• 대한치과의사협회지
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• 제50권10호
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• pp.620-623
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• 2012

The use of botulinum toxin type A in the lower face has increasingly popular. And treatment of the depressor anguli oris muscle(DAO) and the mentalis muscle(MT), particularly in combination with filler substances, produces a remarkable improvement in the lower aged face. The aim of this study was to demonstrate the topographical anatomy of the DAO, MT, and their related structures, thereby providing critical information for determining the safest and most effective site for BTX-A injections. The most effective injection sites of DAO and MT were suggested based on the new anatomical knowledge of the lower face.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.125-128
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• 2011

Purpose: Asymmetric crying facies is caused by agenesis or hypoplasia of the depressor anguli oris muscle and is often associated various anomalies. Several static and dynamic surgical interventions have been reported, but their effects are unreliable. We report on the successful use of botulinum toxin A in an asymmetric crying facies patient. Methods: A 4-year-old girl presented with a facial asymmetry on crying or smiling. Physical examination revealed that her face had no asymmetry at rest. However, the patient showed characteristic asymmetry when smiling, crying, and with other normal facial movements. Asymmetric crying facies was clinically suspected and the weakness of left depressor anguli oris was present on electrophysiology study. Fifteen units of botulinum toxin type A were injected to the right depressor anguli oris muscle. Results: The patient showed the prominent improvement in the facial symmetry without significant complication and the effect persisted until 3 months post injection. Conclusion: Asymmetric crying facies was treated successfully with botulinum toxin A and this method was easy and noninvasive.

• 대한두개안면성형외과학회지
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• 제20권4호
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• pp.265-269
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• 2019

Congenital hypoplasia of the depressor anguli oris muscle is a rare cause of asymmetrical crying facies in newborns. The clinical manifestations range from mild to severe asymmetry and may persist up to adulthood. In the current case, the patient did not exhibit other congenital anomalies or paralysis of other branches of the facial nerve. This adult patient presented with severe asymmetrical lower lip deformity during full mouth opening since birth. A chromosomal study for the detection of 22q gene deletion yielded negative results. The electromyography findings of the lower lip were insignificant. Depressor labii inferioris muscle resection was not effective, but bidirectional (horizontal and vertical) fascia lata grafting improved the aesthetic appearance of the asymmetrical lower lip. The patient showed improved lower lip symmetry during full mouth opening at 1 year after the surgery. Therefore, the details of this rare case are reported herein.

• Anatomy and Cell Biology
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• 제56권2호
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• pp.161-165
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• 2023

The depressor anguli oris (DAO) muscle is a thin, superficial muscle located below the corner of the mouth. It is the target for botulinum neurotoxin (BoNT) injection therapy, aimed at treating drooping mouth corners. Hyperactivity of the DAO muscle can lead to a sad, tired, or angry appearance in some patients. However, it is difficult to inject BoNT into the DAO muscle because its medial border overlaps with the depressor labii inferioris and its lateral border is adjacent to the risorius, zygomaticus major, and platysma muscles. Moreover, a lack of knowledge of the anatomy of the DAO muscle and the properties of BoNT can lead to side effects, such as asymmetrical smiles. Anatomical-based injection sites were provided for the DAO muscle, and the proper injection technique was reviewed. We proposed optimal injection sites based on the external anatomical landmarks of the face. The aim of these guidelines is to standardize the procedure and maximize the effects of BoNT injections while minimizing adverse events, all by reducing the dose unit and injection points.

• 대한후두음성언어의학회지
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• 제5권1호
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• pp.22-28
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• 1994

Previous studies reveal that in English there is no EMG evidence fur the feature tense-lax distinction. The technique of electro-myography(EMG) was used to see if the existing claim holds true, particularly in unstressed syllable. It was found that in unstressed syllable, the peak EMG amplitude from the orbicularis oris superior muscle was significantly greater in /p/ than in /b/, while in stressed syllable this difference was negligible. It was hypothesized that in stressed syllable, /p/ and /b/ may be differentiated by the EMG activities from a muscle other than the orbicularis oris superior muscle, e.g. the respiratory muscles relating to 'aspiration' or depressor anguli oris muscle. In Korean, there was a clear labial gestures for the feature tense-lax distinction. The phoneme-sensitive manifestation of stress and some possible reasons for the inter-speaker variability in the data and the variability within a given speaker were discussed.

• 음성과학
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• 제1권
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• pp.7-26
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• 1997

An electromyographic device was used to investigate the relationship between a linguistic hypothesis of tense-lax distinction and muscular activity. Muscle action potentials of the orbicularis oris muscle and the depressor anguli oris muscle were obtained from four subjects using CVCVCV and CVCVC words in English and VCV and CVC words in Korean. Findings: The hypothesis that the speaker may select at least one of muscles involved in the articulation of a phoneme so that the selected muscle could be activated for tense-lax distinction, and either a timing variable or an amplitude variablethe and/or both from the selected muscle distinguish(es) /p/ from /b/ in English and /$p^{h},\;p^{l}$/ from /p/ in Korean, with the English /p/ and the Korean /$p^{h},\;p^{l}$/ being tense, and the Korean unaspirated /p/ and the English /b/ lax, has been verified, except for the case with subject 2 in stressed syllables in English. (2) Thus, the linguistic hypothesis of tense-lax distinction was strongly supported by the muscular activities during the Korean bilabial stops, with /$p^{h}\;and\;p^{l}$/ being tense and /p/ lax. (3) Considering the intermuscle compensation and the interspeaker variabilities in the choice of a muscle or muscles, in English the usability of the feature 'tensity' appeared to be positive rather than negative although further investigations with more subjects remain to take on the muscles associated with the onset/offset of the labial closure, including the respiratory muscles related with the aspiration. The phoneme-sensitive EMG manifestations of stress and possible reasons for the interspeaker variabilities are discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권4호
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• pp.256-259
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• 2013

Botulinum toxin type A (BTX-A) inhibits muscle contraction, which leads to reversible muscle atrophy and paralysis. Therefore, BTX-A injection can be an effective treatment of facial asymmetry that originated from the uncoordinated muscle movement. A 52-year-old patient was referred from another hospital for the correction of post-traumatic sequelae. The patient had prominent scar in the mandibular symphysis area with asymmetric lower lip movement. The reason for this asymmetric lower lip movement was due to damage in the lower lip depressor muscle. After the injection of BTX-A on the lower lip depressors, asymmetric lip movement has been improved.

• Journal of Acupuncture Research
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• 제25권3호
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• pp.221-228
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• 2008

Objectives : The purpose of this study is to understand the anatomical basis of the facial muscles and to apply this knowledge on the clinical practice of facial acupuncture. Methods : We searched both contemporary and the latest literatures on the practical application of facial muscle anatomy on Facial Acupuncture. Conclusions : Facial Acupuncture improves skin tone, texture and wrinkling by assisting the circulation of Ki. It stimulates the facial muscles directly to undo the stagnation of the meridians. To practice Facial Acupuncture, thorough understanding of facial anatomy is required. In this study the muscles of the head and neck, appropriate depth and angle of acupuncture needle, etc. were reviewed. The upper facial muscles including frontalis, procerus, corrugator supercilii and orbicularis oculi, the mid facial muscles including auricularis, nasalis, levator labii superioris, zygomaticus and so on, and the lower facial muscles including orbicularis oris, depressor labii inferioris, depressor anguli oris, mentalis and platysma etc. were reviewed in this study. For safer and more effective use of Facial Acupuncture, further study on the objective outcome of the technique should be done.