Facial shape and asymmetry in 5-year-old children with repaired unilateral cleft lip and/or palate: an exploratory study using laser scanning

J Djordjevic,C E Donaghy,J Knox,J Knox,A I Zhurov,S Richmond,B M Lewis,L Hunter

doi:10.1093/ejo/cjs075

J Djordjevic, C E Donaghy + Show 6 more

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https://doi.org/10.1093/ejo/cjs075

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Abstract

To investigate the feasibility of facial laser scanning in pre-school children and to demonstrate landmark-independent three-dimensional (3D) analyses for assessment of facial deformity in 5-year-old children with repaired non-syndromic unilateral cleft lip and/or cleft palate (UCL/P). Faces of twelve 5-year-old children with UCL/P (recruited from university hospitals in Cardiff and Swansea, UK) and 35 age-matched healthy children (recruited from a primary school in Cardiff) were laser scanned. Cleft deformity was assessed by comparing individual faces against the age and gender-matched average face of healthy children. Facial asymmetry was quantified by comparing original faces with their mirror images. All facial scans had good quality. In a group of six children with isolated cleft palate coincidence with the average norm ranged from 18.8 to 26.4 per cent. There was no statistically significant difference in facial asymmetry when compared with healthy children (P > 0.05). In a group of six children with UCL with or without cleft palate coincidence with the average norm ranged from 14.8 to 29.8 per cent. Forehead, midface and mandibular deficiencies were a consistent finding, ranging from 4 to 10mm. The amount of 3D facial asymmetry was higher in this group (P < 0.05). Facial laser scanning can be a suitable method for 3D assessment of facial morphology in pre-school children, provided children are well prepared. Landmark-independent methods of 3D analyses can contribute to understanding and quantification of facial soft tissue cleft deformity and be useful in clinical practice.

Highlights

Recent innovations in non-invasive three-dimensional (3D) imaging technology provide tools for comprehensive assessment of facial surface anatomy, which is of particular importance in patients with dentofacial deformity
In the majority of studies performed on patients with cleft lip and/or cleft palate (CL/P) stereophotogrammetry has been the method of choice for capturing 3D facial data (Bilwatsch et al, 2006; Devlin et al, 2007; Bugaighis et al, 2010; van Loon et al, 2010, 2011)
A total of 35 healthy children [17 males, 18 females, average age 5.5 (SD 0.5) years] were voluntarily recruited from a reception year at a primary school in Cardiff. These children met the following criteria: white British, absence of facial trauma, surgical intervention, dysmorphology, and marked asymmetry and consent signed by the parent or legal guardian

Summary

Introduction

Recent innovations in non-invasive three-dimensional (3D) imaging technology provide tools for comprehensive assessment of facial surface anatomy, which is of particular importance in patients with dentofacial deformity. In the majority of studies performed on patients with cleft lip and/or cleft palate (CL/P) stereophotogrammetry has been the method of choice for capturing 3D facial data (Bilwatsch et al, 2006; Devlin et al, 2007; Bugaighis et al, 2010; van Loon et al, 2010, 2011) This is mainly due to fast capture time, simplicity of application, reliable identification of landmarks on photorealistic life-like models, and reliable storing and archiving of data (Ayoub et al, 2003, Devlin et al, 2007, Heike et al, 2010). Interest in the application of this technique lies in the fact that laser scanning devices are less expensive, portable, and produce very accurate 3D facial models (Kau and Richmond, 2010a)

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