Three-dimensional evaluation of midfacial asymmetry in patients with nonsyndromic unilateral cleft lip and palate by cone-beam computed tomography

다국어 초록 (Multilingual Abstract)

Objective: To compare three-dimensionally the midfacial hard- and soft-tissue asymmetries between the affected and the unaffected sides and determine the relationship between the hard tissue and the overlying soft tissue in patients with nonsyndromic complete unilateral cleft lip and palate (UCLP) by cone-beam computed tomography (CBCT) analysis. Methods: The maxillofacial regions of 26 adults (18 men, 8 women) with nonsyndromic UCLP were scanned by CBCT and reconstructed by three-dimensional dental imaging. The frontal-view midfacial analysis was based on a 3 × 3 grid of vertical and horizontal lines and their intersecting points. Two additional points were used for assessing the dentoalveolar area. Linear and surface measurements from three reference planes (Basion-perpendicular, midsagittal reference, and Frankfurt horizontal planes) to the intersecting points were used to evaluate the anteroposterior, transverse, and vertical asymmetries as well as convexity or concavity. Results: Anteroposteriorly, the soft tissue in the nasolabial and dentoalveolar regions was significantly thicker and positioned more anteriorly on the affected side than on the unaffected side (p < 0.05). The hard tissue in the dentoalveolar region was significantly retruded on the affected side compared with the unaffected side (p < 0.05). The other midfacial regions showed no significant differences. Conclusions: With the exception of the nasolabial and dentoalveolar regions, no distinctive midfacial hard- and soft-tissue asymmetries exist between the affected and the unaffected sides in patients with nonsyndromic UCLP.

목차 (Table of Contents)

• INTRODUCTION
• MATERIALS AND METHODS
• RESULTS
• DISCUSSION
• CONCLUSION
• REFERENCES

참고문헌 (Reference)

1 Ras F, "Three-dimensional evaluation of facial asymmetry in cleft lip and palate" 3 : 116-121, 1994

2 Kim YI, "Three-dimensional analysis of midfacial soft tissue changes according to maxillary superior movement after horizontal osteotomy of the maxilla" 21 : 1587-1590, 2010

3 Stauber I, "Three-dimensional analysis of facial symmetry in cleft lip and palate patients using optical surface data" 69 : 268-282, 2008

4 Baik HS, "The prevalence of cleft lip and/or cleft palate in Korean male adult" 31 : 63-69, 2001

5 Breitsprecher L, "The influence of the muscles of facial expression on the development of the midface and the nose in cleft lip and palate patients. A reflection of functional anatomy, facial esthetics and physiology of the nose" 181 : 19-25, 1999

6 Lee LW, "Stigma, body image, and quality of life in women seeking orthognathic surgery" 120 : 225-231, 2007

7 Joos U, "Skeletal growth after muscular reconstruction for cleft lip, alveolus and palate" 33 : 139-144, 1995

8 Suzuki H, "Rhinologic computed tomographic evaluation in patients with cleft lip and palate" 125 : 1000-1004, 1999

9 Atherton JD, "Morphology of facial bones in skulls with unoperated unilateral cleft palate" 4 : 18-30, 1967

10 Hwang HS, "Maxillofacial 3-dimensional image analysis for the diagnosis of facial asymmetry" 130 : 779-785, 2006

11 Laspos CP, "Mandibular asymmetry in noncleft and unilateral cleft lip and palate individuals" 34 : 410-416, 1997

12 Kurt G, "Mandibular asymmetry in cleft lip and palate patients" 32 : 19-23, 2010

13 Carstens MH, "Functional matrix cleft repair: principles and techniques" 31 : 159-189, 2004

14 Markus AF, "Facial balance in cleft lip and palate. II. Cleft lip and palate and secondary deformities" 30 : 296-304, 1992

15 Son WS, "Facial asymmetry of unilateral cleft lip and palate patients" 25 : 13-18, 1995

16 de Moraes ME, "Evaluating craniofacial asymmetry with digital cephalometric images and cone-beam computed tomography" 139 : e523-e531, 2011

17 Meyer-Marcotty P, "Eisenhauer A. Impact of facial asymmetry in visual perception: a 3-dimensional data analysis" 137 : 168.e1-168.e8, 2010

18 Broder HL, "Effects of visible and invisible orofacial defects on self-perception and adjustment across developmental eras and gender" 31 : 429-436, 1994

19 Markus AF, "Effect of primary surgery for cleft lip and palate on mid-facial growth" 35 : 6-10, 1997

20 Smahel Z, "Differences in craniofacial morphology between complete and incomplete unilateral cleft lip and palate in adults" 20 : 113-127, 1983

21 Suri S, "Craniofacial computerized tomography analysis of the midface of patients with repaired complete unilateral cleft lip and palate" 134 : 418-429, 2008

22 Mølsted K, "Cranial base in newborns with complete cleft lip and palate: radiographic study" 32 : 199-205, 1995

23 Kyrkanides S, "Cranial base and facial skeleton asymmetries in individuals with unilateral cleft lip and palate" 37 : 556-561, 2000

24 Mossey PA, "Cleft lip and palate" 374 : 1773-1785, 2009

25 Kolbenstvedt A, "CT appearances of unilateral cleft palate 20 years after bone graft surgery" 43 : 567-570, 2002

26 Kim YH, "Asymmetry of the sphenoid bone and its suitability as a reference for analyzing craniofacial asymmetry" 124 : 656-662, 2003

27 Mølsted K, "Asymmetry of the maxilla in children with complete unilateral cleft lip and palate" 27 : 184-190, 1990

28 Zemann W, "Analysis of midface asymmetry in patients with cleft lip, alveolus and palate at the age of 3 months using 3DCOSMOS measuring system" 30 : 148-152, 2002

29 Li J, "A preliminary study on the hard-soft tissue relationships among unoperated secondary unilateral cleft nose deformities" 113 : 300-307, 2012

30 Sade Hoefert C, "3D soft tissue changes in facial morphology in patients with cleft lip and palate and class III mal occlusion under therapy with rapid maxillary expansion and delaire facemask" 71 : 136-151, 2010