Clinical-Anthropometric and Aesthetic Analysis of Nose and Lip in Unilateral Cleft Lip and Palate Patients

Abstract

Objective Presentation of a technique to determine objectively the degree of symmetry in the area of nose and lip in cleft patients based on analysis of photographs. To compare the objective measurements with the subjective impression. Design This was a retrospective study using a predefined photo documentation standard to capture images of the area of nose and lip. Setting Department of Oral and Maxillofacial Surgery, University of Jena, Germany. Patients Unilateral cleft patients following primary lip repair (group 1; n = 36) or secondary correction (group 2; n = 23). Main Outcome Measures Measurements were taken on standardized photographs of three dimensions in the area of the nose and two dimensions in the upper lip region. Sign tests were used to ascertain differences between the cleft and unaffected sides separately for each group. Subjective impressions regarding symmetry were gathered and quantified by means of a visual analog scale (VAS). The Mann-Whitney U test was employed to compare the observers' impressions between the two groups. Results While significant side differences were found for all distances in group 1, only the side differences in the height of the nostril remained significant in group 2. Subjective evaluation of the nostril area improved significantly following corrective surgery. However, no such change in the area of the upper lip was recognized by the observers. Conclusions We were able to demonstrate that the measurable symmetry of the nostril area, as well as the upper lip, was significantly enhanced by corrective surgery. However, only the subjective impression of the nostril was improved.