Measuring Symmetry in Children with Cleft Lip. Part 3: Quantifying Nasal Symmetry and Nasal Normalcy before and after Unilateral Cleft Lip Repair

2017 ◽  
Vol 54 (5) ◽  
pp. 602-611 ◽  
Author(s):  
Shu Liang ◽  
Linda Shapiro ◽  
Raymond Tse
Keyword(s):  
Cleft Lip ◽  
Reconstruction Error ◽  
3D Analysis ◽  
Older Children ◽  
Before And After ◽  
Automated Processing ◽  
Computer Based ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Area Difference

Objective The purpose of this project was to develop objective computer-based methods to measure nasal asymmetry and abnormality in children undergoing treatment of unilateral cleft lip (UCL) and to determine the correlation of these measures to clinical expectations. Participants Thirty infants with UCL undergoing cleft lip repair; 27 children with UCL aged 8 to 10 years who had previously undergone cleft lip repair; 3 control infants; 3 control children aged 8 to 10 years. Interventions To measure nasal symmetry, we used a process of depth mapping and calculated the Depth Area Difference. To measure abnormality, we used the reconstruction error from Principle Component Analysis (PCA) that was based upon characteristics of a dataset of over 2000 images of normal control subjects. Main Outcome Measures Depth Area Difference and PCA Reconstruction Error for cleft type, changes with surgery, and individual subjects ranked according to cleft severity were assessed. Results Significant differences in Depth Area Difference and PCA Reconstruction Error were found between cleft types and found before and after surgery. Nasal symmetry and normalcy scores for infants with UCL approached those of controls after surgery, and there was a strong correlation with ranked cleft severity. For older children, measures of nasal symmetry and abnormality were better than infants prior to repair but worse than infants following UCL repair. Conclusions Our computer-based 3D analysis of nasal symmetry and normalcy correlated with clinical expectations. Automated processing made measurement convenient. Use of these measures may help to objectively measure cleft severity and treatment outcome.

scholarly journals Antropometric Evaluation Of Gentur's Cheiloplasty Method In Unilateral Cleft Lip

2017 ◽  
Vol 3 (2) ◽  
pp. 52-60
Author(s):  
Rani Septrina ◽  
Gentur Sudjatmiko
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
Before And After ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Palate Patient ◽  
Vertical Height ◽  
Rotation Advancement

Background: Cheiloplasty, the earliest surgical procedure in cleft lip and palate patient, has impact on functional and aesthetical appearance1. The Gentur’s technique is a method of cleft lip surgery that has been developed by him and has been used in RSUPN Cipto Mangunkusumo/Faculty of Medicine Universitas Indonesia2. It uses the rotation-advancement, small triangular, preventing notching concepts with some other details to overcome the wide cleft. This study was conducted to answer whether the Gentur’s technique gives symmetrical result in anthropometric measurements. Methods: Cross sectional analytic study will be taken from medical record in 14 unilateral cleft lip patients underwent cheiloplasty procedure. Direct anthropometric data before and after procedure were analyzed using SPSS17. Anthropometric data such as cupid’s bow, vertical height, horizontal height, vermillion and nostril were noted. Results: From 14 patients, we found 9 patients who underwent surgery in 3 months of age (64.3%) are mostly female (n=9, 64.3%), have complete defect (n=12, 85.8%) and left sided defect (n=8, 57.1%). Gentur’s technique is able to produce significant lip and nose symmetry (CI 95%, pvalue <0.005) in cupid’s bow, vertical height, horizontal height, thickness of vermillion and nose. By doing this technique, the author is able to create good lip and nose symmetry (78.57%) even in wide defect (64.3%) and palatal collapse (57.1%). Conclusion: Gentur’s technique is able to utilize tissue deficiency to create ideal lip and nose in unilateral cleft lip repair even in patients with wide gap.

Unilateral Cleft Lip Repair

1993 ◽  
Vol 20 (4) ◽  
pp. 647-657 ◽  
Author(s):  
Michael B. Lewis
Keyword(s):  
Cleft Lip ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

The unilateral cleft lip repair

2021 ◽  
Vol 42 (3) ◽  
pp. 102908
Author(s):  
Jeewanjot S. Grewal ◽  
Susan C. Yanik ◽  
Alexis M. Strohl-Bryan ◽  
Sherard A. Tatum
Keyword(s):  
Cleft Lip ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

scholarly journals Atypical Outcomes of Nasal and Lip Appearance After Unilateral Cleft Lip Repair: Judgment by Professionals, Patients, and Laypeople

2021 ◽  
pp. 105566562098280
Author(s):  
Robin A. Tan ◽  
Frans J. Mulder ◽  
Roderic M. F. Schwirtz ◽  
David G. M. Mosmuller ◽  
Henrica C. W. De Vet ◽  
...  
Keyword(s):  
Analysis Of Variance ◽  
Online Survey ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Old Patients ◽  
Rank Score ◽  
Cleft Lip Repair ◽  
Typical Appearance ◽  
Unilateral Cleft Lip Repair ◽  
Insight Into

Objective: To gain more insight into the assessment of “atypical” nasal and lip appearance outcomes compared to “typical” appearance outcomes after unilateral cleft lip and palate (UCLP) repair, when judged by professionals, patients with repaired UCLP, and laypeople. Design: An online survey containing 3 series of photographs with various degrees of “typical” and “atypical” nasal and lip appearance outcomes after UCLP repair was sent to 30 professionals, 30 patients with repaired UCLP, and 50 laypeople in 2 countries. Participants were instructed to rank the photographs from excellent to poor based on overall appearance. Mean rank positions of photographs were analyzed and differences in mean rank score between “typical” and “atypical” results were assessed using a T-test. Agreement of ranking between the 3 groups was assessed with an analysis of variance analysis. Setting: Amsterdam UMC, location VUmc, Netherlands and Boston Children’s Hospital, Boston, USA. Patients: Photographs of 6- to 18-year-old patients with repaired UCLP. Results: “Atypical” appearance outcomes were ranked significantly less favorably (small nostril: P = 0.00; low vermillion border: P = 0.02; whistling deformity: P = 0.00) compared to “typical” outcomes. Difference between professionals, patients and laypeople in rank positioning the photographs was not statistically significant ( P = 0.89). Conclusions: Noses with a smaller nostril and lips containing a whistling deformity were perceived as poorer outcome compared to the “typical” results. Professionals, patients, and laypeople are in agreement when assessing these outcomes.

Anthropometric Outcome of Primary Unilateral Cleft Lip Repair in Indonesia

2021 ◽  
pp. 105566562098275
Author(s):  
Robertus Arian Datusanantyo ◽  
Magda Rosalina Hutagalung ◽  
Sitti Rizaliyana ◽  
Djohansjah Marzoeki
Keyword(s):  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Inclusion Criteria ◽  
Initial Size ◽  
Tertiary Center ◽  
Observational Cohort ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Junior Residents

Objective: This study aimed to measure and analyze the outcome of primary unilateral cleft lip repair. Design: Observational cohort study. Setting: Surabaya Cleft Lip and Palate (CLP) Center, a major referral center for the Eastern part of Indonesia, affiliated with a tertiary center. Patients, Participants: From 69 patients who met the inclusion criteria, we excluded 31 patients who were more than 2 years of age and were operated on by junior residents under supervision. Interventions: We performed anthropometric measurements of the patients on photographs taken before, immediately after, and a year after the surgery. Main Outcome Measure(s): This study measured nasal width, vertical lip height, horizontal lip length, and philtral height ratios. Results: While nasal width and philtral height ratios decreased significantly ( P = .000 and P = .000, respectively) reaching symmetry immediately after surgery, the horizontal lip length, and vertical lip height ratios remained unchanged ( P = .862 and P = .981, respectively). A year after surgery, the nasal width and horizontal lip length ratios increased significantly ( P = .017 and P = .006, respectively), while philtral height and vertical lip height ratios remained unchanged ( P = .927 and P = .138, respectively). There was no difference in the ratios based on the initial size and completeness of the cleft. Conclusion: In Surabaya CLP Center, the symmetry of nasal width, philtral height, horizontal lip length, and vertical lip height were achieved by the unilateral cleft lip repair despite the initial size and completeness of the cleft.

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