title: Assessment of Labionasal Structures in Patients With Unilateral Cleft Lip.
abstract: BACKGROUND
  Unilateral cleft lip (UCL) patients have lip and nose deformities that must be addressed during lip repair. Currently, devices to achieve lip and nose improvements have been developed. The most researched presurgical molding device is the nasoalveolar molding (NAM), which has shown favorable results. However, clinical observation shows that unilateral cleft patients, even without molding devices, achieve spontaneous improvements. The aim of this study is to compare morphological and symmetry changes in nose and lip, between patients less than 30-day old and those submitted to cheiloplasty, at 6 months of age.
  
  
  METHODS
  A total of 27 UCL patients with 2 photographs were selected. The pictures were taken from frontal view and nasal base view at 2 distinct moments: before 30 days of life (t1) and at 6 months of age, during cheiloplasty surgery (T2). Images were analyzed with indirect measurement to assess lip and nose dimensions and nasal symmetry. ImageJ software was used to perform the analyses.
  
  
  RESULTS
  A total of 20 patients (P < 0.05) had an average cleft width reduction of 15% [standard deviation (SD) ± 11%]. A 55% average increase (SD ± 29%) was observed in nostril height of cleft side in 16 of patients (P < 0.05). There was an reduction in facial asymmetry of nostril width (P < 0.05), from 95% (SD ± 90%) (t1) to 59% (SD ± 50) (T2). Also, nasal base width asymmetry (P < 0.05) was decreased from 64% (SD ± 66%) (t1) to 40% (SD ± 29%) (T2).
  
  
  CONCLUSIONS
  Facial growth causes a natural improvement on cleft morphological changes and nasal symmetry.
authors.affiliation: *Federal University of Parana †Plastic Surgery Unit, Department of Surgery, School of Medicine, Federal University of Parana (UFPR) ‡Assistance Center for Cleft Lip and Palate (CAIF), Curitiba, Brazil.
authors.forename: Bruno Leonardo Bancke
authors.initials: BL
authors.lastname: Laverde
authors.forename: Renato
authors.initials: R
authors.lastname: da Silva Freitas
authors.forename: Isis Juliane Guarezi
authors.initials: IJ
authors.lastname: Nasser
mesh_terms: D002971:Cleft Lip / Q000473:pathology* / Q000601:surgery; D005146:Facial Asymmetry / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007231:Infant, Newborn; D008046:Lip / Q000254:growth & development / Q000473:pathology* / Q000601:surgery; D008445:Maxillofacial Development / Q000502:physiology; D009666:Nose / Q000254:growth & development / Q000473:pathology*; D010781:Photography / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods