Facial Soft-Tissue Morphology of Adolescent Patients With Nonsyndromic Bilateral Cleft Lip and Palate

Abstract

The purpose of this study was to cephalometrically evaluate the facial soft-tissue characteristics of adolescent patients with bilateral cleft lip and palate (BCLP) and to compare them with a noncleft control group. Lateral cephalometric radiographs obtained from 56 adolescents with nonsyndromic BCLP (29 boys and 27 girls) were analyzed and compared with 67 control subjects (29 boys and 38 girls) who were matched for sex, age, and ethnicity. All patients had been operated on before the age of 2 years for the surgical repair of cleft lip and palate. None had received any orthopedic or orthodontic treatment. Independent-samples t test revealed that patients with BCLP significantly differed from the control group by having a flatter facial profile, thinner and more retruded nasal base, flatter nasal tip (in males), and reduced upper-lip length. Furthermore, thicker lower-lip pit, shallower mentolabial sulcus, and increased inclination angles of the upper and lower lips relative to the horizontal plane were observed in female patients compared with the normal group. The findings of the current study suggested that adolescent patients with BCLP showed several facial soft-tissue deformities when compared with normal individuals with the same age, sex, and ethnic origin. This study provides objective measures that could lead to better treatment planning and prediction of the need for corrective surgeries in patients with BCLP.

Facial soft-tissue thickness in patients affected by bilateral cleft lip and palate: A retrospective cone-beam computed tomography study

“…Thinner subnasale thickness was also reported by Liu et al, 12 who investigated the soft-tissue morphology of the patients affected by unilateral CLP. Hasanzadeh et al 18 reported that the male patients with BCLP had statistically significantly thinner subnasale thickness, and the female patients had thinner subnasale and thicker labrale inferius values compared with the controls. The differences between our findings and those of Hasanzadeh et al might be due to several factors, including different film techniques used in the studies, and the distribution of the ages and the study samples.…”

“…Few studies have reported on the hard-tissue and soft-tissue morphologies of patients affected by unilateral CLP. 8,9,14,15 Only 1 study, by Hasanzadeh et al, 18 gave information about facial soft-tissue morphology. According to that unique study, the BCLP patients differed from the control subjects by having a flatter facial profile, a thinner and retruded nasal base, a flatter nasal tip, and a reduced upper lip length.…”

“…According to that unique study, the BCLP patients differed from the control subjects by having a flatter facial profile, a thinner and retruded nasal base, a flatter nasal tip, and a reduced upper lip length. 18 Although the study gave valuable information that could lead to better treatment planning and prediction of the need for corrective surgeries in patients affected by BCLP, it was performed on conventional cephalometric lateral films that have several limitations, including distortion, low reproducibility caused by difficulties in landmark identification, differences in magnification, and superimposition of bilateral craniofacial structures. 4,7,25,26 In addition, CBCT technology made it feasible to achieve true (1:1 size) images without magnification and showed high intraobserver and interobserver reproducibilities.…”

“…[12][13][14][15][16] However, this topic was almost neglected for patients affected by bilateral CLP (BCLP), probably because of the low frequency of BCLP occurrence. 17 In a recent study, Hasanzadeh et al, 18 who assessed the facial soft-tissue morphology of adolescent patients affected by BCLP using conventional cephalometric lateral films, reported that they had several facial soft-tissue deformities compared with the matched control group.…”

Evaluation of mandibular transverse widths in patients affected by unilateral and bilateral cleft lip and palate using cone beam computed tomography

“…1 High incidence rates of this anomaly were reported for Asian populations (0.079%-0.374%), intermediate rates for whites (0.091%-0.269%), and low rates for the African populations (0.018%-0.167%). 2 CLP usually leads to various functional disturbances, including problems with feeding, hearing, speech, respiratory system, and dentofacial development [3][4][5][6] ; thus, its treatment requires a multidisciplinary team approach with good interaction between different specialties such as speech therapy, otolaryngology, psychology, audiology, pedodontics, orthodontics, prosthodontics, and plastic and maxillofacial surgery. 7 Previous studies have shown that patients affected by CLP usually have anterior and posterior crossbite, midface deficiency with a tendency toward a Class III malocclusion, increased vertical dimensions, and decreased pharyngeal airway volume.…”