Figure 2 : Orthopantomogram at 27 months.
Treatment:
The management of this labial hypoplasia can be discussed, but the less
invasive technique remains lipofilling with autologous fat graft or
hyaluronic acid. In the meantime, follow-up is required to monitor
speech development and eruption of the teeth.
Discussion:
The presence of a gingival notch, a mucosal bridle, and difficulty
erupting teeth led us to believe that this may be an incomplete Tessier
cleft 28-29. There are only five articles in the literature reporting a
paramedian cleft of the lower lip 3–7 from localised
lower lip hypoplasia associated with bilateral upper lip and palate
clefts (Oka et al. 1983), to complete lower lip clefts without
mandibular clefts (Hassanpour et al. 2018, Chauvel-Picard et al. 2018,
Ghorpade et al. 2023), to incomplete lower lip cleft with mandibular
defect (Morritt et al. 2007). In all these cases, the lip defect is
localised on a thin part of the lower lip without extension to the
commissure. Regarding the anatomical differences between a lower cleft
lip defect and this total external third lower lip hypoplasia, we
believe that this may be the first congenital partial lower lip
hypoplasia reported in the literature.
For Chisholm et al 8, atrophic skin conditions are
caused by abnormalities in the dermis and/or subcutaneous tissue.
Although the epidermis may be thin and atrophic, there must be a loss of
substance in the subepidermal tissue for the skin to look and feel
atrophic. In this case, we can assume that both the orbicularis oris and
the depressor labii inferioris are hypotrophic but remain functional