Analysis of preoperative measurements in unilateral cleft lip patients toward the outcome of secondary cleft deformities

Abstract

Introduction: The purpose of this study is to determine whether the severity of the initial cleft deformity has any effect on the postoperative result of primary lip and palate repair in terms of the presence or severity of secondary deformity. The anthropometric measurements of the cleft side will be measured against the noncleft side as control. Materials and Methods: This was a cross-sectional, noninterventional study conducted for 12 months from March 2017 to March 2018. All children aged 5–12 years old with unilateral cleft lip deformity who underwent cleft lip repair from the year 2005 to 2013 were included in the study with a total of 42 patients. Both preoperative and postoperative lip and nose, anthropometric measurements were taken with a ruler and caliper. Difference between cleft and noncleft sides for philtrum lateral height (PLH), lip height (LH), nostril floor width (NF), and nostril height (NH) were taken to represent asymmetry or the severity of deformity and categorized into a grading system representing initial severity (IS) and postoperative asymmetry (PA). Relationship between the IS and PA were analyzed. Results: All four indices were lesser for the postoperative measurements showing an improved outcome after surgery. There was a significant difference between the IS and PA for PLH (P < 0.001) and NF (P = 0.007), thereby inferring that IS grade is not symmetrical from PA for both indices measured. However, there was no statistically significant difference between the IS and PA for LH (P = 0.055) and NH (P = 0.410). Therefore, the IS and the PA for these two indices are symmetrical. A majority of patients are within the similar grade for both IS and PA for LH; 15 patients for IS and PA Grade 1 and 11 patients for IS and PA Grade 2 (n = 26). As for NH, there were 13 patients with IS and PA Grade 1 and eight patients with IS and PA Grade 2 (n = 21). Conclusion: This study determines a coherent connection between the preoperative and postoperative LH and NH asymmetry. Thus, the postoperative lip and nose height asymmetry was worse in more severe clefts compared to those with a less severe initial cleft deformity.