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Fourth-dimensional changes in nasolabial dimensions following rotation-advancement repair of unilateral cleft lip.
Plast Reconstr Surg 2012; 129(2):491-8PR

Abstract

BACKGROUND

Repair of unilateral cleft lip requires three-dimensional craftsmanship and understanding four-dimensional changes.

METHODS

Ninety-nine children with unilateral complete or incomplete cleft lip were measured by direct anthropometry following rotation-advancement repair (intraoperatively) and again in childhood. Changes in heminasal width, labial height, and labial width were analyzed and compared measures depending on whether the cleft was incomplete/complete or involved left/right side.

RESULTS

Average heminasal width (sn-al) was set 1 mm less on the cleft side and measured only 0.7 mm less at 6 years. Labial height (sn-cphi) was slightly greater on the cleft side at repair and matched the noncleft side at follow-up. Vertical dimension (sbal-cphi) was slightly less at operation; the percent change was the same on both sides. Transverse labial width (cphi-ch) was set short on the cleft side and lengthened disproportionately, resulting in less than 1 mm difference at 6 years. All anthropometric dimensions grew less in complete cleft lips compared with incomplete forms; however, only labial height and width were significantly different. There were no disparities in nasolabial growth between left- and right-sided cleft lips.

CONCLUSIONS

Cleft side alar base drifts laterally and should be positioned slightly more medial and secured to nasalis or periosteum. Growth in labial height lags and, therefore, the repaired side should be equal to or slightly greater than on the normal side, particularly in a complete labial cleft. Transverse labial width grows more on the cleft side; thus, lateral Cupid's bow peak point can be marked closer to the commissure to match the labial height on the noncleft side.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, IV.

Authors+Show Affiliations

Department of Plastic and Oral Surgery, Children's Hospital Boston and Harvard Medical School, Boston, Mass. 02115, USA. john.mulliken@childrens.harvard.eduNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22286429

Citation

Mulliken, John B., and Richard A. LaBrie. "Fourth-dimensional Changes in Nasolabial Dimensions Following Rotation-advancement Repair of Unilateral Cleft Lip." Plastic and Reconstructive Surgery, vol. 129, no. 2, 2012, pp. 491-8.
Mulliken JB, LaBrie RA. Fourth-dimensional changes in nasolabial dimensions following rotation-advancement repair of unilateral cleft lip. Plast Reconstr Surg. 2012;129(2):491-8.
Mulliken, J. B., & LaBrie, R. A. (2012). Fourth-dimensional changes in nasolabial dimensions following rotation-advancement repair of unilateral cleft lip. Plastic and Reconstructive Surgery, 129(2), pp. 491-8. doi:10.1097/PRS.0b013e31822b69b4.
Mulliken JB, LaBrie RA. Fourth-dimensional Changes in Nasolabial Dimensions Following Rotation-advancement Repair of Unilateral Cleft Lip. Plast Reconstr Surg. 2012;129(2):491-8. PubMed PMID: 22286429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fourth-dimensional changes in nasolabial dimensions following rotation-advancement repair of unilateral cleft lip. AU - Mulliken,John B, AU - LaBrie,Richard A, PY - 2012/1/31/entrez PY - 2012/1/31/pubmed PY - 2012/3/20/medline SP - 491 EP - 8 JF - Plastic and reconstructive surgery JO - Plast. Reconstr. Surg. VL - 129 IS - 2 N2 - BACKGROUND: Repair of unilateral cleft lip requires three-dimensional craftsmanship and understanding four-dimensional changes. METHODS: Ninety-nine children with unilateral complete or incomplete cleft lip were measured by direct anthropometry following rotation-advancement repair (intraoperatively) and again in childhood. Changes in heminasal width, labial height, and labial width were analyzed and compared measures depending on whether the cleft was incomplete/complete or involved left/right side. RESULTS: Average heminasal width (sn-al) was set 1 mm less on the cleft side and measured only 0.7 mm less at 6 years. Labial height (sn-cphi) was slightly greater on the cleft side at repair and matched the noncleft side at follow-up. Vertical dimension (sbal-cphi) was slightly less at operation; the percent change was the same on both sides. Transverse labial width (cphi-ch) was set short on the cleft side and lengthened disproportionately, resulting in less than 1 mm difference at 6 years. All anthropometric dimensions grew less in complete cleft lips compared with incomplete forms; however, only labial height and width were significantly different. There were no disparities in nasolabial growth between left- and right-sided cleft lips. CONCLUSIONS: Cleft side alar base drifts laterally and should be positioned slightly more medial and secured to nasalis or periosteum. Growth in labial height lags and, therefore, the repaired side should be equal to or slightly greater than on the normal side, particularly in a complete labial cleft. Transverse labial width grows more on the cleft side; thus, lateral Cupid's bow peak point can be marked closer to the commissure to match the labial height on the noncleft side. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. SN - 1529-4242 UR - https://www.unboundmedicine.com/medline/citation/22286429/Fourth_dimensional_changes_in_nasolabial_dimensions_following_rotation_advancement_repair_of_unilateral_cleft_lip_ L2 - http://Insights.ovid.com/pubmed?pmid=22286429 DB - PRIME DP - Unbound Medicine ER -