Significant asymmetry in children with unilateral cleft lip and palate

By medwireNews Reporters

There is significant asymmetry between the cleft and noncleft sides of the lip in infants with unilateral cleft lip/palate (UCLP), research shows.

Lip measurements of the cleft side of children with UCLP also differ significantly from those of noncleft children with normal facial appearance, whereas measurements of the noncleft side were very similar, bar a slight difference in lip height.

"These results suggest that there is a lip tissue hypoplasia on the cleft side in patients with complete UCLP," state senior researcher Lun-Jou Lo (Chang Gung Memorial Hospital, Taoyuan, Taiwan) and colleagues.

The study, published in the Journal of Plastic, Reconstructive, and Aesthetic Surgery, includes data from 168 children with UCLP collected between 1983 and 1997. The measurements were performed under general anesthesia by a senior surgeon prior to the first lip repair, so the facial skin surface and underlying muscles were completely relaxed.

Comparisons between the cleft and noncleft sides identified a significantly longer lip on the noncleft side, "including lip height from alar base to Cupid's bow, lip width from Cupid's bow to commissure and the vermillion thickness," write the researchers.

The mean values of differences between the cleft and noncleft side in the vertical lip height, lateral lip length, width of vermillion, and philtrum height were 2.8, 3.7, 0.4, and 4.4 mm, respectively.

The lip measurements on the cleft side of the UCLP children also differed significantly from measurements of 50 children who had normal facial appearance but who were undergoing hernia repair. Specifically, lip height, lateral lip length, width of vermillion, and philtrum height were significantly shorter, with respective differences of 3.2, 3.6, 0.6, and 4.2 mm. The mean difference in the width of Cupid's bow was 1.2 mm.

On the noncleft side, however, the lip measurements were not different between the UCLP children and healthy controls.

The researchers say the measurement data in the study provide a fundamental basis for presurgical consultations, surgical planning, and postoperative assessment. In addition, the measurements might help serve as a predictor for treatment outcomes.

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