title: Three-dimensional analysis of facial symmetry in cleft lip and palate patients using optical surface data.
abstract: OBJECTIVE
  Presentation of a new technique to determine the plane of symmetry of a face, and to assess the degree of facial symmetry in patients with unilateral cleft lip and palate based on three-dimensional (3D) optical surface data.
  
  
  METHODS
  After having determined a plane of symmetry according to optical 3D facial surface data, we identified differences in landmarks, the surface areas of the upper lip vermilion and nostrils and virtual volumes of the midface, nose and upper lip for cleft and unaffected sides in forty 10-year-old patients suffering from complete unilateral cleft lip, alveolus and palate. The children had undergone lip repair via the Tennison-Randall technique and had received subsequent orthodontic treatment (but not secondary osteoplasty).
  
  
  RESULTS
  Statistically significant differences were apparent between cleft and non-cleft sides in terms of the nasal landmarks, nostril angle and virtual volume of the nose. The upper lip was symmetrical when cleft and non-cleft sides were compared.
  
  
  CONCLUSIONS
  This new technique of symmetry analysis reveals that the noses of 10-year-old patients with complete unilateral cleft lip and palate who had not undergone revisional surgery present a measurable and significant degree of asymmetry, while the upper lip is symmetrical as a consequence of interdisciplinary treatment by orthodontists and oral and maxillofacial surgeons. Further 3D analyses on larger numbers of patients will allow more comprehensive and consistent analysis of the potential and limitations of various surgical and conservative methods so as to identify those techniques with the best outcome in terms of facial symmetry.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Irene
authors.initials: I
authors.lastname: Stauber
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Vairaktaris
authors.forename: Alexandra
authors.initials: A
authors.lastname: Holst
authors.forename: Maria
authors.initials: M
authors.lastname: Schuster
authors.forename: Ursula
authors.initials: U
authors.lastname: Hirschfelder
authors.forename: Friedrich Wilhelm
authors.initials: FW
authors.lastname: Neukam
authors.forename: Emeka
authors.initials: E
authors.lastname: Nkenke
mesh_terms: D000465:Algorithms; D002648:Child; D002971:Cleft Lip / Q000473:pathology*; D002972:Cleft Palate / Q000473:pathology*; D005145:Face / Q000473:pathology; D005146:Facial Asymmetry / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D010780:Photogrammetry / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity