Three-Dimensional Assessment of Early Surgical Outcome in Repaired Unilateral Cleft Lip and Palate: Part 2. Lip Changes

Abstract

Objective To evaluate three-dimensional lip morphology, following primary reconstruction in children with unilateral cleft lip and palate relative to contemporaneous noncleft data. Design Prospective, cross-sectional, controlled study. Setting Glasgow Dental Hospital and School, University of Glasgow, U.K. Patients and Participants Two groups of 3-year-old children (21 with unilateral cleft lip and palate and 96 controls) with facial images taken using a three-dimensional vision-based capture technique. Method Three-dimensional images of the face were reflected so the cleft was on the left side to create a homogeneous group for statistical analysis. Three-dimensional coordinates of anthropometric landmarks were extracted from facial images. Three-dimensional, generalized Procrustes superimposition was implemented and a set of linear measurements were used to compare cleft and control subjects for right and left sides, adjusting for sex differences. Results Crista philtri on both the cleft and noncleft sides were displaced laterally and posteriorly; there was also a statistically significant increase in philtrum width. No significant differences between cleft and control regarding the cutaneous height of the upper lip. The lip in the cleft patients was flatter than in the noncleft individuals, with less prominence of labialis superioris. Conclusions Stereophotogrammetry allows detection of residual dysmorphology following cleft repair. There was significant increase of the philtrum width. The lip appeared flatter and more posterior displaced in unilateral cleft lip and palate patients compared with controls.