Lip Height Research Articles

Using rotation cross-advancement flap for repairing complete unilateral cleft lip and nasolabial deformity

To evaluate the efficacy of rotation cross-advancement flap method in repairing the nasolabial deformity of complete unilateral cleft lip. A retrospective study was performed to analyze the children who were treated by using the rotating cross-advancement flap for repairing the complete unilateral cleft lip at the Fujian Medical University Union Hospital from October 2018 to July 2019. The clinical data such as patient's lip height, lip length, nostril height, nostril width, nostril area and so on were collected at the pre-operation, post-operation and following-up visits respectively and used to evaluate the efficacy of the treatment. Six children were included in the present study. The ratios of lip height on noncleft side to cleft side were 2∶1 at the pre-operation time. The ratios of nostril height on the noncleft side to the cleft side were about 2∶1. The ratios of the width and the area of the nostril were 1∶2 to 1∶3. At the post-operation time, the ratios of length and height of the lip at the cleft side to the noncleft side were around 1∶1. The shape of the nostrils and nasolabial fold were almost symmetrical between the cleft side and noncleft side. The shapes of the nasal sill were acceptable and the postoperative scars were not obvious. There were no obvious incision healing complications and the treatment effects were satisfactory. Rotation cross-advancement flap method was safe and reliable for repairing the nasolabial deformities in children with complete unilateral cleft lip.

English

BACKGROUND Failure in managing the airway is the most important cause of death in patients undergoing general anaesthesia (GA). For effectively preventing airway catastrophe it is essential to have a meticulous airway assessment pre-operatively. Many methods are in use to predict difficult airway like Mallampati, Wilson’s scoring, percentage of glottic opening (POGO) scoring, Cormack - Lehane classification, thyromental distance, mandibular hyoid distance, atlantooccipital joint extension etc. In this study, we compared between two popular methods of airway assessment, upper lip bite test (ULBT) and height to thyromental distance ratio (RHTMD) to predict the difficulty in tracheal intubation. METHODS This descriptive study was conducted at Government Medical college, Thrissur, over a period of one year , on 76 patients of American society of Anaesthesiologist (ASA) - PS l - lll, requiring general anaesthesia. ULBT and RHTMD were used to assess the patient’s airway. It was correlated with Cormack - Lehane classification during direct laryngoscopy. The data was analysed using Fisher exact test (P < 0.05) and Kappa statistics. RESULTS Out of the 76 patients, 41 (53.9%) were women 35 were men (46.1 %). ULBT predicted 89.6 % [25 + 43] belonging to class 1 and 2 as easy, while 10.5 % [8] of class 3 as difficult. RHTMD predicted 35 patients (46 %) as easy (grade 1) and 41 patients (54 %) as grade 2. Using ULBT, of the 8 patients predicted to have difficult intubation (Class 3), 2 were found practically difficult and 6 were easy. In remaining 68 patients, 23 patients had difficult view and 45 had easy view. According to Cormac and Lehane, among 41 patients who predicted difficult by RHTMD, 19 patients were practically difficult and 22 were easy. Of 35 patients, 6 patients were difficult and 29 were easy. CONCLUSIONS The RHTMD is more sensitive compared to ULBT in predicting difficult intubation. As assessed by Cormack - Lehane classification. KEYWORDS Difficult Intubation, Ratio of Height to Thyromental Distance, Upper Lip Bite Test

Variations in Facial Anthropometric Measurements among Major Ethnic Groups in Nigeria: A 3-Dimentional Stereophotogrammetry Analysis

Objectives: The aim of the study is to highlight variations in facial anthropometric measurements among the major ethnic groups in Nigeria using 3D photogrammetry. Materials and Methods: This study was conducted in Lagos, Nigeria. Acquisition of 3D facial photographs was done using a Vectra H1 portable 3D photogrammetry imaging system. Descriptive analysis of collected data was done and a test of associations performed using independent samples t-test. The level of significance was set at <.05. Results: The total number of participants in this study was 503. The study population was made up of 302 (60%) males and 201 (40%) females. Mean upper facial height among Yoruba, Igbo, Hausa, and other ethnic groups were 68.93 ± 5.85, 70.18 ± 5.99, 63.79 ± 4.80, and 69.29 ± 5.95 mm respectively, while mean interpupillary distances were 66.99 ± 3.70, 67.34 ± 3.56, 66.73 ± 3.80, and 67.09 ± 3.72 mm respectively. A Tukey posthoc test revealed significant pairwise differences for upper facial height between the Yoruba and Hausa population with a mean difference of 5.15 mm ( P < .001, 95% CI 2.94-7.35) ( P < .001, 95% CI 2.94-7.35), and Hausa and Igbo population with a mean difference of 6.39 mm ( P < .001, 95% CI 3.75-9.03). Multivariate regression analysis confirmed the presence of significant inter-ethnic differences between Hausa ethnic group and the Yoruba ethnic group for midfacial height ( P < .001), upper lip height ( P = .004), lower lip height ( P = .003), total face height ( P = .010), and orbital fissure width ( P < .001). Conclusion: The result of this study shows that distinct difference does exist in the facial anthropological measurements between the ethnicities included in this study especially in vertical facial measurements.

Morphological Changes in Faces Depending on Posture.

Facial surgeries are usually performed with the patient in the supine position; however, it is crucial to predict postoperative results in the upright position. This study aimed to clarify the posture-related morphological changes in the facial soft tissue regarding age and sex, using physical measurements to obtain results in specific linear metric measurements of standard facial features. One hundred healthy volunteers were divided into four groups based on age and sex (25 young men, 25 young women, 25 old men, 25 old women). For all participants, 18 measuring points were marked on the skin along with 18 paired linear measurements, and the angle was measured using a digital sliding caliper and angle meter in both upright and supine positions. In all four groups, the intercanthal width (en-en), binocular width (ex-ex), length of the eye fissure (en-ex), length of the nasal bridge (n-prn), width of the nose (al-al), height of the lower face (sn-gn), vermilion height of the lower lip (sto-li), height of the lower lip (sto-sl), width of the philtrum (cphi-cphi), width of the mouth (ch-ch), and nasolabial angle (NLA) were significantly larger in the supine position than in the upright position. The increase was larger in the older age groups than in the younger age groups. Moreover, the increase was larger in old men than in old women. During facial surgery involving these areas, surgeons should consider the patient's age and sex and understand what facial figuration change would occur depending on posture and change their preoperative design or make minor adjustments during operation in the supine position to increase patient satisfaction.

Increasing the height of the anterior lip on a tibial insert in a posterior stabilized knee prosthesis has little effect on the wear rate

A high anterior lip on a total knee prosthesis is an effective way of reducing anterior translation, but the effect on joint wear is unclear. Using finite element analysis (FEA), this study quantitatively compared wear rates and anterior contact stresses in three posterior stabilized knee prostheses with different heights for the anterior lip during six daily activities (walking, stair ascent, stair descent, sit-to-stand, pivot turn and crossover turn). The wear rate and location of maximum wear depth were similar for the three lip heights tested, but the knee with the highest anterior lip also showed slight anterior wear scaring due to articular contact stress during swing phase, which was highly dependent on the shape of the contact interface. This study illustrates that tibial inserts with a high anterior lip maintain a wear rate similar to moderate and low lip posterior stabilized designs.

Lip morphology estimation models based on three-dimensional images in a modern adult population from China

Lips are the main part of the lower facial soft tissue and are vital to forensic facial approximation (FFA). Facial soft tissue thickness (FSTT) and linear measurements in three dimensions are used in the quantitative analysis of lip morphology. With most FSTT analysis methods, the surface of soft tissue is unexplicit. Our study aimed to determine FSTT and explore the relationship between the hard and soft tissues of lips in different skeletal occlusions based on cone-beam CT (CBCT) and 3dMD images in a Chinese population. The FSTT of 11 landmarks in CBCT and 29 lip measurements in CBCT and 3dMD of 180 healthy Chinese individuals (90 males, 90 females) between 18 and 30years were analyzed. The subjects were randomly divided into two groups with different skeletal occlusions distributed equally: 156 subjects in the experimental group to establish the prediction regression formulae of lip morphology and 24 subjects in the test group to assess the accuracy of the formulae. The results indicated that FSTT in the lower lip region varied among different skeletal occlusions. Furthermore, sex discrepancy was noted in the FSTT in midline landmarks and linear measurements. Measurements showing the highest correlation between soft and hard tissues were between total upper lip height and Ns-Pr (0.563 in males, 0.651 in females). The stepwise multiple regression equations were verified to be reliable with an average error of 1.246mm. The method of combining CBCT with 3dMD provides a new perspective in predicting lip morphology and expands the database for FFA.

Lower Lip Reanimation: Experience Using the Anterior Belly of Digastric Muscle in 2-stage Procedure.

Retrospective analysis of 2-stage lower lip reanimations between 2010 and 2018 was performed. Demographics, etiology, and operative details were recorded. Videos were graded pre/postoperatively using a 5-point Likert scale by 21 independent observers. Objective changes of symmetry were analyzed using Photogrammetry (Emotrics). Twenty-seven patients were identified (median age 34.9 years, range 6-64). The mean duration between the 2 stages was 15.1 months. Follow-up ranged from 18-72 months. There were minor complications in 4 patients, and 1 case was abandoned due to insufficient length of anterior belly of digastric muscle. Average peer-reviewed scores improved from 2.1 to 3.2 (P < 0.05). Emotrics did not show improvement in static symmetry (P > 0.05). However, during open-lip smiling, lower lip height improved significantly (P < 0.05) whilst dental show improvements approached significance (P < 0.08). Lower lip symmetry was also improved during lower lip depression, as shown by improvements in lower lip height (P < 0.05), smile angle, and dental show (both P < 0.05). These results show the safety and efficacy of 2-stage lower lip reanimation using anterior belly of digastric muscle transposition. This procedure is our choice for longstanding lower lip paralysis and provides coordinated spontaneous lower lip depression, thus enhancing the overall perioral animation and smile.

The craniofacial indicators of aggression: a cross-sectional multiparametric anthropometry study.

The craniofacial features of a person are unique and critical in the evaluation of age, gender, and ethnicity. The relationships between craniofacial properties and behavioural patterns have been one of the most common research topics. There are studies on the association of facial width-to- -height ratio (fWHR) and aggressive behaviour in men; however, no consensus has been reached as there are inconsistent study results. Most of the studies focus on measuring the pre-determined fWHR in searching for a link to aggression. As the literature lacks data on the associations of multiple craniofacial ratios and aggression, we aimed to study the correlation of aggressive behaviour and multiparametric anthropometric measurements of the craniofacial region in a study group consisting of university students aging 18-38 years. The aggression questionnaire results showed that male students had statistically higher scores than females in all subdomains, except physical aggression. Anthropometric studies revealed that males had higher mean values of craniofacial dimensions and indices than females, except the frontal height, the total lip height, frontal index, and cranial length-head circumference index. The statistical analyses for correlations showed that frontal, upper facial, and total facial height-facial width indices correlated with general and verbal aggression, frontal and upper facial indices correlated with physical aggression, and upper facial and total facial height-facial width indices correlated with indirect aggression only in males. We conclude that our study represents the first example of an extensive craniofacial anthropometric research that correlates several craniofacial measurements and ratios with various aggression subdomains.

Variational Characteristics of Nasolabial Appearance and Its Influencing Factors for the Unilateral Cleft Lip Repair With Modified Huaxi Technique.

After many years in clinical practice, the authors found that the long-term aesthetics of the upper lip and nose following repair of a unilateral cleft lip deformity using the Huaxi method remained unsatisfactory. The immediate postoperative effect was often good, while the long-term postoperative effect was poor. Therefore, this study aimed to evaluate the characteristics and influencing factors of a modified Huaxi method for repairing unilateral cleft lip over time, and to explore the relationship between immediate and long-term outcomes after cleft lip surgery. Patients with unilateral cleft lip who visited the Department of Maxillofacial Surgery of the Stomatological Hospital of Zunyi Medical University from June 2014 to March 2016 were selected. The study group consisted of 51 consecutive patients (30 boys and 21 girls), aged between 3 months and 2 years. Of these, 24 presented with complete unilateral cleft lip (12 wore a nasoalveolar mold as required, 12 did not) and 27 with incomplete unilateral cleft lip (13 wore a nasoalveolar mold as required, 14 did not). Photographs were taken of 51 patients before surgery and immediately, 7 days, and 6 months postoperatively. Various indexes of nasolabial contour of each patient were measured using iWitness photogrammetry, and the slit width; lip height ratio, lip width ratio, nostril width ratio, and nostril height ratio of the healthy side; and degree of deviation of the nasal columella were calculated. Long-term symmetry of lip height and width remained stable postoperatively (P > 0.05), whereas nostril height symmetry was significantly reduced (P > 0.05). Nasal width symmetry and midpoint deviation of the nasal columella were stable in patients with nasoalveolar molding (P > 0.05), but significantly decreased in patients without nasoalveolar molding (P < 0.05). In patients with complete unilateral cleft lip, there was a significant correlation between fissure width and lip width symmetry 6 months postoperatively (r = 0.431, P < 0.05). The symmetry of the upper lip is satisfactory and stable following surgical repair with the modified Huaxi technique. However, undercorrection of nasal symmetry is commonplace. Fissure width and nasoalveolar molding may influence long-term aesthetics following unilateral cleft lip repair.

Pengaruh Jarak Sekrup terhadap Kapasitas dan Perilaku Penampang Tersusun Boks (Closed Section) Baja Canai Dingin

The capacity and behaviour of cold-formed steel built-up sections are affected by the arrangement of the connections. This study aims to determine the effect of the screw spacing to the bending capacity and behaviour of the cold-formed steel built-up box section which made from lipped-channel (1.0 mm thick, 81 mm web height, 8.5 mm lip height, upper and lower wing width 38 mm and 40 mm). A total of 19 beams with a length of 1200 mm each are subjected to pure bending moments by applying two point loads spaced 600 mm in the midspan. The screw spacing variations in the moment span are 100 mm, 150 mm, 200 mm, 250 mm, 300 mm, 328 mm, and 350 mm. The test results show the average of bending capacity of the beam test is increasing with the reduction in screw spacing while the screw configuration also affects the beam capacity. Analysis of the bending capacity using the effective width method and the direct strength method based on AISI S100-16 gives very conservative results. The failure mode of the built-up box sections were observed in the form of local buckling, distortion, and lateral-torsional buckling.

Unilateral Cleft Lip Repair Using the Chang Gung Technique: An Outcome Analysis.

This retrospective study analyzed the outcomes of patients undergoing complete or incomplete unilateral cleft lip repair using the Chang Gung technique. The goal was to compare the symmetry and change of the technique through the measurement of anthropometric points on digital photographs. From 2010 to 2016, a total of 274 complete and incomplete cleft lip patients without other craniofacial deformities were included in the study. All included patients had a minimum 1-year follow-up with frontal view photographs taken. The vermilion area, lip width, vermilion height, lateral lip length, lip height, and Cupid's bow width of both cleft and noncleft sides were measured for all patients. The Cleft Lip Component Symmetry Index was used to determine the symmetry of the cleft and noncleft sides in both incomplete and complete cleft groups. A total of 152 complete and 122 incomplete cleft lip patients were included in the study. The mean Cleft Lip Component Symmetry Index values showed that the vermilion area, lip height, and Cupid's bow width were symmetric on both cleft and noncleft sides. Lip width and lateral lip length were noted to be shorter, whereas the vermilion height was thicker on the cleft side than on the noncleft side. Significant differences between the complete and incomplete cleft group measurements were found for lateral lip length and lip height, and complete cleft measurements were shorter than those for incomplete clefts. There were no significant differences in vermilion area, lip width, vermilion height, and Cupid's bow width. The outcome analysis showed that vermilion height reduction and modifications could be made for both complete and incomplete groups. The complete cleft lip has been found to have a significantly shorter lateral lip length and lip height, reflecting a more severe anatomical soft tissue deficiency in this group. A long-term outcome anthropometric point study may further verify the results of this surgical technique.

Anthropometric Outcome of Primary Unilateral Cleft Lip Repair in Indonesia.

This study aimed to measure and analyze the outcome of primary unilateral cleft lip repair. Observational cohort study. Surabaya Cleft Lip and Palate (CLP) Center, a major referral center for the Eastern part of Indonesia, affiliated with a tertiary center. From 69 patients who met the inclusion criteria, we excluded 31 patients who were more than 2 years of age and were operated on by junior residents under supervision. We performed anthropometric measurements of the patients on photographs taken before, immediately after, and a year after the surgery. This study measured nasal width, vertical lip height, horizontal lip length, and philtral height ratios. While nasal width and philtral height ratios decreased significantly (P = .000 and P = .000, respectively) reaching symmetry immediately after surgery, the horizontal lip length, and vertical lip height ratios remained unchanged (P = .862 and P = .981, respectively). A year after surgery, the nasal width and horizontal lip length ratios increased significantly (P = .017 and P = .006, respectively), while philtral height and vertical lip height ratios remained unchanged (P = .927 and P = .138, respectively). There was no difference in the ratios based on the initial size and completeness of the cleft. In Surabaya CLP Center, the symmetry of nasal width, philtral height, horizontal lip length, and vertical lip height were achieved by the unilateral cleft lip repair despite the initial size and completeness of the cleft.

NUMERICAL STUDY OF FLAME PROPERTIES AND ENERGY BALANCE IN MEDIUM SCALE n-HEPTANE POOL FIRE WITH VARIOUS LIP HEIGHTS AND WIND VELOCITIES

NUMERICAL STUDY OF FLAME PROPERTIES AND ENERGY BALANCE IN MEDIUM SCALE n-HEPTANE POOL FIRE WITH VARIOUS LIP HEIGHTS AND WIND VELOCITIES

Comparative study between fisher anatomical subunit approximation technique and millard rotation- advancement technique in unilateral cleft lip repair

ABSTRACT Introduction: The ideal lip repair is characterized by; the symmetrical shape of nasolabial folds and both alae of the nose with a natural-looking philtrum and Cupid’s bow in both static and dynamic states, in addition to a hidden scar. Objective: to compare between Fisher anatomical subunit approximation technique and Millard rotational advancement technique in unilateral cleft lip repair. Methods: Prospective study for 40 patients presented to Alexandria Main University hospital with unilateral cleft lip deformity between March 2019 and October 2020. Twenty patients with unilateral cleft lip deformity were repaired by Fisher anatomical subunit approximation technique, while the other twenty were repaired by Millard rotational-advancement technique. The postoperative photographs of the patients were captured and processed in computer photogrammetry software through which anthropometric parameters including (lip height, lip width, vermilion height, and alar base width) were compared between the normal side and the repaired side. In this software, each anthropometric parameter length on the normal side is taken as a control with a fixed value of (1) then the same parameter on the repaired side was measured as a ratio of this value to avoid bias. Comparison between both groups for assessment of the quality of cleft lip repair was also done based on Steffensen grading criteria. Results: Comparison between both techniques in unilateral cleft lip repair showed that there was no significant difference between them in the anthropometric measurements. While the comparison between the two groups using Steffensen grading criteria showed that Fisher’s technique surpassed Millard’s technique. Conclusion: We recommend the use of the Fisher anatomical subunit approximation technique in unilateral cleft lip repair for its superior results over the Millard rotational advancement technique.

Revisiting straight-line repair in unilateral complete cleft lip: a comparison with rotation-advancement repair

Rotation-advancement repair (RAR) has been the most widely used technique for unilateral cleft lip repair. We recently used a straight-line repair with medial orbicularis muscle lengthening (SLR-ml) technique, based on the hypothesis that it could minimize the postoperative scar appearance without causing s short-lip deformity when muscle reorientation is performed correctly. A retrospective cohort study was conducted on unilateral complete cleft lip patients who underwent cheiloplasty between 2009 and 2017. Two cheiloplasty techniques were compared: RAR and SLR-ml. Outcomes were evaluated by assessing follow-up photographs using three methods: (1) glance impression on a five-point scale, (2) Manchester Scar Scale, and (3) indirect anthropometry. Seventy-one patients were analysed: 41 in the RAR group (28 male, 13 female) and 30 in the SLR-ml group (15 male, 15 female). The glance impression (P=0.506) and Manchester Scar Scale (P=0.347) scores did not differ between the groups. According to the symmetry ratio (cleft side value/non-cleft side value), vertical lip height (P=0.804), horizontal lip length (P=0.881), and Cupid’s bow width (P=0.122) did not differ significantly between the groups. The preoperative lip height discrepancy was not correlated with the postoperative vertical lip height. The SLR-ml method can be regarded as a successful tool for symmetric repair of unilateral cleft lip.

TUBE-TO-SHEET JOINTS OF DISSIMILAR MATERIALS USING COMBINED PLASTIC DEFORMATION PROCESS IN SINGLE PASS

Joining by plastic deformation is needed in applications such as joining of similar and dissimilar metal parts, fluid transmission pipeline, aircraft and automobile components. This paper presents a new plastic deformation technique to connect sheet to tube in one pass of dissimilar material. A single pass joining is accomplished to produce bosses and a tube lip edge over flat sheet. The tube constrained length and tube lip height were checked by finite element analysis (FE) and experimental testing. Aluminum tube specimens with 48 mm outer diameter and 2 mm initial thickness were used. Tube lip height of 6, 8, 10, 12 and 14 mm and constrained length of 6, 8, 10, 15, 20, 25, 30 and 35 mm were used to form the boss part. Minimum punch nose radius was used to produce severe deformation of the tube lip over sheet surface as well as to avoid the tube lip curls. The tube passes through several stages until it is connected with the metal sheet, partial flare-bend, partial boss forming and the seaming stage. A new design of the punch was used to control the internal tube diameter and prevent the inward tube flow during the deformation process. Good agreement was found when comparing FE to experimentally-obtained results concerning deformation stages, trend of load/displacement curves.

A Three-Dimensional Comparison of Nasolabial Soft Tissue between Children with Repaired Unilateral Complete Cleft Lip and Palate and Unaffected Children in Khon Kaen, Thailand.

The objectives were to assess the treatment outcomes of unilateral cleft lip and palate after primary surgery on nasolabial soft tissue of children ages 4-5 years old as compared with unaffected children and to establish a nasolabial soft tissue norm within Khon Kaen. This cross-sectional study consisted of 60 unaffected subjects living in Khon Kaen province and 20 subjects with repaired complete unilateral cleft lip and palate who were treated at Srinagarind Hosipital, Khon Kaen, Thailand. 3D images were taken by a Morpheus 3D Scanner and measured by the Morpheus 3D program. Independent t-tests and paired t-tests were used to analyze the significant differences between subjects with cleft and unaffected subjects. There were statistically significant differences (p<0.05) of nasolabial measurements between affected subjects and unaffected subjects. Unilateral measurements showed decreased nostril height, columella lengths, and nose protrusion from ala base and ala length in the affected group. In addition, bilateral measurements found decreased upper lip protrusion, philtrum length, upper lip height, upper vermillion thickness, and lip angle. This study attempted to establish a norm for evaluating the treatment outcome of cleft lip and cleft palate repair at Srinagarind Hospital in relation to unaffected or noncleft individuals. The results suggest that the noncleft side in affected patients is not an optimal surgical guide for cleft repair and the surgeon should correct both sides of lip and nose features according to the norms. A surgical treatment plan should emphasize correcting nostril height, columella length, nose protrusion from ala base, ala length, and upper lip features.

The use of botulinum toxin A in upper lip augmentation.

Full lips are beauty standards. Botulinum toxin A (BTA) paralyzes the orbicularis oris muscle to achieve the eversion of the lip, and thus makes the lip look plump. This study presents three cases of BTA injection to the lip and evaluates the possible changes in the labial morphology and the lip surface area. Three patients received a total of 4U BTA injection at the vermilion border of the upper lip. Vectra® H1 3D imaging system was used to capture 3D photographs of the lips before injection and two weeks after injection. Eight linear distances and the upper lip surface area were measured. Anthropometric measurements before and after injection were compared. Patients displayed a larger upper vermillion height (P=.038) and a smaller cutaneous upper lip height (P=.024). There was a trend for a larger upper lip surface area, but not statistically significant (P=.109). Symptoms of slight perioral muscular palsy and mouth incompetence lasted about one month in three patients. BTA helps to enlarge the upper lip and shorten the philtrum. The BTA injection can be an option for lip enhancement with caution.

Lip height estimation in a southern African sample

INTRODUCTION: The South African Police Service frequently relies on craniofacial approximation and superimposition to assist in identifying unknown deceased individuals. Standards to estimate lip height are however limited. Findings from this study share medical applications. Aims and objectives: Establish reliable standards for estimating lip height using dentoskeletal measurements. METHODS: Cone-beam CTs comprising 124 black and 39 white southern African adults were assessed. A series of dimensions were recorded using a DICOM viewer with an inbuilt measuring tool. Relationships between hard tissue structures (maxillary, mandibular and total central incisor heights, their corresponding root lengths, face height (N-Gn), and nose height (N-Sn)) and respective overlaying soft tissues (upper, lower and total lip heights) were evaluated. RESULTS AND CONCLUSIONS: Statistically significant differences were observed between population, sex and age groups. A selection of regression equations to estimate lip height was calculated that included population, sex and approximate age (20-39 and 40+ years) for improved goodness-of-fit (r2-value). Regression models using face height produced the strongest multiple correlation (r-value) and goodness-of-fit (r2-value). Validation testing indicated that regression models often improved upon mean measurements, while offering a degree of individuality that mean values do not.

Degree of Asymmetry Between Patients With Complete and Incomplete Cleft Lips.

Surgical outcomes for patients with complete cleft lips are not as ideal as those achieved for milder phenotypes. We hypothesized that in addition to the greater width of the cleft, patients with complete cleft lip and palate exhibit a greater degree of hypoplasia and asymmetry. Stereophotographs of 14 infants with unrepaired unilateral complete and 14 with incomplete cleft lips were measured using Vectra imaging software (Canfield Imaging). Unpaired t tests were used to compare measured asymmetry between groups. Measurements included nasion to endocathion, sn-sbal, subnasale to alare (sn-al), subnasale to crista philtra, subalare to crista philtra (sbal-cphi), chelion to crista philtra, lateral lip element fullness, medial lip element fullness (mef), and non-cleft lip fullness. Duplicate measurements allowed Pearson correlation to be used to determine intra-rater reliability. Statistical significance was set at P < .05. Degree of asymmetry of the nasal base, sn-al, and sn-sbal was significantly greater for patients with complete clefts (P = .0001, P = .0001). Hypoplasia of the lateral lip element was seen when comparing lateral and mef (P = .04, P = .004) and lateral lip height (sbal-cphi''; P = .002). The degree of cupid's bow asymmetry did not differ between groups (P = .23). Intrarater reliability was high for all facial measures, ranging from 0.70 to 0.99. More severe, complete cleft lips demonstrate statistically significant greater asymmetry in surgically relevant dimensions. There was greater width of the nasal base. Vertical asymmetry of cupid's bow was unaffected by cleft severity, but that asymmetry was greater in patients with complete clefts due to hypoplasia of the lateral lip element. This may contribute to the less favorable results in these patients.