Validity of the combined use of two esthetic rating systems, the infant index and 5-point aesthetic index, for pre- and postsurgical evaluation of cleft lip repair

Analysis of Dental Arch Symmetry of Children With Unilateral Cleft Lip and Palate: Seven-Year Follow-Up

BACKGROUND

Orofacial cleft is the most common craniofacial deformity, resulting in facial anatomical disorders.

AIM

To evaluate maxillary dental arch symmetry of children with unilateral complete cleft lip, alveolus, and palate before and after primary surgeries.

DESIGN

A total of 27 dental casts were analyzed: (T1) Presurgical; (T2) Postsurgical 1; and (T3) Postsurgical 2. Six linear measurements were analyzed (I-C', I-C, I-T', I-T, C'-T', and C-T). Paired t test, Pearson correlation, and ANOVA, followed by the Tukey test, were conducted (α = 5%).

RESULTS

The asymmetry was confirmed by I-C versus I-C' across all periods and I-T versus I-T' (at T1). The Pearson correlation test showed significant values for Δ1×Δ2 and Δ1×Δ3, but not for Δ2×Δ3. The longitudinal analysis showed that the I-C' mean was greater at T1 than at T2/T3 (p < 0.001). The I-C mean was smaller at T1 than at T2/T3 (p < 0.001). I-T' was greater only at T3 (p < 0.001). I-T, C'-T', and C-T means were greater at all periods.

CONCLUSION

The maxillary asymmetry of children with unilateral cleft lip and palate is inherent to the cleft type, evidenced by the maxillary hypoplasia in the smaller segment, probably higher in the anterior region (I-C').

Photoanthropometric study: are non-professional photographs suitable for objective and reliable analysis of facial features?

BACKGROUND

The face has been widely investigated using professionally taken frontal and lateral photographs, however, there is a lack of studies of non-professional facial photographs. It is not known if they could be suitable for facial analysis. The analysis of non-professional photographs could allow the performance of cost- effective longitudinal studies.

AIM

To determine if non-professional photographs could be used for a reliable analysis of facial features.

SUBJECTS AND METHODS

The frontal profiles of 18-21-year-olds (35 males, 39 females) were measured by direct anthropometry, in addition, professional photographs were taken and non-professional photographs were obtained. Anthropometric landmarks were superimposed on those photographs. The indices calculated on the basis of the measurements of direct anthropometry and both types of photographs were compared.

RESULTS

The comparison of the measurements of direct anthropometry and professional photographs showed no difference between 14 out of 25 male and 10 out of 25 female facial indices (p > 0.05) after comparing the results of direct anthropometry with those of non-professional photographs, no difference was found in 8 out of 25 male and 7 out of 25 female indices. These indices were mostly composed of vertical parameters and eye measurements.

CONCLUSION

Vertical facial dimensions and eye measurements may not only be used interchangeably for both facial photographs and direct anthropometry, but may also be suitable for objective and reliable facial analyses.

Lips and noses in 10-year old patients with repaired complete unilateral clefts of lip, alveolus, and palate. A prospective three-centre study of the Baltic Cleft Network

This multicenter study aimed at comparing different techniques of lip and nose repair with or without NAM and primary anterior rhinoplasty in pre-adolescent children. Patients with unilateral clefts of lip, alveolus, and palate who had undergone cleft lip and nose repair were evaluated in a prospective three-centre study using standardized monochromatic, cropped photographs. Four cleft surgeons evaluated the aesthetics of the central part of the face when the patients had reached age ten years. Seventy-six sets of photographs out of 87 patients were evaluated. The overall ratings of lips and noses did not differ much between centres. However, noses of centres 1 (mean 0.74; SD 0.57) and 2 (mean 0.76; SD 0.60) had been rated better than centre 3 (mean 1.32; SD 0.78; p = 0.0078), especially "Deformation of upper part of nostril rim or poor position of alar cartilage". Centre 3 had produced better looking scars (mean 0.33; SD 0.48); p = 0.0036. Within the limitations of the study it seems that NAM and primary anterior rhinoplasty including postoperative nasal stents should be performed whenever possible in order to achieve a favorable shape of the nose and to reduce the need for secondary corrective surgery.