title: Surgical treatment of persistent macrocheilia in patients with Melkersson-Rosenthal syndrome and cheilitis granulomatosa.
abstract: BACKGROUND
  Various conservative methods for treatment of labial swelling in patients with cheilitis granulomatosa have been attempted, often with only moderate success and sometimes with persistent disfiguring lip swelling. Severe macrocheilia can produce an unaesthetic facial deformity associated with functional disturbances. In patients with persistent macrocheilia, reduction cheiloplasty with excision of excess tissue may be indicated when conservative treatment has proven ineffective in reducing swelling but may have been successful in stabilizing disease.
  
  
  OBJECTIVE
  To evaluate long-term results after reduction cheiloplasty in patients with macrocheilia caused by Melkersson-Rosenthal syndrome or cheilitis granulomatosa.
  
  
  METHODS
  Follow-up study in 7 patients with severe persisting macrocheilia, including 3 patients with Melkersson-Rosenthal syndrome and 4 patients with cheilitis granulomatosa in a stable state of disease, treated by reduction cheiloplasty at our hospital between January 1, 1987, and December 31, 2002. Preoperative and postoperative medical histories were obtained, and criteria for the success of surgical treatment were evaluated by clinical examination. Different techniques of reduction cheiloplasty are described and demonstrated in representative cases of severe macrocheilia.
  
  
  RESULTS
  Surgical treatment in all 7 patients showed satisfying aesthetic and functional outcomes that persisted throughout follow-up (median follow-up, 6.5 years).
  
  
  CONCLUSIONS
  Reduction cheiloplasty is an effective method to correct persistent macrocheilia and improve lip aesthetics in patients with Melkersson-Rosenthal syndrome or granulomatous cheilitis in the persistent state of disease. With careful planning, proper sequencing of treatment, and proficiency in the various surgical techniques, optimal results can be achieved.
authors.affiliation: Department of Cranio-Maxillofacial Surgery, University of Münster, Waldeyerstrasse 30, D-48129 Münster, Germany. losler@uni-muenster.de
authors.forename: Birgit
authors.initials: B
authors.lastname: Kruse-Lösler
authors.forename: Dagmar
authors.initials: D
authors.lastname: Presser
authors.forename: Dieter
authors.initials: D
authors.lastname: Metze
authors.forename: Ulrich
authors.initials: U
authors.lastname: Joos
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008046:Lip / Q000473:pathology / Q000601:surgery*; D008297:Male; D008556:Melkersson-Rosenthal Syndrome / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged