Quantifying Labial Strength and Function in XXXX : Effect of Targeted Lip Injection Augmentation.

@entity1 @entity1347 @entity3986 @entity425 @entity3541 @entity3384 @entity912
IMPORTANCE: Facial @entity425 from @entity912 or @entity3986 can significantly affect lip strength and function. Lip @entity425 may result in articulation difficulties and spillage of food, both of which are socially and functionally disruptive for @entity1 . There are few quantitative data on the effect of @entity3541 on lip strength. OBJECTIVES: To quantify the effect of @entity3541 and @entity3986 on lip strength and evaluate the effectiveness of targeted lip injection augmentation. DESIGN, SETTING, AND @entity1 : Analysis of @entity1 at the Johns Hopkins Hospital between January 1, 2008, and July 31, 2014, presenting for treatment of @entity3384 due to @entity3541 and @entity3986 was prospectively undertaken. @entity1 who had undergone direct surgical lip procedures were excluded. MAIN OUTCOMES AND MEASURES: Lip pressure measurements, anterior bolus spillage, and articulation of bilabial sounds before and after treatment were assessed by a single speech pathologist. Lip pressures were measured with the Iowa Oral Performance Instrument. RESULTS: Twenty-two @entity1 with unilateral @entity3541 were evaluated for this study. Three @entity1 with @entity3986 were also evaluated. In unilateral @entity3541 , central lip strength was reduced in all @entity1 compared with sex-corrected normative data (mean [SD] central lip strength, 5.5   [2.5] kPa in females and 9.6   [4.6] kPa in males). Compared with the nonparalyzed side, labial strength on the paralyzed sided was reduced by 69%. After injection augmentation of the paralyzed side, labial strength improved across the entire lip. Mean lip strength improved by 0.7-fold in the central lip from 5.60 to 9.30 kPa (P   =   .009), by 1.4-fold on the paralyzed side from 2.2 to 5.33 kPa (P   =   .006), and by 0.4-fold on the unaffected side from 7.11 to 9.56 kPa (P   =   .12). Lip strength in the 3 @entity1 with @entity3986 were uniformly reduced across the entire lip and improved by 6- to 7-fold after injection augmentation. All @entity1 were noted by the speech pathologist to have improved articulation of plosive sounds and @entity1347 after the injection. CONCLUSIONS AND RELEVANCE: Labial strength is reduced across the lip in @entity1 with unilateral @entity3541 . The Iowa Oral Performance Instrument is an effective tool for measuring labial strength and can be use to evaluate the effectiveness of facial reanimation procedures. Injection augmentation of the lip is a simple and effective means of improving labial strength, bilabial sounds, and @entity1347 in @entity1 with @entity3541 or @entity3986 . LEVEL OF EVIDENCE: 3.
