Susanne Kluba1, Christoph Bopp2, Margit Bacher3, Siegmar Reinert2, Michael Krimmel2. 1. 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. 2. Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert, M.D., D.M.D., Ph.D.), University Hospital Tuebingen, Germany. 3. Department of Orthodontics (Temporary Head: Tim Schott D.M.D., Ph.D.), University Hospital Tuebingen, Germany.
Abstract
INTRODUCTION: 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. MATERIAL AND 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°). CONCLUSION: 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.
INTRODUCTION: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. MATERIAL AND 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°). CONCLUSION: 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: Lucas M Ritschl; Maximilian Roth; Andreas M Fichter; Fabienna Mittermeier; Bettina Kuschel; Klaus-Dietrich Wolff; Florian D Grill; Denys J Loeffelbein Journal: Head Face Med Date: 2018-08-03 Impact factor: 2.151