Three-dimensional assessment of facial appearance following surgical repair of unilateral cleft lip and palate

Bell, A., Lo, T.-W. R., Brown, D. , Bowman, A. W. , Siebert, J. P., Simmons, D. R. , Millett, D. T. and Ayoub, A. F. (2014) Three-dimensional assessment of facial appearance following surgical repair of unilateral cleft lip and palate. Cleft Palate: Craniofacial Journal, 51(4), pp. 462-471. (doi:10.1597/12-140)

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Publisher's URL: http://dx.doi.org/10.1597/12-140

Abstract

<b>Background and Objective:</b>  Objective assessment of postsurgical facial asymmetry can be difficult, but three-dimensional (3D) imaging techniques have made this possible. The objective of this study was to assess residual asymmetry in surgically repaired unilateral cleft lip (UCL) and unilateral cleft lip and palate (UCLP) patients and to compare this with noncleft controls.<p></p> <b>Design:</b>  Retrospective multicohort comparative study.<p></p> <b>Patients and Methods:</b>  Fifty-one 10-year-old children with surgically managed UCLP and 44 children with UCL were compared with a control group of 68 ten-year-olds. The 3D facial models at rest and with maximum smile were created using a 3D imaging system. Asymmetry scores were produced using both anatomical landmarks and a novel method of facial curve analysis.<p></p> <b>Results:</b>  Asymmetry for the whole face was significantly higher in both cleft groups compared with controls (P < .001). UCLP asymmetry was higher than UCL (P < .001). In cleft patients, the upper lip and nasal rim were the most asymmetric (P < .001 to .05). Control subjects also displayed a degree of facial asymmetry. Maximum smile did not significantly affect the symmetry of the whole face, but it increased asymmetry of the vermillion border and nasal rim in all three groups (P < .001).<p></p> <b>Conclusions:</b>  Despite surgical intervention at an early age, asymmetry remains significant in cleft patients at 10 years of age. Three-dimensional imaging is a noninvasive objective assessment tool that identifies specific areas of the face responsible for asymmetry. Facial curve analysis describes the face more comprehensively and characterizes soft tissue contours.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Bell, Dr Aileen and Ayoub, Professor Ashraf and Lo, Miss Tsz-Wai and Brown, Dr Denise and Bowman, Professor Adrian and Simmons, Dr David and Siebert, Dr Jan
Authors: Bell, A., Lo, T.-W. R., Brown, D., Bowman, A. W., Siebert, J. P., Simmons, D. R., Millett, D. T., and Ayoub, A. F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
College of Science and Engineering > School of Computing Science
College of Science and Engineering > School of Mathematics and Statistics > Statistics
Journal Name:Cleft Palate: Craniofacial Journal
Publisher:American Cleft Palate-craniofacial Association
ISSN:1055-6656
ISSN (Online):1545-1569
Published Online:31 January 2013

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
399591A multidisciplinary assessment of residual deformities following surgical repair of cleft lip and palateAshraf AyoubScottish Executive Health Department (SEHHD-CSO)CZH/4/264SM - DENTAL SCHOOL