Nasolabial aesthetics correlates poorly with skeletal symmetry in unilateral cleft lip and palate

Urbanová, Wanda; Brudnicki, Andrzej; Strydom, Hardus; Bronkhorst, Ewald M.; Katsaros, Christos; Fudalej, Piotr

doi:10.1016/j.bjps.2012.08.032

Cited by 14 publications

(4 citation statements)

References 31 publications

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“…Similar to a previous study indicating that a weak correlation exists between nasal soft and hard tissues in patients with repaired UCLP (Urbanova et al, 2013 ), the current study revealed that statistically significant correlations exist between the asymmetries of hard‐tissue landmarks (LPA) and those for soft tissues (Gbase, Glat, and Sbal) in all three dimensions. This finding suggests that the restoration of the LPA is crucial for nasal alar symmetry.…”

Section: Discussionsupporting

confidence: 90%

Nasal asymmetry changes during growth and development in 6‐ to 12‐year‐old children with repaired unilateral cleft lip and palate: A 3D computed tomography analysis

et al. 2021

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Repaired unilateral cleft lip and palate (UCLP) is often accompanied by the deformity and asymmetry of the nasal region. Three‐dimensional analysis was performed to investigate the relationship between nasal soft‐ and hard‐tissue asymmetries, as well as the changes in nasal asymmetry with age, among children with repaired UCLP (age: 6–12 years). Forty‐seven patients were included in this study. Their computed tomography records were retrieved for analysis of the 3D asymmetry of 10 landmarks of the nasal soft and hard tissues. We observed that asymmetry was more severe in nasal hard tissues than in soft tissues, particularly in the sagittal dimension. Compared with patients aged 6–9 years old, patients aged 10 to 12 years old had significantly increased vertical asymmetry at the base of the alar groove (Gbase, p = 0.027) and the lateral point of the piriform aperture (LPA), ( p < 0.001). The correlation between the LPA and the alar region was weak to moderate ( r = 0.290 to 0.488). In conclusion, we found no evidence of growth and development in nasal hard‐tissue asymmetry among 6‐ to 12‐year‐old children with repaired UCLP, except for the vertical dimension. Nasal soft tissue exhibited a more preferable symmetry than hard tissue, and this could be attributed to the compensatory growth of nasal soft tissue, particularly in the vertical and sagittal dimensions. The weak to moderate correlations between nasal soft‐tissue asymmetry and hard‐tissue asymmetry were observed in the three dimensions. Surgeons should consider these factors when repositioning the nasal alar and controlling the size of the nostrils.

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Section: Discussionsupporting

confidence: 90%

Nasal asymmetry changes during growth and development in 6‐ to 12‐year‐old children with repaired unilateral cleft lip and palate: A 3D computed tomography analysis

et al. 2021

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“…Several studies cited in the literature on the outcome of surgery for CL/P have focused on retrospective data and have evaluated only photographic Images [44][45][46] . Few published studies have evaluated the results of CLP repair via Fisher's technique, combining objective anthropometric assessment and subjective assessments based on the Asher-McDade Aesthetic Index.…”

Section: Discussionmentioning

confidence: 99%

Anthropometric and aesthetic outcomes for the nasolabial region in 101 consecutive African children with unilateral cleft lip one year after repair using the anatomical subunit approximation technique

Mbuyi-Musanzayi

Katombe

Lukusa-Tshilobo

et al. 2017

International Journal of Oral and Maxillofacial Surgery

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One hundred and one patients with complete or incomplete cleft lip underwent the anatomical subunit approximation technique for repair. The patients were followed up prospectively for 1year. The objective of this study was to determine the outcomes for the nasolabial area through anthropometric measurements and assessment of the Asher-McDade Aesthetic Index and Steffensen's criteria at 1year after surgery. Six assessors (three cleft surgeons and three non-surgeon medical professionals) examined cropped images; reliability was assessed using Cronbach's alpha. The difference in lip length between the healthy and operated sides was 0.61mm and the difference in nostril diameter was 0.37mm (differences not significant). The average scar width was 2.78±1.35mm. Hypertrophic scars were observed in 9.9% of cases. The average Asher-McDade Aesthetic Index rating varied between 1.35 and 1.98 for all parameters. Cronbach's alpha coefficient was 0.83, 0.89, 0.98, and 0.89 for nasal form, nasal symmetry, vermilion border, and nasolabial profile, respectively. Steffensen's criteria rated appearance as 'good' in 69.3% to 91.1% of cases. The anatomical subunit approximation technique can be performed in Sub-Saharan Africans for all types of unilateral cleft lip. It significantly improves the length of the medial and lateral lips, leaving an acceptable scar. A study with a larger sample size and longer follow-up is warranted.

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“…Facial attractiveness plays a major role in the social life and in the interaction among individuals 1 . Attractive people experience benefits within today's society, are more popular, and are regarded as having more positive qualities and abilities than their less attractive counterparts 2 . Despite the speed of decision-making about attractiveness, the process of judging facial appearance is complex 3 .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Autologous Alveolar Bone Grafting on Nasolabial Asymmetry in Unilateral Cleft Lip and Palate

Thierens

Kerckhof

Roo

et al. 2020

Journal of Craniofacial Surgery

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The objective of this study was to examine whether an autologous alveolar bone graft has an effect on the nasolabial asymmetry in unilateral cleft lip, alveolus, and palate. Fifteen children (mean age 7.5  2.4 years) with non-syndromic unilateral cleft lip and palate (CLP) were included. Non-ionizing three-dimensional images were acquired prior to and three months after the alveolar bone grafting procedure. A 2D and a landmark-independent 3D asymmetry assessment were used to detect changes of asymmetry in the nasolabial area. For the 2D assessment, a cleft and non-cleft side ratio for 4 linear nasal and 2 linear labial distances was expressed as a Coefficient of Asymmetry (CA). The 3D asymmetry assessment comprised a robust superimposition of the face with its mirror image, expressed as a root-mean-square-error (RSME) in mm. A significant decrease in the CA for the labial distance from the facial midline to the labial commissure was observed (P=0.036). Also, the CA for the labial distance from the facial midline to the highest point of Cupid's bow increased significantly (P=0.028). Nonsignificant changes were observed for the CA for the 2 nasal distances and the 2 other labial distances. No significant changes in 3D nasal asymmetry were detected (P=0.820). Alveolar bone grafting completes the alveolar ridge but has only little to no clinical effect on the asymmetry of the secondary cleft lip nasal deformity.

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Nasolabial aesthetics correlates poorly with skeletal symmetry in unilateral cleft lip and palate

Cited by 14 publications

References 31 publications

Nasal asymmetry changes during growth and development in 6‐ to 12‐year‐old children with repaired unilateral cleft lip and palate: A 3D computed tomography analysis

Nasal asymmetry changes during growth and development in 6‐ to 12‐year‐old children with repaired unilateral cleft lip and palate: A 3D computed tomography analysis

Anthropometric and aesthetic outcomes for the nasolabial region in 101 consecutive African children with unilateral cleft lip one year after repair using the anatomical subunit approximation technique

The Effect of Autologous Alveolar Bone Grafting on Nasolabial Asymmetry in Unilateral Cleft Lip and Palate

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