Three-dimensional facial morphology following surgical repair of unilateral cleft lip and palate in patients after nasoalveolar molding

Authors

  • GD Singh,

    1. G. Dave Singh, Adjunct Professor, Portland State University, Portland, OR, USA
      Daniel Levy-Bercowski, Assistant Professor, School of Dentistry, Medical College of Georgia, Augusta, GA, USA
      Miguel A. Yáñez, Assistant Professor, Center for Craniofacial Disorders, School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA
      Pedro E. Santiago, Professor and Director, Center for Craniofacial Disorders, School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA
    Search for more papers by this author
  • D Levy-Bercowski,

    1. G. Dave Singh, Adjunct Professor, Portland State University, Portland, OR, USA
      Daniel Levy-Bercowski, Assistant Professor, School of Dentistry, Medical College of Georgia, Augusta, GA, USA
      Miguel A. Yáñez, Assistant Professor, Center for Craniofacial Disorders, School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA
      Pedro E. Santiago, Professor and Director, Center for Craniofacial Disorders, School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA
    Search for more papers by this author
  • MA Yáñez,

    1. G. Dave Singh, Adjunct Professor, Portland State University, Portland, OR, USA
      Daniel Levy-Bercowski, Assistant Professor, School of Dentistry, Medical College of Georgia, Augusta, GA, USA
      Miguel A. Yáñez, Assistant Professor, Center for Craniofacial Disorders, School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA
      Pedro E. Santiago, Professor and Director, Center for Craniofacial Disorders, School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA
    Search for more papers by this author
  • PE Santiago

    1. G. Dave Singh, Adjunct Professor, Portland State University, Portland, OR, USA
      Daniel Levy-Bercowski, Assistant Professor, School of Dentistry, Medical College of Georgia, Augusta, GA, USA
      Miguel A. Yáñez, Assistant Professor, Center for Craniofacial Disorders, School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA
      Pedro E. Santiago, Professor and Director, Center for Craniofacial Disorders, School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA
    Search for more papers by this author

Dr. G. Dave Singh DDSc PhD BDS
Department of Speech and Hearing Sciences
Portland State University
85 Neuberger Hall
724 SW Harrison St
Portland, OR 97207-0751
USA
E-mail: gdsingh@pdx.edu

Structured Abstract

Authors –  Singh GD, Levy-Bercowski D, Yáñez MA, Santiago PE

Objective –  To evaluate three-dimensional (3D) facial morphology in patients surgically corrected for unilateral cleft lip and palate (UCLP) following pre-surgical nasoalveolar molding (NAM).

Design –  Prospective, longitudinal study. Digital stereophotogrammetry was used to capture 3D facial images, and x, y, and z coordinates of five landmarks were digitized to compute mean morphologies. The sample comprised 15 patients with left UCLP and 10 matched control subjects. Facial form differences at age 37 weeks, using principal components analysis and finite-element scaling analysis (FESA) were assessed.

Results –  Using the first two principal components, which accounted for 63% of the total shape-change, UCLP and control groups showed similar distributions in the modal space (p > 0.05). For the UCLP group, the mean 3D facial form was smaller and less protrusive when superimposed on the non-cleft mean. Using FESA, reductions in facial volume were found in the UCLP group, involving the columella (29%), labial tubercle (51%), lower lip (29%) and lateral aspects of the face (19%). The UCLP group also showed increases in size above the tip of the nose (25%) and laterally to the columella directly below the nares (29%).

Conclusions –  Following surgical repair of UCLP in patients previously treated with NAM, 3D facial morphology was virtually indistinguishable from the non-cleft mean. Clinically, the apparent improvement in the facial soft tissues may mask dysmorphic skeletal growth, and further studies are required to characterize the underlying bony changes associated with the soft tissue changes reported here.

Ancillary