Three-Dimensional Assessment of Facial Appearance following Surgical Repair of Unilateral Cleft Lip and Palate

Bell, Adam; Lo, Tsz-Wai Rachel; Brown, Denise; Bowman, Adrian; Siebert, J. Paul; Simmons, David R.; Millett, Declan T; Ayoub, Ashraf

doi:10.1597/12-140

Cited by 37 publications

(29 citation statements)

References 26 publications

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“…To date the majority of studies involving the assessment of the aesthetic outcome of residual facial deformities in cleft lip and palate patients have focused on the relatively short term effects of surgical repair; concentrating on the outcome of primary repair of the nasolabial complex in children. 6,18,19 Even though cleft care begins at birth treatment extends well into adult life with several major surgical interventions, the last of which is generally orthognathic surgery. The aim of which is to correct the underlying dentoskeletal deformity to improve both function and aesthetics.…”

Section: Discussionmentioning

confidence: 99%

“…This overcomes the shortcomings of using landmark based analysis or a combination of landmark-based and shape analysis. 18,23 This is because the 3D mesh creates a surface topography that will allow for accurate assessment of disparities in areas that might otherwise be difficult to detect with 2D measurements. 24,25 The results of the present study are similar to previous studies fully acknowledging the different age groups and ethnic backgrounds.…”

Section: Discussionmentioning

confidence: 99%

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Using three-dimensional average facial meshes to determine nasolabial soft tissue deformity in adult UCLP patients

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Using three-dimensional average facial meshes to determine nasolabial soft tissue deformity in adult UCLP patients

et al. 2019

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“…29–32 Although secondary rhinoplasty has been shown to be an effective means of improving persistent stigmata of the cleft nasal deformity, efforts to improve primary outcomes might obviate the need for such measures. 33–35 To date, nasoalveolar molding (NAM) and other types of presurgical nasal molding represent our best attempts at optimizing cleft nasal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol

Hammoudeh

Imahiyerobo

Fan

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:The optimal timing for cleft lip repair has yet to be established. Advances in neonatal anesthesia, along with a growing body of literature, suggesting benefits of earlier cleft lip and nasal repair, have set the stage for a reexamination of current practices.Methods:In this prospective study, cleft lip and nasal repair occurred on average at 34.8 days (13–69 days). Nasal correction was achieved primarily through molding the nasal cartilage without the placement of nasal sutures at the time of repair. A standardized anesthetic protocol aimed at limiting neurotoxicity was utilized in all cases. Anesthetic and postoperative complications were assessed. A 3-dimensional nasal analysis compared pre- and postoperative nasal symmetry for unilateral clefts. Surveys assessed familial response to repair.Results:Thirty-two patients were included (27 unilateral and 5 bilateral clefts). In this study, the overall complication rate was 3.1%. Anthropometric measurements taken from 3-dimensional-image models showed statistically significant improvement in ratios of nostril height (preoperative mean, 0.59; postoperative mean, 0.80), nasal base width (preoperative mean, 1.96; postoperative mean, 1.12), columella length (preoperative mean, 0.62; postoperative mean, 0.89; and columella angle (preoperative mean, 30.73; postoperative mean, 9.1). Survey data indicated that families uniformly preferred earlier repair.Conclusions:We present evidence that early cleft lip and nasal repair can be performed safely and is effective at improving nasal symmetry without the placement of any nasal sutures. Utilization of this protocol has the potential to be a paradigm shift in the treatment of cleft lip and nasal deformity.

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“…CLP can impair breathing, swallowing, and mastication (Bugaighis et al, ). Facial traits typically associated with CLP include a clefted lip and palate, midfacial hypoplasia, a deviated anterior nasal spine, a distorted nasal septum, reduced nasal chamber width, an inferiorly positioned nasal border, and asymmetry of the maxilla, mandible, and nasolabial regions of the face (Harvold, ; Molsted and Dahl, ; Ras et al, ; Ras et al, ; Son, ; Kolbenstvedt et al, ; Suri et al, ; Jena et al, ; Agarwal et al, ; Bell et al, ; Bugaighis et al, ; Choi et al, ; Freeman et al, ; Hasanzadeh et al, ). Surgical repair of the primary cutaneous upper lip is usually carried out around 2–3 months of age, whereas surgical repair of the hard palate is generally carried out around 6–12 months of age (Kolbenstvedt et al, ; Marazita, ).…”

Section: Introductionmentioning

confidence: 99%

Nasal airway and septal variation in unilateral and bilateral cleft lip and palate

et al. 2014

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Cleft lip and palate (CLP) affects the dentoalveolar and nasolabial facial regions. Internal and external nasal dysmorphology may persist in individuals born with CLP despite surgical interventions. 7-18 year old individuals born with unilateral and bilateral CLP (n 5 50) were retrospectively assessed using cone beam computed tomography. Anterior, middle, and posterior nasal airway volumes were measured on each facial side. Septal deviation was measured at the anterior and posterior nasal spine, and the midpoint between these two locations. Data were evaluated using principal components analysis (PCA), multivariate analysis of variance (MAN-OVA), and post-hoc ANOVA tests. PCA results show partial separation in high dimensional space along PC1 (48.5% variance) based on age groups and partial separation along PC2 (29.8% variance) based on CLP type and septal deviation patterns. MANOVA results indicate that age (P 5 0.007) and CLP type (P 0.001) significantly affect nasal airway volume and septal deviation. ANOVA results indicate that anterior nasal volume is significantly affected by age (P 0.001), whereas septal deviation patterns are significantly affected by CLP type (P 0.001). Age and CLP type affect nasal airway volume and septal deviation patterns. Nasal airway volumes tend to be reduced on the clefted sides of the face relative to non-clefted sides of the face. Nasal airway volumes tend to strongly increase with age, whereas septal deviation values tend to increase only slightly with age. These results suggest that functional nasal breathing may be impaired in individuals born with the unilateral and bilateral CLP deformity. Clin. Anat. 00:000-000,

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Three-Dimensional Assessment of Facial Appearance following Surgical Repair of Unilateral Cleft Lip and Palate

Cited by 37 publications

References 26 publications

Using three-dimensional average facial meshes to determine nasolabial soft tissue deformity in adult UCLP patients

Using three-dimensional average facial meshes to determine nasolabial soft tissue deformity in adult UCLP patients

Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol

Nasal airway and septal variation in unilateral and bilateral cleft lip and palate

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