The effect of facial expression on facial symmetry in surgically managed unilateral cleft lip and palate patients (UCLP)

Al-Rudainy, D. , Ju, X., Mehendale, F. and Ayoub, A. (2019) The effect of facial expression on facial symmetry in surgically managed unilateral cleft lip and palate patients (UCLP). Journal of Plastic, Reconstructive and Aesthetic Surgery, 72(2), pp. 273-280. (doi: 10.1016/j.bjps.2018.10.004) (PMID:30522896)

Abstract

Aim: To evaluate the symmetry of facial expression in surgically managed UCLP patients. Materials and methods: The study was conducted on 13 four-year-old children. Facial images were captured at rest and at maximum smile using stereophotogrammetry. A generic mesh, which is a mathematical facial mask consisting of a fixed number of indexed vertices, was utilised for the assessment of facial asymmetry. This was quantified by measuring the disparity between the left- and right-hand sides of the face after superimposing the original 3D images on their mirror copies. Results: Residual asymmetries at rest were identified at the vermillion of the upper lip and at the nares with a deviation of the philtrum towards the scar tissue. Vertical and anteroposterior asymmetries were identified on the cleft side. At maximum smile, the asymmetry increased noticeably at the vermillion of the upper lip and at the alar base. In the mediolateral direction, the philtrum deviated towards the cleft side with a significant increase of the asymmetry scores. Discussion: Asymmetry of the upper lip has significantly increased at maximum smile as a result of the upward forces of all perioral lifting muscles, which affected the lip directly. Conclusions: The innovation of this study is the measurement of facial asymmetry for the objective outcome measure of the surgical repair of UCLP. The philtrum was the main site of residual asymmetry, which indicates the need for refining the primary repair of the cleft lip. Further corrective surgery may be required.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ayoub, Professor Ashraf and Ju, Dr Xiangyang and Al-Rudainy, Dhelal Hatem Nsaif
• Authors: Al-Rudainy, D., Ju, X., Mehendale, F., and Ayoub, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: Journal of Plastic, Reconstructive and Aesthetic Surgery
• Publisher: Elsevier
• ISSN: 1748-6815
• ISSN (Online): 1878-0539
• Published Online: 02 November 2018
• Copyright Holders: Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons
• First Published: First published in Journal of Plastic, Reconstructive and Aesthetic Surgery 72(2): 273-280
• Publisher Policy: Reproduced in accordance with the publisher copyright policy