Commissural symmetry in unilateral transverse facial cleft patients: an anthropometric study.
OBJECTIVE
To evaluate the commissural symmetry and commissural migration among patients with unilateral transverse facial cleft.


METHODS
From 2006 to 2009, 31 patients with unilateral transverse facial cleft were repaired with superiorly based vermillion-mucosal flap and orbicularis oris reconstruction. Linear closure and superiorly rotated and inferiorly rotated Z-plasty were randomly chosen for skin closure. An anthropometric method was used immediately after the repair and at the follow-up examination to evaluate the commissural symmetry in both horizontal and vertical directions.


RESULTS
A total of 21 patients was followed-up for 19 months on average. Satisfactory horizontal symmetry was obtained right after surgery; however, the new commissure was generally lower than the unaffected commissure. At the follow-up examination, no significant lateral commissural displacement was observed; however, the commissural droop on the cleft side became more noticeable.


CONCLUSIONS
The anthropometric method used was convenient and reliable for facial symmetry analysis. Rectangular vermillion-mucosal flap and proper muscle reconstruction could prevent the lateral commissural migration caused by skin scar contracture. Both horizontal and vertical symmetry should be considered for macrostomia repair.
Department of Cleft Lip and Palate Surgery and State Key Laboratory of Oral Disease, West China College of Stomatology, Sichuan University, Chengdu, China.
Jingto
J
Li
Kun
K
Liu
Jiayu
J
Sbi
Yan
Y
Wang
Qian
Q
Zbeng
Bing
B
Sbi
D000367:Age Factors; D000465:Algorithms; D002508:Cephalometry / Q000379:methods*; D002921:Cicatrix / Q000473:pathology; D003286:Contracture / Q000473:pathology; D062109:Dermatologic Surgical Procedures; D005152:Facial Muscles / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008046:Lip / Q000473:pathology / Q000601:surgery*; D008265:Macrostomia / Q000601:surgery*; D008297:Male; D009055:Mouth / Q000473:pathology / Q000601:surgery*; D009061:Mouth Mucosa / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012867:Skin / Q000473:pathology; D013524:Surgical Flaps; D016896:Treatment Outcome