title: Morphological analysis of the lip and nose following cleft lip repair with simultaneous partial primary rhinoplasty: A prospective study over 4 years.
abstract: BACKGROUND
  Facial clefts involve complex abnormalities. The therapy is elaborate, and a critical evaluation of therapeutic outcome is required. Our study analyzed the lip and nose deformities associated with unilateral clefts in a prospective longitudinal study.
  
  
  METHODS
  A total of 33 patients with a cleft lip or cleft lip and alveolus (UCL) and 46 with a cleft lip and palate (UCLP) were treated using a similar concept. Standardized photographs were taken preoperatively (age 0.4-0.52 years) and again aged 4.04-4.59 years. Anthropometric analyses were performed and compared with age-matched normal values.
  
  
  RESULTS
  Nostril width (UCL = 1.01, UCLP = 1.03) and nostril floor width (UCL = 1.02, UCLP = 1.04) were almost symmetric. Nasal tip angles were normalized by surgery. Upper labial height improved, but remained slightly reduced (-4% to -6%). Upper vermillion length was increased (15-17%), and vermillion width was reduced (-12% to -13%) postoperatively. A significantly flatter nostril axis inclination persisted, especially on the affected side (UCL: 37.5°; UCLP: 38.5°), when compared with normal values (53.8°).
  
  
  CONCLUSIONS
  Most cleft irregularities were almost eliminated by therapy; however, the outcome is still not satisfactory for some parameters. The rehabilitation of patients with clefts remains a considerable surgical challenge. Facial anthropometric assessment must play an important role in order to detect and overcome therapeutic shortcomings.
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert, M.D., D.M.D., Ph.D.), University Hospital Tuebingen, Germany. Electronic address: susanne.kluba@med.uni-tuebingen.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Kluba
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert, M.D., D.M.D., Ph.D.), University Hospital Tuebingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Bopp
authors.affiliation: Department of Orthodontics (Temporary Head: Tim Schott D.M.D., Ph.D.), University Hospital Tuebingen, Germany.
authors.forename: Margit
authors.initials: M
authors.lastname: Bacher
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert, M.D., D.M.D., Ph.D.), University Hospital Tuebingen, Germany.
authors.forename: Siegmar
authors.initials: S
authors.lastname: Reinert
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert, M.D., D.M.D., Ph.D.), University Hospital Tuebingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Krimmel
mesh_terms: D059925:Anatomic Landmarks / Q000033:anatomy & histology; D016022:Case-Control Studies; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008046:Lip / Q000033:anatomy & histology*; D008137:Longitudinal Studies; D008297:Male; D055171:Nasal Cartilages / Q000033:anatomy & histology; D009666:Nose / Q000033:anatomy & histology*; D010781:Photography / Q000379:methods; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome
keywords: Cleft; Facial anthropometry; Primary rhinoplasty