scholarly journals Three-Dimensional Soft-Tissue Evaluation in Patients with Cleft Lip and Palate

2018 ◽  
Vol 24 ◽  
pp. 8608-8620 ◽  
Author(s):  
Selin Alpagan Ozdemir ◽  
Elçin Esenlik
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional

A Quantitative Three-Dimensional Assessment of Abnormal Variations in Facial Soft Tissues of Adult Patients with Cleft Lip and Palate

2003 ◽  
Vol 40 (5) ◽  
pp. 544-549 ◽  
Author(s):  
Virgilio F. Ferrario ◽  
Chiarella Sforza ◽  
Claudia Dellavia ◽  
Gianluca M. Tartaglia ◽  
Davide Sozzi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Z Score ◽  
Soft Tissue Profile ◽  
Variability Index ◽  
The Mean ◽  
Facial Soft Tissues

Objective To supply quantitative information about the facial soft tissues of adult operated patients with cleft lip and palate (CLP). Design, Setting, and Patients The three-dimensional coordinates of soft tissue facial landmarks were obtained using an electromagnetic digitizer in 18 Caucasian patients with CLP (11 males and 7 females aged 19 to 27 years) and 162 healthy controls (73 females and 89 males aged 18 to 30 years). From the landmarks, 15 facial dimensions and two angles were calculated. Data were compared with those collected in healthy individuals by computing z-scores. Two summary anthropometric measurements for quantifying craniofacial variations were assessed in both the patients and reference subjects: the mean z-score (an index of overall facial size), and its SD, called the craniofacial variability index (an index of facial harmony). Results In treated patients with CLP, facial size was somewhat smaller than in normal individuals, but in all occasions the mean z-score fell inside the normal interval (mean ± 2 SD). Almost all patients had a craniofacial variability index larger than the normal interval, indicating a global disharmonious appearance. Overall, in patients pronasale, subnasale, and pogonion were more posterior, the nose was shorter and larger, the face was narrower, and the soft tissue profile and upper lip were flatter than in the reference population. Conclusions The facial soft tissue structures of adult operated patients with CLP differed from those of normal controls of the same age, sex, and ethnic group. In this patient group, surgical corrections of CLP failed to provide a completely harmonious appearance, even if the deviations from the reference were limited. Further analyses of larger groups of patients are needed.

Comparative Osseous and Soft Tissue Morphology following Cleft Lip Repair

2008 ◽  
Vol 45 (5) ◽  
pp. 511-517 ◽  
Author(s):  
Lynn M. Seidenstricker-Kink ◽  
Devra B. Becker ◽  
Daniel P. Govier ◽  
Valerie B. DeLeon ◽  
Lun-Jou Lo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Processing System ◽  
Distance Matrix ◽  
Euclidean Distance Matrix ◽  
Computed Tomography Scans ◽  
Nasal Region

Objective: To quantify comparative improvement between osseous and soft tissue asymmetry following primary lip repair. Design: Retrospective analysis of preoperative and postoperative computed tomography scans of infants with unilateral cleft lip and palate. Sixteen soft tissue landmarks were placed using an exploratory two-/three-dimensional image processing system and compared for asymmetry. Patients: Computed tomography scans were obtained on 26 patients (13 boys, 13 girls) of Chinese ethnicity (mean age  =  0.25 years) prior to Millard lip repair. Nineteen of these contributed to follow-up comparative studies prior to palatoplasty at a mean age of 0.92 years. There were 18 left-sided and eight right-sided clefts. Main Outcome Measure: Euclidean distance matrix asymmetry analysis was used to determine the amount of soft tissue asymmetry pre- and postlip repair. Similar analyses of the same scans were performed for 41 osseous landmarks. Results: Soft tissue landmarks had 36/39 (92%) preoperative and 13/39 (33%) postoperative asymmetric pairs. Osseous distances demonstrated 77/125 (61%) asymmetric pairs preoperatively and 60/125 (48%) postoperatively. Soft tissue and osseous distances of the lip region demonstrated 32% and 39% postoperative asymmetry, respectively. Soft tissue and osseous distances of the nasal region demonstrated 52% and 72% postoperative asymmetry, respectively. Soft tissue and osseous distances of the facial landmarks demonstrated 24% and 34% postoperative asymmetry, respectively. Conclusions: Primary lip repair appears to effect gains in symmetry in soft tissue and provides sufficient molding forces to cause correlating symmetry changes in underlying osseous structures.

Importance of Soft Tissue for Skeletal Stability in Maxillary Advancement in Patients with Cleft Lip and Palate

2003 ◽  
Vol 40 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Arnulf Baumann ◽  
Klaus Sinko
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Jaw Surgery ◽  
Le Fort I ◽  
Skeletal Stability

Objective Assessment of stability of the advanced maxilla after two-jaw surgery and Le Fort I osteotomy in patients with cleft palate based on soft tissue planning. Subjects Between 1995 and 1998, 15 patients with cleft lip and palate deformities underwent advancement of a retruded maxilla, without insertion of additional bone grafts. Eleven patients had bimaxillary osteotomies and four patients only a Le Fort I osteotomy. Relapse of the maxilla in horizontal and vertical dimensions was evaluated by cephalometric analysis after a clinical follow-up of at least 2 years. Results In the bimaxillary osteotomies, horizontal advancement was an average 4 mm at point A. After 2 years, there was an additional advancement of point A of an average of 0.7 mm. In the mandible, a relapse of 0.8 mm was seen after an average setback of 3.9 mm. In the four patients with Le Fort I osteotomy, point A was advanced by 3.8 mm and the relapse after 2 years was 0.9 mm. Vertical elongation at point A resulted in relapse in both groups. Impaction of the maxilla led to further impaction as well. Conclusion Cephalometric soft tissue analysis demonstrates the need for a two-jaw surgery, not only in severe maxillary hypoplasia. Alteration of soft tissue to functional harmony and three-dimensional correction of the maxillomandibular complex are easier to perform in a two-jaw procedure. It results in a more stable horizontal skeletal position of the maxilla.

Three-Dimensional Computer-Assisted Single-Splint 2-Jaw Cleft Orthognathic Surgery: Toward Patient-Centered Surgical Rationale

2020 ◽  
Vol 57 (12) ◽  
pp. 1428-1433
Author(s):  
Rafael Denadai ◽  
Yu-Ray Chen ◽  
Lun-Jou Lo
Keyword(s):  
Soft Tissue ◽  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Patient Centered ◽  
3 Dimensional ◽  
Facial Contour ◽  
Tissue Abnormalities

Skeletally mature patients with cleft lip and palate commonly present with skeletofacial deformities characterized by varying degrees of intrinsic and acquired dentoskeletal and soft tissue abnormalities. These abnormalities are associated with scarring from previous surgeries and the asymmetric midline and facial contour that impose challenges for adequate reconstruction. These patients frequently require 2-jaw orthognathic surgery to improve occlusal function and for correction of facial deformities. In this article, we have detailed a 3-dimensional computer-assisted single-splint 2-jaw orthognathic surgery technique as a surgical approach for cleft skeletofacial reconstruction, allowing for the surgery to be tailored according to the specific needs and requests of the patients. Further, we have addressed the multidimensionality and specificities of cleft treatment, the wide versatility, adaptability, and applicability of this technique, and the patient-centered rationale for the adoption of this method.

A Three-Dimensional Comparison of Nasolabial Soft Tissue between Children with Repaired Unilateral Complete Cleft Lip and Palate and Unaffected Children in Khon Kaen, Thailand

2020 ◽  
Vol 44 (6) ◽  
pp. 442-450
Author(s):  
N Kumjan ◽  
A Manosudprasit ◽  
A Pisek ◽  
K Winaikosol ◽  
M Manosudprasit ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Plan ◽  
Three Dimensional ◽  
Cross Sectional Study ◽  
Upper Lip ◽  
Cross Sectional ◽  
Surgical Guide ◽  
Khon Kaen

Objectives: The objectives were to assess the treatment outcomes of unilateral cleft lip and palate after primary surgery on nasolabial soft tissue of children ages 4–5 years old as compared with unaffected children and to establish a nasolabial soft tissue norm within Khon Kaen. Study design: This cross-sectional study consisted of 60 unaffected subjects living in Khon Kaen province and 20 subjects with repaired complete unilateral cleft lip and palate who were treated at Srinagarind Hosipital, Khon Kaen, Thailand. 3D images were taken by a Morpheus 3D Scanner and measured by the Morpheus 3D program. Independent t-tests and paired t-tests were used to analyze the significant differences between subjects with cleft and unaffected subjects. Results: There were statistically significant differences (p<0.05) of nasolabial measurements between affected subjects and unaffected subjects. Unilateral measurements showed decreased nostril height, columella lengths, and nose protrusion from ala base and ala length in the affected group. In addition, bilateral measurements found decreased upper lip protrusion, philtrum length, upper lip height, upper vermillion thickness, and lip angle. Conclusion: This study attempted to establish a norm for evaluating the treatment outcome of cleft lip and cleft palate repair at Srinagarind Hospital in relation to unaffected or noncleft individuals. The results suggest that the noncleft side in affected patients is not an optimal surgical guide for cleft repair and the surgeon should correct both sides of lip and nose features according to the norms. A surgical treatment plan should emphasize correcting nostril height, columella length, nose protrusion from ala base, ala length, and upper lip features.

A Quantitative Three-Dimensional Assessment of Soft Tissue Facial Asymmetry of Cleft Lip and Palate Adult Patients

2003 ◽  
Vol 14 (5) ◽  
pp. 739-746 ◽  
Author(s):  
Virgilio F. Ferrario ◽  
Chiarella Sforza ◽  
Claudia Dellavia ◽  
Gianluca M. Tartaglia ◽  
Anna Colombo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Facial Asymmetry ◽  
Adult Patients ◽  
Dimensional Assessment

Facial Characterization of Infants with Cleft Lip and Palate Using a Three-Dimensional Capture Technique

2004 ◽  
Vol 41 (1) ◽  
pp. 27-35 ◽  
Author(s):  
C. A. Hood ◽  
M. T. Hosey ◽  
M. Bock ◽  
J. White ◽  
A. Ray ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Horizontal Displacement ◽  
Soft Tissue Defect ◽  
Facial Morphology ◽  
Primary Surgery ◽  
Alar Base

Objective To characterize the soft tissue features of infants with unilateral cleft lip (UCL) and unilateral complete cleft lip and palate (UCLP) prior to primary surgery and compare with noncleft controls. Design Prospective controlled capture of the facial morphology of infants using a noninvasive three-dimensional stereophotogrammetry method. Participants 23 children with presurgical cleft: 11 UCL (M = 6, F = 5); 12 UCLP (M = 9, F = 3), and 21 noncleft controls (M = 7, F = 14) were imaged at approximately 3 months of age (range 10 to 16 weeks). Main Outcome Measure Accurate, repeatable quantification of facial soft tissues in infants with clefts prior to surgery. Results Significant differences (p < .05) were found between the UCLP group and UCL and control groups in anatomical and soft nose width, cleft-side alar wing length, and nasal tip horizontal displacement. Both cleft groups were significantly different from controls and from each other in cleft-side nostril dimensions, alar wing angulation, columella angle, and alar base to corner of mouth dimension; alar base width; and soft tissue defect in nose and the lip and philtrum length bordering the cleft. Significant differences between clefts and controls were identified in the nostril and philtrum on the noncleft side. Conclusions The use of children with UCL as controls for UCLP studies is inappropriate. This technique overcame the limitations of direct measurement of infant faces to aid the surgeon in the planning and subsequent re-evaluation of surgical rationale.

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