Nasolabial shape differences and esthetics in unilateral cleft lip and palate: A comparison of nasolabial shape using a mean 3D facial template. MA Kuijpers, TJ Maal, JW Meulstee, CE Carels, EM Bronkhorst, SJ Bergé, PS Fudalej.

Date: November 2018.
Source: 3D imaging in patients with orofacial clefts. Chapter 6.
Objective: To determine the amount of deviation in nasolabial shape in patients with a cleft, compared with an average non-cleft face, and assess whether this difference was related to nasolabial esthetics.
Methods: 3D stereophotogrammetric images of 60 patients with a unilateral cleft (cleft lip, n=10; cleft lip and alveolus, n=23; cleft lip, alveolus, and palate, n=27) were used. To quantify shape differences, four average non-cleft faces were constructed from stereophotogrammetric images of 141 girls and 60 boys (both sexes ≤10.5 years and >10.5 years). Three-dimensional shape differences were calculated between superimposed cleft faces and the average non-cleft face for the same sex and age group. Nasolabial esthetics were rated with the modified Asher-McDade Aesthetic Index using a visual analogue scale (VAS).
Results: Mean VAS scores (overall, nasal deviation, nasal form, nasal profile) ranged from 51.44 (8.70) to 60.21 (8.41) for clefts, with lower esthetic ratings associated with increasing cleft severity. Shape differences were found between cleft faces and the average non-cleft face. No relation was found for the VAS, age, and sex, except that a lower VAS was related to a higher nose and lip distance between superimposed cleft and average non-cleft faces for nasal profile (p=0.02), but the explained variance was low (R2 = 0.066).
Conclusions: Except for nasal profile, nasolabial esthetics were not influenced by the extent of shape differences from the average non-cleft face.
Clinical Relevance: Objective measurements for cleft treatment outcome may differ from patient’s satisfaction and esthetic rating. This complicates evaluating treatment outcome.

Article: Nasolabial shape differences and esthetics in unilateral cleft lip and palate: A comparison of nasolabial shape using a mean 3D facial template.
Authors: MA Kuijpers, TJ Maal, JW Meulstee, CE Carels, EM Bronkhorst, SJ Bergé, PS Fudalej. Department of Dentistry, section of Orthodontics & Craniofacial Biology, Radboud university medical center, Nijmegen, the Netherlands.