Facial characterization of infants with cleft lip and palate using a three-dimensional capture technique

Digital surface photogrammetry for anthropometric analysis of the cleft infant face

OBJECTIVE

To analyze the three-dimensional morphology of the cleft infant face with digital surface photogrammetry.

DESIGN

Fifty plaster casts of unoperated infants with cleft lip and palate were imaged three-dimensionally with digital surface photogrammetry. Twenty-one standard craniofacial measurements were taken. The plaster casts were divided into 4 groups with unilateral, bilateral, complete, and incomplete clefts of the lip and palate. The measurements were compared with standard values for healthy infants.

RESULTS

Significant differences (p < .0025) were found for the alar base width (33% to 55%), the alar base root width (59% to 103%), the width of the nose (7% to 25%), the length of the alar wing (18% to 25%), and the intercanthal (6% to 17%) and biocular (4% to 12%) width, depending on the cleft type. The vertical dimensions of the nose and the upper lip did not differ significantly from the controls.

CONCLUSION

This study describes preliminary data on the cleft infant facial deformity. The obtained results were mainly in agreement with data in the limited literature. Three-dimensional photogrammetry has proven to be reliable and can be applied more readily to potentially uncooperative patients.

Nasolabial symmetry following Tennison-Randall lip repair: a three-dimensional approach in 10-year-old patients with unilateral clefts of lip, alveolus and palate

AIM

To assess the degree of facial symmetry in patients suffering from unilateral cleft lip, alveolus and palate (UCLAP) by determining differences between the cleft and the non-cleft hemifaces from 3D surface data.

PATIENTS AND METHODS

In twenty-two 10-year-old UCLAP patients, who had the lip repaired using the Tennison-Randall technique and did not undergo further revisional surgery, differences were determined between landmarks, surface areas of the upper lip vermilion and nostrils and virtual volumes of midface, nose and upper lip for cleft and non-cleft sides, separately, after having established a plane of symmetry calculated from optical 3D facial surface data.

RESULTS

Statistically significant differences could be found between cleft and non-cleft sides for the nasal landmarks G(lat), G(sup) and La(med), the nostril angle and the virtual volume of the nose (p(Glat)=0.011, p(Gsup)<0.0005, p(Lamed)=0.002, p(nostril angle)=0.036 and p(nose volume)<0.0005, resp.).

CONCLUSION

Analysis of 3D data shows that complete nasal symmetry is difficult to achieve with Tennison-Randall's lip repair without revisional surgery. Further trials on larger populations of patients will allow a more comprehensive and consistent analysis of the consequence of different methods for cp repair in order to identify the techniques with the best outcome in terms of facial symmetry.

Three-dimensional facial characteristics of Caucasian infants without cleft and correlation with body measurements

OBJECTIVE

The aim of this study was to characterize the soft tissue facial features of infants without cleft and to report on the correlation between these with weight, length, and head circumference.

DESIGN

This was a prospective study using a noninvasive three-dimensional (3D) stereophotogrammetry (C3D) system to capture the images of the participants. Landmarks were identified on the 3D facial images. Means and SDs were derived for facial distances and angles. A facial asymmetry score was calculated for each image. Two sample Student's t tests, Pearson's correlation coefficients and analysis of covariance were used to ascertain any gender differences and determine whether these could be explained by weight differences.

PARTICIPANTS

Eighty-three infants, 41 boys and 42 girls, were captured at rest with their lips apart, at approximately 3 months of age.

RESULTS

Significant sex differences, of 1 to 2 mm, were found in several facial dimensions, such as face height and nose width. The larger facial measurements correlated significantly with body measurements. Analysis of variance confirmed these differences could be explained by differences in weight. There were no sex differences in the nose/mouth width ratios or in any of the angles measured, suggesting that there may be little sex difference in shape. A slight degree of asymmetry in the faces of infants without cleft was detected.

CONCLUSIONS

Comparisons between noncleft controls and infants with cleft should take cognizance of normal age and sex variations in height and weight that occur among infants.

Facial asymmetry--3D assessment of infants with cleft lip & palate

OBJECTIVES

To determine the degree of facial asymmetry in infants with unilateral cleft lip and/or palate, and quantify improvements following primary surgery, in three dimensions.

DESIGN

The faces of 20 infants with unilateral clefts (10 UCL; 10 UCLP), and 20 age-matched, non-cleft controls, were captured using the C3D stereophotogrammetry system prior to primary lip/nose repair (at 3 months), at 6 months and at age 1 year.

METHODS

Procrustes techniques were applied to 3D landmark configurations to its mirror image. Mean squared distances between landmarks and their antimeres were calculated and expressed as asymmetry scores for each 3D configuration. Full-face, nose and lip median scores were compared and changes with time evaluated (P < 0.01).

RESULTS

There were no significant changes in asymmetry scores in the control group from 3 months to 1 year. The UCLP group was more asymmetric than the UCL group, displaying greatest improvement in nasal symmetry following primary repair. The lips continued to improve over time. The UCL group had significant nasal asymmetry, which did not appear to improve with primary surgery.

CONCLUSIONS

Immediate improvement in asymmetry scores in children with UCLP is related to the production of a more symmetrical nasal form after primary surgery. In contrast, the nasal asymmetry seen in children with UCL is unchanged despite surgery. Full face asymmetry scores may mask subtle changes over time. Nasal and lip asymmetry should be considered individually.