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Related Experiment Video

Updated: Mar 28, 2026

In Vivo Functional Assessment of Rat Masseter Muscle Following Surgical Creation of a Volumetric Muscle Loss (VML) Injury
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Musculovascular pattern in the myrtiform area: implications for cleft lip reconstruction.

S Gschwindt1, A A Mueller2, B K Benitez2

  • 1Department of Anatomy, Histology and Embryology (Oral Morphology Group), Semmelweis University, Budapest, Hungary.

International Journal of Oral and Maxillofacial Surgery
|March 26, 2026
PubMed
Summary

This study clarifies the myrtiform muscular system (MMS) in cleft lip repair. Repositioning the MMS origin restores facial anatomy and function, improving cleft lip-nose repair outcomes.

Keywords:
Anatomic VariationBlood vesselsCleft lipFacial musclesReconstructive surgery

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Area of Science:

  • Anatomy and surgical reconstruction
  • Craniofacial morphology
  • Plastic surgery

Background:

  • The myrtiform area is crucial for facial aesthetics and function but is poorly understood in cleft lip reconstruction.
  • Existing literature lacks detailed documentation of the perioral musculovascular structures relevant to cleft lip repair.

Purpose of the Study:

  • To investigate the morphological characteristics of perioral musculovascular relationships.
  • To determine the surgical implications of these findings for cleft lip-nose repair.

Main Methods:

  • Examination of 21 adult and 3 fetal human specimens.
  • Morphological analysis of the myrtiform muscular system (MMS) and associated vasculature.
  • Intraoperative observations during cleft lip-nose repair procedures.

Main Results:

  • The MMS comprises nasalis, myrtiformis, and depressor septi nasi muscles, with W-type (69.2%) and V-type (30.8%) patterns identified.
  • Variations in arterial supply to the alar region were mapped (Types A-D).
  • Cleft lip-related displacement distorts muscular vector orientations, despite generally normal muscle attachments.

Conclusions:

  • A novel surgical approach involving detaching and repositioning the MMS origin can restore the natural alar-facial groove in cleft lip-nose repair.
  • This technique corrects cleft-induced muscular vector distortion and preserves anatomical alar base insertion, enabling realignment with minimal dissection.