Comparative Osseous and Soft Tissue Morphology following Cleft Lip Repair

• Published in: The Cleft palate-craniofacial journal 2008-09, Vol.45 (5), p.511-517
• Main Authors: Seidenstricker-Kink, Lynn M., Becker, Devra B., Govier, Daniel P., DeLeon, Valerie B., Lo, Lun-Jou, Kane, Alex A.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cephalometry - methods; Chin - pathology; China - ethnology; Cleft Lip - surgery; Deformities; Dentistry; Eyelids - pathology; Facial Asymmetry - pathology; Facial Asymmetry - surgery; Facial Bones - pathology; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Follow-Up Studies; Frontal Bone - pathology; Humans; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Infant; Lip - pathology; Male; Maxilla - pathology; Medical sciences; Morphology; Non tumoral diseases; Nose - pathology; Otorhinolaryngology. Stomatology; Retrospective Studies; Studies; Tissues; Tomography, X-Ray Computed - methods; Zygoma - pathology
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1597/07-001.1

Objective: To quantify comparative improvement between osseous and soft tissue asymmetry following primary lip repair. Design: Retrospective analysis of preoperative and postoperative computed tomography scans of infants with unilateral cleft lip and palate. Sixteen soft tissue landmarks were placed using an exploratory two-/three-dimensional image processing system and compared for asymmetry. Patients: Computed tomography scans were obtained on 26 patients (13 boys, 13 girls) of Chinese ethnicity (mean age  =  0.25 years) prior to Millard lip repair. Nineteen of these contributed to follow-up comparative studies prior to palatoplasty at a mean age of 0.92 years. There were 18 left-sided and eight right-sided clefts. Main Outcome Measure: Euclidean distance matrix asymmetry analysis was used to determine the amount of soft tissue asymmetry pre- and postlip repair. Similar analyses of the same scans were performed for 41 osseous landmarks. Results: Soft tissue landmarks had 36/39 (92%) preoperative and 13/39 (33%) postoperative asymmetric pairs. Osseous distances demonstrated 77/125 (61%) asymmetric pairs preoperatively and 60/125 (48%) postoperatively. Soft tissue and osseous distances of the lip region demonstrated 32% and 39% postoperative asymmetry, respectively. Soft tissue and osseous distances of the nasal region demonstrated 52% and 72% postoperative asymmetry, respectively. Soft tissue and osseous distances of the facial landmarks demonstrated 24% and 34% postoperative asymmetry, respectively. Conclusions: Primary lip repair appears to effect gains in symmetry in soft tissue and provides sufficient molding forces to cause correlating symmetry changes in underlying osseous structures.