Changes in Nasolabial Dimensions Following Repairs of Unilateral Cleft Lip: A Follow-Up Anthropometric Study in Late Childhood

Abstract

Background: The ultimate three-dimensional symmetry following unilateral cleft labial repair requires objective assessment of changes in the fourth-dimension. Methods: Fifty patients with unilateral cleft lip with or without cleft palate underwent repair in 1999 through 2004 and were followed through 2014. Anthropometric measurements were performed immediately post-operatively, at a first follow-up point an average 6.6 years after repair and a second follow up assessment an average 11.5 years after repair. Differences in the second period between cleft and non-cleft dimensions encompassing heminasal width (sn-al), labial height (sn-cphi, sbal-cphi), and transverse labial width (cphi-ch) and their rates of growth were tested using t-tests for correlated measures. The differential between cleft and non-cleft rates of growth in the second period was tested against that in the first period using the same method. Results: Sn-al continued to be larger on the non-cleft side but this difference decreased over time. Sn-cphi remained longer on the cleft side but no difference was detected in cleft and non-cleft rates of growth in the second period. Sbal-cphi was shorter on the cleft side by a consistent difference over time. Cphi-ch was shorter on the cleft side but this difference decreased over time. Likewise, the differential between cleft and non-cleft rates of growth decreased in the second period for sn-cphi and cphi-ch. Conclusions: Understanding how nasolabial features change with growth is critical to the initial repairs of unilateral cleft lip and nasal deformity.