patients with unilateral complete cleft lip.

Topographic Anatomy of the Infraorbital Artery and Its Clinical Implications for Nasolabial Fold Augmentation.

BACKGROUND: Understanding the topography of the blood vessels distributed around the nasolabial fold region is essential for ensuring the safety of dermal filler injections into the nasolabial fold. The purpose of this study was to provide anatomical information on the infraorbital artery distribution and its relationship with the facial artery for use in clinical procedures involving filler injection during nasolabial fold augmentation. METHODS: The infraorbital artery was investigated in the nasolabial fold region divided into zones I to XII based on clock-hour meridians centered on the infraorbital foramen. The running layers of the infraorbital artery and infraorbital nerve were also compared in the infraorbital foramen. Changes in the infraorbital artery were observed according to vascular dominance of the facial artery. RESULTS: The infraorbital artery was divided into three main branches, palpebral, nasal, and labial infraorbital artery branches in 34.7, 100, and 100 percent of the specimens, respectively; with these branches of palpebral, nasal, and labial infraorbital artery observed most commonly in zones I, V, and VI, respectively. Analysis of the bilateral facial artery topography revealed that its vascular dominance was observed in 19.4 percent. The infraorbital artery was thicker and had a wider distribution on the nondominant side of the facial artery, whereas the nasal infraorbital nerve anastomosed with the facial artery in the lateral nasal region in 57.1 percent. CONCLUSION: Investigating and verifying the vascular structure regarding its interactions with the facial artery and infraorbital artery will provide critical information to physicians performing facial surgery and cosmetic procedures.