Tek taraflı dudak damak yarıklı hastalarda üç boyutlu görüntüleme ile nazolabial asimetrinin değerlendirilmesi

Year 2020, Volume: 37 Issue: 3, 58 - 63, 01.09.2020

Selin Alpağan Özdemir Elçin Esenlik

https://doi.org/10.17214/gaziaot.596496

Abstract

Amaç: Dudak damak yarıklı hastaların tedavi başarısında fasiyal asimetri önemli bir komponenttir. Bu retrospektif çalışmanın amacı, nonsendromik tek taraflı dudak damak yarıklı hastalarda üç boyutlu yüz görüntüleme kullanılarak pronazal, nazolabial ve paranazal bölge asimetrilerinin değerlendirmektir.

Gereç ve Yöntem: Çalışma grubu tek taraflı total dudak damak yarığı bulunan, yaşları 8-29 yıl arasında olan 29 hastadan oluşmaktadır. Tüm hastaların 3 boyutlu stereofotografik yumuşak doku görüntüleri analiz edildi. Ölçümler yarık olan ve olmayan taraflar için yapılarak birbirleriyle karşılaştırıldı. Yarıklı ve yarıksız taraf ölçüm farklılıklarının tespiti için eşleştirilmiş t testi kullanıldı.

Bulgular: Yarıklı ve yarıksız taraf ölçümlerinde istatistiksel olarak önemli farklılıklar gözlendi. Alar kontur-Pronazal mesafesi, yarık olan tarafta yarık olmayan tarafa göre istatistiksel olarak önemli düzeyde daha uzun bulundu (p<0.05). Subnazal-Pronazal/Alar kontur-Pronazal oranı, yarık olan tarafta yarık olmayan tarafa göre istatistiksel olarak önemli ölçüde düşük bulundu (p<0.05).

Sonuç: Tek taraflı total dudak damak yarıklı hastalarda yanak ve bukkal kontürlerinde ve dudak köşesi-Subnazal ile Krista filtri -Subnazal ölçümlerinde önemli bir asimetri göstermedi. Asimetrik görüntü, alar taban ve pronazale bölgelerinde belirgindi.

Keywords

Damak yarığı, dudak yarığı, fasiyal asimetri

Evaluation of pronasale, nasolabial and paranasal asymmetries in patients with unilateral cleft lip and palate using three-dimensional imaging

Abstract

Objective: Facial symmetry is an important component of a successful treatment of patients with cleft lip and palate. The aim of this retrospective study was to examine the pronasale, nasolabial, and paranasal region asymmetries in patients with nonsyndromic unilateral cleft lip and palate (UCLP) using three-dimensional (3D) facial imaging.

Materials and Method: The study group consisted of 29 patients with complete UCLP aged 8–29 years. 3D stereophotogrammetric soft tissue recordings of all patients were analyzed. Measurements were performed on the cleft and noncleft side and compared with each other by the paired t-test.

Results: Statistically significant differences were observed between the cleft and noncleft sides. Alar contour-Pronasale distance was longer on the cleft side than on the noncleft side, with the difference between them being statistically significant (p<0.05). The Subnasale-Pronasale / Alar contour-Pronasale ratio was also significantly lower on the cleft side than on the noncleft side (p<0.05).

Conclusion: Patients with UCLP did not present significant asymmetries regarding Cheek and Buccal contours and Chelion-Subnasale and Christa Philtry-Subnasale heights. Asymmetrical appearance was prominent on alar base and pronasale regions.

Keywords

Cleft lip, cleft palate, facial asymmetry

References

• Meyer-Marcotty P, Kochel J, Boehm H, Linz C, Klammert U, Stellzig-Eisenhauer A. Face perception in patients with unilateral cleft lip and palate and patients with severe Class III malocclusion compared to controls. J Craniomaxillofac Surg 2011;39:158-63.
• Rhodes G. The evolutionary psychology of facial beauty. Annu Rev Psychol 2006;57:199-226.
• Farkas LG, Cheung G. Facial asymmetry in healthy North American Caucasians: an anthropometrical study. Angle Orthod 1981;51:70-7.
• Bugaighis I, Mattick C, Tiddeman B, Hobson R. 3D facial morphometry in children with oral clefts. Cleft Palate Craniofac J 2014;51:452-61.
• Bernstein NR, Kapp K. Adolescents with cleft palate: body-image and psychosocial problems. Psychosomatics 1981;22:697-700.
• Meyer-Marcotty P, Alpers GW, Gerdes AB, Stellzig-Eisenhauer A. Impact of facial asymmetry in visual perception: a 3-dimensional data analysis. Am J Orthod Dentofac Orthop 2010;137:161-8.
• Bugaighis I, Mattick C, Tiddeman B, Hobson R. 3D asymmetry of operated children with oral clefts. Orthod Craniofac Res 2014;17:27-37.
• Zreaqat M, Hassan R, Halim A. Facial dimensions of Malay children with repaired unilateral cleft lip and palate: a three dimensional analysis. Int J Oral Maxillofac Surg 2012;41:783-8.
• Maull DJ, Grayson BH, Cutting CB, Brecht LL, Bookstein FL, Khorrambadi D, et al. Long-term effects of nasoalveolar molding on three-dimensional nasal shape in unilateral clefts. Cleft Palate Craniofac J 1999;36:391-7.
• Edler R, Rahim MA, Wertheim D, Greenhill D. The use of facial anthropometrics in aesthetic assessment. Cleft Palate Craniofac J 2010;47:48-57.
• Scheib JE, Gangestad SW, Thornhill R. Facial attractiveness, symmetry and cues of good genes. Proc Biol Sci 1999;266:1913-7.
• Desmedt DJ, Maal TJ, Kuijpers MA, Bronkhorst EM, Kuijpers-Jagtman AM, Fudalej PS. Nasolabial symmetry and esthetics in cleft lip and palate: analysis of 3D facial images. Clin Oral Investig 2015;19:1833-42.
• Pietruski P, Majak M, Pawlowska E, Skiba A, Antoszewski B. A novel computer system for the evaluation of nasolabial morphology, symmetry and aesthetics after cleft lip and palate treatment. Part 2: Comparative anthropometric analysis of patients with repaired unilateral complete cleft lip and palate and healthy individuals. J Craniomaxillofac Surg 2017;45:505-14.
• Ras F, Habets LL, Van Ginkel FC, Prahl-Andersen B. Three-dimensional evaluation of facial asymmetry in cleft lip and palate. Cleft Palate Craniofac J 1994;31:116-21.
• Ishiguro K, Krogman W, Mazaheri M, Harding R. A longitudinal study of morphological craniofacial patterns via PA x-ray headfilms in cleft patients from birth to six years of age. Cleft Palate J 1976;13:104-26.
• Krisztian N, Mommaerts MY. Analysis of the cleft-lip nose in submental-vertical view, Part I–reliability of a new measurement instrument. J Craniomaxillofac Surg 2007;35:265-77.
• Harikrishnan P, Balakumaran V. Analysis of Intramaxillary and Mid-Face Skeletal Asymmetry in a Three-Dimensional Model With Complete Unilateral Cleft Lip and Palate. J Craniofac Surg 2018; 29(8):e759-e762.
• Ferrario VF, Sforza C, Dellavia C, Tartaglia GM, Colombo A, Carù A. A quantitative three-dimensional assessment of soft tissue facial asymmetry of cleft lip and palate adult patients. J Craniofac Surg 2003;14:739-46.
• Moslerová V, Dadáková M, Dupej J, Hoffmannova E, Borský J, Černý M, et al. Three-dimensional assessment of facial asymmetry in preschool patients with orofacial clefts after neonatal cheiloplasty. Int J Pediatr Otorhinolaryngol 2018;108:40-5.
• Wong KWF, Keeling A, Achal K, Khambay B. Using three-dimensional average facial meshes to determine nasolabial soft tissue deformity in adult UCLP patients. Surgeon 2019;17(1):19-27.
• Ferrario VF, Sforza C, Miani A, Tartaglia G. Craniofacial morphometry by photographic evaluations. Am J Orthod Dentofacial Orthop 1993;103:327-37.
• Shah SM, Joshi M. An assessment of asymmetry in the normal craniofacial complex. Angle Orthod 1978;48:141-8.
• Wong JY, Oh AK, Ohta E, Hunt AT, Rogers GF, Mulliken JB, et al. Validity and reliability of craniofacial anthropometric measurement of 3D digital photogrammetric images. Cleft Palate Craniofac J 2008;45:232-9.
• Bagante I, Akota I. Cleft-related nose deformation evaluation and measurement methods. Literature review. Stomatologija 2015;17:75-83.
• Bell A, Lo T-WR, Brown D, Bowman AW, Siebert JP, Simmons DR, et al. Three-dimensional assessment of facial appearance following surgical repair of unilateral cleft lip and palate. Cleft Palate Craniofac J 2014;51:462-71.
• Van Loon B, Maal T, Plooij J, Ingels K, Borstlap W, Kuijpers-Jagtman A, et al. 3D Stereophotogrammetric assessment of pre-and postoperative volumetric changes in the cleft lip and palate nose. Int J Oral Maxillofac Surg 2010;39:534-40.
• Kane AA, Pilgram TK, Moshiri M, Marsh JL. Long-term outcome of cleft lip nasal reconstruction in childhood. Plast Reconstr Surg 2000;105:1600-8.
• Bagante I, Zepa I, Akota I. 3D Assessment of Nasolabial Appearance in Patients With Complete Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2018;55:220-5.
• Devlin MF, Ray A, Raine P, Bowman A, Ayoub AF. Facial symmetry in unilateral cleft lip and palate following alar base augmentation with bone graft: a three-dimensional assessment. Cleft Palate Craniofac J 2007;44:391-5.
• Singh GD, Levy‐Bercowski D, Yáñez MA, Santiago PE. Three‐dimensional facial morphology following surgical repair of unilateral cleft lip and palate in patients after nasoalveolar molding. Orthod Craniofac Res 2007;10:161-6.
• Aldridge K, Boyadjiev SA, Capone GT, DeLeon VB, Richtsmeier JT. Precision and error of three‐dimensional phenotypic measures acquired from 3dMD photogrammetric images. Am J Med Genet 2005;138:247-53.
• De Menezes M, Rosati R, Ferrario VF, Sforza C. Accuracy and reproducibility of a 3-dimensional stereophotogrammetric imaging system. J Oral Maxillofac Surg 2010;68:2129-35.
• Ghoddousi H, Edler R, Haers P, Wertheim D, Greenhill D. Comparison of three methods of facial measurement. Int J Oral Maxillofac Surg 2007;36:250-8.
• Honrado CP, Lee S, Bloomquist DS, Larrabee WF. Quantitative assessment of nasal changes after maxillomandibular surgery using a 3-dimensional digital imaging system. Arch Facial Plast Surg 2006;8:26-35.
• Lübbers H-T, Medinger L, Kruse A, Grätz KW, Matthews F. Precision and accuracy of the 3dMD photogrammetric system in craniomaxillofacial application. J Craniofac Surg 2010;21:763-7.
• Plooij J, Swennen G, Rangel F, Maal T, Schutyser F, Bronkhorst E, et al. Evaluation of reproducibility and reliability of 3D soft tissue analysis using 3D stereophotogrammetry. Int J Oral Maxillofac Surg 2009;38:267-73.
• Weinberg SM, Naidoo S, Govier DP, Martin RA, Kane AA, Marazita ML. Anthropometric precision and accuracy of digital three-dimensional photogrammetry: comparing the Genex and 3dMD imaging systems with one another and with direct anthropometry. J Craniofac Surg 2006;17:477-83.
• Grayson BH, Cutting CB. Presurgical nasoalveolar orthopedic molding in primary correction of the nose, lip, and alveolus of infants born with unilateral and bilateral clefts. Cleft Palate Craniofac J 2001;38:193-8.
• Maull DJ, Grayson BH, Cutting CB, Brecht LL, Bookstein FL, Khorrambadi D, Webb JA, Hurwitz DJ. Long-term effects of nasoalveolar molding on three-dimensional nasal shape in unilateral clefts. Cleft Palate Craniofac J 1999;36(5):391-7.
• Kyrkanides S, Bellohusen R, Subtelny JD. Asymmetries of the upper lip and nose in noncleft and postsurgical unilateral cleft lip and palate individuals. Cleft Palate Craniofac J 1996;33:306-11.