Soft Tissue Asymmetry in Patients With Cleft Lip and Palate Using Stereoscopic Photography.

Abstract

Objective: To evaluate the long-term facial soft tissue asymmetry of unilateral cleft lip with alveolar cleft (UCLA) and unilateral complete cleft lip and palate (UCLP) in patients with cleft lip and palate.

Methods: Three-dimensional photography (3dMD) was used to scan 21 UCLA and 18 UCLP patients, generating 3D digital models. Bilateral facial symmetry indices were analyzed using paired t-tests. Further, as a demonstration, symmetrical mirror image analysis was conducted on one patient from each group to assess asymmetry distribution and severity.

Results: There were significant differences in nostril, nasal alar, and upper lip measurement indices between the 2 sides in both patient groups. These included the base of the nostril width, nasal alar projection length, depth of midface, and all of the lip indices in both groups. The nasal lateral length was different in the UCLA group, whereas the axial length of the nostril was different in the UCLP group. According to the mirror image analysis, the facial asymmetry of UCLA patients was identified principally in the ala, nostril, and cheilion, which was considered as mild asymmetry. Patients with UCLP showed severe asymmetry, including the entire midface.

Conclusions: Three-dimensional evaluation revealed facial soft tissue deformities in both groups, primarily in the nasolabial area. UCLP patients exhibited greater asymmetry and a broader range of deformity than UCLA patients. Further treatment is needed to improve facial malformations in both groups.