Facial Anthropometric Evaluation of Unilateral Cleft Lip and Palate Patients: Infancy Through Adolescence

Featuring growth of the external nose among patients with congenital cleft anomalies

Cleft lip and palate deformities are usually accompanied by abnormal external nasal morphology which seriously affects facial aesthetics and quality of life. In-depth understanding of the growth pattern of external nasal morphology in patients with cleft lip and palate is essential for deciding the optimal timing of surgical intervention and for furthering improvements in surgical technique. In this review we systematically depict the cross-sectional changes in external nose morphology during growth in the normal population and in patients with clefts, and summarise the iatrogenic impacts on growth of the cleft nose, aiming to provide a reference to further improve the management of the nose in patients with clefts.

In-vivo assessment of application of folinic acid and botulinum toxin A in cleft lip surgical defects

INTRODUCTION

Folinic acid and botulinum toxin A have shown promising results in wound healing in different studies. This study aimed to compare the effects of these approaches on wound healing after simulating cleft lip surgery in rats.

METHODS

In this experimental animal study, after creating lip defects, 30 rats were randomly divided into three groups and received normal saline (CTL), botulinum toxin A (BOT), and folinic acid (FOL). Biopsy from the skin wounds was performed after 14- and 28-days. These samples were stained with haematoxylin and eosin and Masson trichrome staining. Finally, each pathological parameter of wound healing was rated in this study.

RESULTS

While the inflammatory response was not different among the study groups, fibroblast proliferation and collagen deposition were significantly higher in FOL group compared to BOT group. Moreover, both BOT and FOL facilitated epithelial healing and 14-day angiogenesis as compared with normal saline.

CONCLUSIONS

Improved wound healing was observed using both botulinum toxin A and folinic acid in rat animal models. However, the application of botulinum toxin A caused less fibroblast proliferation and collagen deposition which can potentially lead to less scar formation, which can be particularly important in the aesthetic zone.

Evaluation of Divine Proportions in Face and Smile of Patients With Unilateral Cleft Lip and Palate

INTRODUCTION AND AIM

The facial view of patients with cleft lip and palate greatly affects their psychological well-being and usually leads to introspection. The aim of this study was to compare the face and smile of cleft lip and palate patients and normal population with divine proportion.

METHOD

In this retrospective study, 20 female patients (14-25 years) with unilateral cleft lip and palate, who referred to Orthodontic Department of Mashhad School of Dentistry, were selected. The control group consisted of 10 normal female persons with ideal face and normal occlusion. After scanning photographs of full face, profile, and smile views of them, the divine proportions were measured by Photoshop software. Then the data were entered into SPSS software version 22 and analyzed using 2 sample independent t test. P value less than 0.05 were considered as significant.

RESULTS

In the study group all proportions were significantly less than the golden proportion. Ls-Rcus/Rch-Rcus and Ls-Lcus/Lch-Lcus had the least difference and Sn-Sm/N-Sn and Sn-Sm/Sm-Me had the most. In the control group, all proportions except Ls-Lcus/Lch-Lcus and Ls-Rcus/Rch-Rcus, were less than the golden proportion. Sn-Sm/N-Sn had the most difference and N-Sn/Sm-Me had the least.Approximately all proportions in cleft patients were significantly different from normal population. Ls-Lcus/Lch-Lcus had the highest difference between study and control group; however, Tr-Sn/Tr-Me in both groups were equal.

CONCLUSIONS

The differences between facial indices in cleft lip and palate patients, normal people and golden proportion were significant. As facial proportions of normal people in the authors' study were also different from divine proportions, the authors can conclude that to reach acceptable esthetic results, the authors can approximate patients to normal populations. Unfortunately, the patients with large bone defects, cannot reach to the "esthetic" divine proportion even after reconstructive surgery.