Facial asymmetry--3D assessment of infants with cleft lip & palate.
OBJECTIVE
To determine the degree of facial asymmetry in infants with unilateral cleft lip and/or palate, and quantify improvements following primary surgery, in three dimensions.


METHODS
The faces of 20 infants with unilateral clefts (10 UCL; 10 UCLP), and 20 age-matched, non-cleft controls, were captured using the C3D stereophotogrammetry system prior to primary lip/nose repair (at 3 months), at 6 months and at age 1 year.


METHODS
Procrustes techniques were applied to 3D landmark configurations to its mirror image. Mean squared distances between landmarks and their antimeres were calculated and expressed as asymmetry scores for each 3D configuration. Full-face, nose and lip median scores were compared and changes with time evaluated (P < 0.01).


RESULTS
There were no significant changes in asymmetry scores in the control group from 3 months to 1 year. The UCLP group was more asymmetric than the UCL group, displaying greatest improvement in nasal symmetry following primary repair. The lips continued to improve over time. The UCL group had significant nasal asymmetry, which did not appear to improve with primary surgery.


CONCLUSIONS
Immediate improvement in asymmetry scores in children with UCLP is related to the production of a more symmetrical nasal form after primary surgery. In contrast, the nasal asymmetry seen in children with UCL is unchanged despite surgery. Full face asymmetry scores may mask subtle changes over time. Nasal and lip asymmetry should be considered individually.
University of Glasgow, UK. kayhood@rossmore.me.uk
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Hood
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Bock
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Hosey
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Bowman
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Ayoub
D016022:Case-Control Studies; D002508:Cephalometry; D002971:Cleft Lip / Q000150:complications* / Q000601:surgery; D002972:Cleft Palate / Q000150:complications* / Q000601:surgery; D005146:Facial Asymmetry / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D009666:Nose / Q000002:abnormalities / Q000601:surgery; D010780:Photogrammetry; D023861:Photography, Dental; D011446:Prospective Studies; D012225:Rhinoplasty; D018709:Statistics, Nonparametric