Early Bone Grafting in Complete Cleft Lip and Palate Cases Following Maxillofacial Orthopedics: VI. Assessments from Photographs and Anthropometric Measurements

Abstract

The superficial facial topography of children born with complete unilateral or bilateral cleft lip and palate was studied with anthropometry and subjective assessments of standardized photographs. All the children had been bone grafted early with Nordin's ‘‘four-flap’’ technique. The unilateral deformities group comprised two sub-groups: one of 39 children (mean age 17.6 years) primarily operated without preoperative orthopedics, and another of 46 children (mean age 10.8 years) primarily operated after preoperative ‘‘T-traction’’ The bilateral group, 19 children (mean age 15.1 years) was primarily operated after preoperative premaxillary retropositioning pressure, if necessary, combined with outward rotation of the lateral maxillary segments. The groups were compared with each other and then in the anthropometric study with nonclefts. With 14 expert observers the subjective assessment method was found to be useful when comparing groups of children. When comparing the two unilateral groups, the ‘‘T-traction’’ group showed a straighter and more normal nose and less difference in sagittal and vertical directions between the levels of the alar bases. Overall facial features scored closer to normals than did those of the non-traction group. On comparing the unilateral groups with nonclefts our findings for several variables corresponded to what was found by others earlier. The width of the mouth was narrower in unilateral clefts than in nonclefts. Unlike that reported by others, our unilateral cleft sample had shorter medial vertical upper lip length and shorter and broader noses than nonclefts.