Microanatomy of Philtral ridge

Abstract

Many efforts are made to achieve satisfactory cosmetic and functional result in the repair of cleft lip. However, repair may be complicated in many cases by distortion of the vermilion border, obliteration of the normal contour of the philtrum, and eclabium in spite of many methods used in these days. To achieve better results in cleft lip repair, thorough understandings of the relationship between the surface morphology of the upper and lower lip and the underlying musculature is necessary but reports about this topic is rare. So, our studies were performed on the full-thickness upper lips containing both philtral ridge up to columelar base and lower lip, 4 post-mortem specimens of 2 females and 2 males aged from 16 to 42, using serial histological sections taken in the transverse and vertical planes under light microscopy. Thorough understanding of the anatomical relationships is established and on the basis of our findings, we can postulate some criteria to create a normal and natural philtrum in a patient with a cleft lip, it would be necessary to restore the normal deep muscle attachments and superficial dermal attachments of the orbicularis muscle, to close the lip without tension, to restore thickness of the philtral ridge, and to minimise nonelastic scar tissue