Facial characterization of infants with cleft lip and palate using a three-dimensional capture technique

Objective: To characterize the soft tissue features of infants with unilateral cleft lip (UCL) and unilateral complete cleft lip and palate (UCLP) prior to primary surgery and compare with noncleft controls. Design: Prospective controlled capture of the facial morphology of infants using a noninvasive three-dimensional stereophotogrammetry method. Participants: 23 children with presurgical cleft: 11 UCL (M=6, F=5); 12 UCLP (M=9, F=3), and 21 noncleft controls (M=7, F=14) were imaged at approximately 3 months of age (range 10 to 16 weeks). Main Outcome Measure: Accurate, repeatable quantification of facial soft tissues in infants with clefts prior to surgery. Results: Significant differences (p<.05) were found between the UCLP group and UCL and control groups in anatomical and soft nose width, cleft-side alar wing length, and nasal tip horizontal displacement. Both cleft groups were significantly different from controls and from each other in cleft-side nostril dimensions, alar wing angulation, columella angle, and alar base to corner of mouth dimension; alar base width; and soft tissue defect in nose and the lip and philtrum length bordering the cleft. Significant differences between clefts and controls were identified in the nostril and philtrum on the noncleft side. Conclusions: The use of children with UCL as controls for UCLP studies is inappropriate. This technique overcame the limitations of direct measurement of infant faces to aid the surgeon in the planning and subsequent re-evaluation of surgical rationale.