Objective: To assess 3D facial asymmetry, relative to normal, in children with repaired unilateral cleft lip (UCLP).

Methods:

11 children with repaired UCLP and 73 matched controls were recruited at 3 years.

Using computerised stereophotogrammetry, an image of each subject's face at rest was recorded. 20 anthropometric landmarks were digitised on each image and the 3D co-ordinates extracted.

The landmark configuration for each subject was mirror-imaged and superimposed on the original set of landmarks using Procrustes analysis. All configurations were scaled to unit size. The average distance between corresponding landmarks in the superimposed sets was expressed as a score of asymmetry for each subject in unit size x 10^-5 .

Full facial and regional asymmetry scores of the study group were compared with those calculated for the control group using a two sample Student's t test.

Results:

The midline landmarks were not coincident when superimposed on their mirror images.

The lowest normal median asymmetry score, 1.2 (0.4 - 3.0), was in the ocular area. The greatest median asymmetry score, 2 (1.0 - 5.0), was seen in ocular and perioral landmarks combined.

Full facial and nasal landmark configurations in the study group were significantly more asymmetric than normal (p value <0.001). Perioral asymmetry was significantly greater than normal (p value 0.01).

Conclusions:

Midline landmarks do not lie on a single sagittal plane.

Assumptions of a valid plane of facial symmetry, constructed from midline landmarks or between paired landmarks, may be erroneous.

Greater facial asymmetry in repaired UCLP is not restricted to the site of surgery.

Funded by the Cleft Lip and Palate Association.

Back to the Oral & Maxillofacial Surgery Program
Back to the 81st General Session of the International Association for Dental Research (June 25-28, 2003)

Top Level Search