D Al Rudainy1, X Ju2, F Mehendale3, A Ayoub4. 1. Glasgow Dental Hospital & School, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK; Orthodontic Department, College of Dentistry, University of Baghdad, Baghdad, Iraq. 2. Glasgow Dental Hospital & School, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK; Medical Device Unit, Department of Clinical Physics and Bioengineering, NHS Greater Glasgow and Clyde, 1055 Great Western Rd, Glasgow G12 0XH, UK. 3. Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh, EH9 1LF, Edinburgh, UK. 4. Glasgow Dental Hospital & School, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK. Electronic address: ashraf.ayoub@glasgow.ac.uk.
Abstract
AIM: To evaluate the symmetry of facial expression in surgically managed UCLP patients. MATERIALS AND METHODS: The study was conducted on 13 four-year-old children. Facial images were captured at rest and at maximum smile using stereophotogrammetry. A generic mesh, which is a mathematical facial mask consisting of a fixed number of indexed vertices, was utilised for the assessment of facial asymmetry. This was quantified by measuring the disparity between the left- and right-hand sides of the face after superimposing the original 3D images on their mirror copies. RESULTS: Residual asymmetries at rest were identified at the vermillion of the upper lip and at the nares with a deviation of the philtrum towards the scar tissue. Vertical and anteroposterior asymmetries were identified on the cleft side. At maximum smile, the asymmetry increased noticeably at the vermillion of the upper lip and at the alar base. In the mediolateral direction, the philtrum deviated towards the cleft side with a significant increase of the asymmetry scores. DISCUSSION: Asymmetry of the upper lip has significantly increased at maximum smile as a result of the upward forces of all perioral lifting muscles, which affected the lip directly. CONCLUSIONS: The innovation of this study is the measurement of facial asymmetry for the objective outcome measure of the surgical repair of UCLP. The philtrum was the main site of residual asymmetry, which indicates the need for refining the primary repair of the cleft lip. Further corrective surgery may be required.
AIM: To evaluate the symmetry of facial expression in surgically managed UCLP patients. MATERIALS AND METHODS: The study was conducted on 13 four-year-old children. Facial images were captured at rest and at maximum smile using stereophotogrammetry. A generic mesh, which is a mathematical facial mask consisting of a fixed number of indexed vertices, was utilised for the assessment of facial asymmetry. This was quantified by measuring the disparity between the left- and right-hand sides of the face after superimposing the original 3D images on their mirror copies. RESULTS: Residual asymmetries at rest were identified at the vermillion of the upper lip and at the nares with a deviation of the philtrum towards the scar tissue. Vertical and anteroposterior asymmetries were identified on the cleft side. At maximum smile, the asymmetry increased noticeably at the vermillion of the upper lip and at the alar base. In the mediolateral direction, the philtrum deviated towards the cleft side with a significant increase of the asymmetry scores. DISCUSSION: Asymmetry of the upper lip has significantly increased at maximum smile as a result of the upward forces of all perioral lifting muscles, which affected the lip directly. CONCLUSIONS: The innovation of this study is the measurement of facial asymmetry for the objective outcome measure of the surgical repair of UCLP. The philtrum was the main site of residual asymmetry, which indicates the need for refining the primary repair of the cleft lip. Further corrective surgery may be required.