Three-dimensional facial morphology following surgical repair of unilateral cleft lip and palate in patients after nasoalveolar molding

G. Dave Singh, Daniel Levy Bercowski, Miguel A. Yáñez, Pedro E. Santiago

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

To evaluate three-dimensional (3D) facial morphology in patients surgically corrected for unilateral cleft lip and palate (UCLP) following pre-surgical nasoalveolar molding (NAM). Design - Prospective, longitudinal study. Digital stereophotogrammetry was used to capture 3D facial images, and x, y, and z coordinates of five landmarks were digitized to compute mean morphologies. The sample comprised 15 patients with leftUCLPand 10 matched control subjects. Facial form differences at age 37 weeks, using principal components analysis and finite-element scaling analysis (FESA) were assessed. Results - Using the first two principal components, which accounted for 63% of the total shape-change, UCLP and control groups showed similar distributions in the modal space (p > 0.05). For the UCLP group, the mean 3D facial form was smaller and less protrusive when superimposed on the non-cleft mean. Using FESA, reductions in facial volume were found in the UCLP group, involving the columella (29%), labial tubercle (51%), lower lip (29%) and lateral aspects of the face (19%). The UCLP group also showed increases in size above the tip of the nose (25%) and laterally to the columella directly below the nares (29%). Conclusions - Following surgical repair of UCLP in patients previously treated with NAM, 3D facial morphology was virtually indistinguishable from the non-cleft mean. Clinically, the apparent improvement in the facial soft tissues may mask dysmorphic skeletal growth, and further studies are required to characterize the underlying bony changes associated with the soft tissue changes reported here.

Original languageEnglish (US)
Pages (from-to)161-166
Number of pages6
JournalOrthodontics and Craniofacial Research
Volume10
Issue number3
DOIs
StatePublished - Dec 1 2007

Fingerprint

Cleft Lip
Cleft Palate
Finite Element Analysis
Lip
Photogrammetry
Masks
Principal Component Analysis
Nose
Longitudinal Studies
Prospective Studies
Control Groups
Growth

Keywords

  • Cleft
  • Morphology
  • Morphometrics
  • Pre-surgical orthopedics

ASJC Scopus subject areas

  • Orthodontics
  • Oral Surgery
  • Otorhinolaryngology
  • Surgery
  • Medicine(all)

Cite this

Three-dimensional facial morphology following surgical repair of unilateral cleft lip and palate in patients after nasoalveolar molding. / Singh, G. Dave; Levy Bercowski, Daniel; Yáñez, Miguel A.; Santiago, Pedro E.

In: Orthodontics and Craniofacial Research, Vol. 10, No. 3, 01.12.2007, p. 161-166.

Research output: Contribution to journalArticle

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abstract = "To evaluate three-dimensional (3D) facial morphology in patients surgically corrected for unilateral cleft lip and palate (UCLP) following pre-surgical nasoalveolar molding (NAM). Design - Prospective, longitudinal study. Digital stereophotogrammetry was used to capture 3D facial images, and x, y, and z coordinates of five landmarks were digitized to compute mean morphologies. The sample comprised 15 patients with leftUCLPand 10 matched control subjects. Facial form differences at age 37 weeks, using principal components analysis and finite-element scaling analysis (FESA) were assessed. Results - Using the first two principal components, which accounted for 63{\%} of the total shape-change, UCLP and control groups showed similar distributions in the modal space (p > 0.05). For the UCLP group, the mean 3D facial form was smaller and less protrusive when superimposed on the non-cleft mean. Using FESA, reductions in facial volume were found in the UCLP group, involving the columella (29{\%}), labial tubercle (51{\%}), lower lip (29{\%}) and lateral aspects of the face (19{\%}). The UCLP group also showed increases in size above the tip of the nose (25{\%}) and laterally to the columella directly below the nares (29{\%}). Conclusions - Following surgical repair of UCLP in patients previously treated with NAM, 3D facial morphology was virtually indistinguishable from the non-cleft mean. Clinically, the apparent improvement in the facial soft tissues may mask dysmorphic skeletal growth, and further studies are required to characterize the underlying bony changes associated with the soft tissue changes reported here.",
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