A Guide to Bilateral Cleft Lip Markings: An Anthropometric Study of the Normal Cupid's Bow

2021 ◽  
pp. 105566562110363
Author(s):  
Yew L. Loo ◽  
Aaron C. Van Slyke ◽  
Pragaash Shanmuganathan ◽  
Robert Reitmaier ◽  
David K. Chong
Keyword(s):  
Cleft Lip ◽  
Three Dimensional ◽  
Image Database ◽  
3D Image ◽  
3D Images ◽  
Linear Distance ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Repair ◽  
The Right ◽  
Prior Trauma

Objective The aim of this study was to define the ratio of the heights of the vermilion between the peaks and trough of the Cupid’s bow and hence assist in defining the point of closure on the lateral lip element to achieve a balanced Cupid's bow in bilateral lip repair based on our findings. Design This study is a retrospective observational study of the anthropometrics of the upper lip's Cupid’s bow. Three-dimensional (3D) images of toddlers between 2009 and 2016 were extracted from a normative 3D image database of toddlers at the Royal Children's Hospital, Melbourne. Patients Participants from the normative 3D image database at the age of 1 year were studied. This excluded any patients with prior trauma or surgical intervention of the nasolabial region. Intervention Landmarks measured were right and left crista philtri (cphR and cphL), labial superius (ls), stomion (sto), right and left chelion, and labial fissure (lf). Outcome Vermilion height of the right peak, trough, and left peak of the Cupid’s bow was calculated by analyzing the vertical linear distance between cphR–lf, ls–sto, and cphL–lf. The ratio between the median and paramedian heights were recorded. Results The paramedian height of the upper lip vermilion is consistently greater than the midline height. There was no significant sexual dysmorphism between ratio of paramedian to midline height on the right ( P = .538) and left ( P = .410). Conclusion We describe an anthropometric observation of the vermilion relationship at the Cupid’s bow and define a specific lateral lip marking for bilateral cleft lip repair based on our anthropometric findings.

The three-dimensional stable mandibular landmarks in patients between the ages of 12.5 to 17.1 years

2020 ◽  
Author(s):  
Gui Chen ◽  
Mona Al Awadi ◽  
David William Chambers ◽  
Manuel O Lagravère-Vich ◽  
Tianmin Xu ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Growth Period ◽  
Mandibular Canal ◽  
Mental Foramen ◽  
Three Dimensions ◽  
Head Orientation ◽  
Facial Growth ◽  
Linear Distance ◽  
The Right ◽  
Stable Structures

Abstract Background: With the aid of implants, Björk identified the two-dimensional mandibular stable structures in cephalogram during facial growth. However, we don't know the three-dimensional stable structures exactly. The purpose of this study was to identify the most stable mandibular landmarks in growing patients using three-dimensional images.Methods: The sample was comprised of two cone-beam computed tomography (CBCT) scans taken about 4.6 years apart in 20 growing patients between the ages of 12.5 (T1) to 17.1 years (T2). After head orientation, landmarks were located on the chin (Pog), internal symphysis (Points C, D and E), and mandibular canals, which included the mental foramina (MF and MFA) and mandibular foramina (MdF). The linear distance change between Point C and these landmarks was measured on each CBCT to test stability through time. The reliability of the suggested stable landmarks was also evaluated. Results: The total distance changes between Point C and points D, E, Pog, MF, and MFA were all less than 1.0 mm from T1 to T2. The reliability measures of these landmarks, which were measured by the Cronbach alpha, were above 0.94 in all three dimensions for each landmark. From T1 to T2, distance changes from Point C to the right and left mandibular foramina were respectively 3.39±3.29 mm and 3.03±2.83 mm. Conclusions: During a growth period that averaged 4.6-years, ranging from 11.2 to 19.8 years, the structures that appeared relatively stable and could be used in mandibular regional superimposition included Pog, landmarks on the inferior part of the internal symphysis, and the mental foramen. The centers of the mandibular foramina, the starting points of the mandibular canal, underwent significant changes in the transverse and sagittal dimensions.

A Foxtail-Shaped Vermilion Flap to Reconstruct the Medial Tubercle in Asymmetric Bilateral Cleft Lip With Contralateral Lesser Form Defect

2019 ◽  
Vol 56 (8) ◽  
pp. 1052-1057
Author(s):  
Yuta Nakajima ◽  
Shunsuke Yuzuriha ◽  
Fumio Nagai ◽  
Kenya Fujita ◽  
Masahiko Noguchi
Keyword(s):  
Cleft Lip ◽  
Primary Repair ◽  
Tertiary Care ◽  
Senior Author ◽  
The Body ◽  
University Hospital ◽  
Bilateral Cleft Lip ◽  
Group A ◽  
Cleft Lip Repair ◽  
Group B

Objective: There have been few reports addressing asymmetric bilateral cleft lip repair with contralateral lesser form defects. Two studies have described the thin medial tubercle as the most common remaining labial deformity. In this study, we aimed to evaluate the use of a foxtail-shaped vermilion flap to reconstruct the median tubercle in primary repair. Design: A blinded retrospective study of photography and chart review. Setting: Shinshu University Hospital, tertiary care. Private practice. Patients: Forty-nine patients with asymmetric bilateral cleft lip with lesser form defects treated using a primary “unilateral” repair by the senior author (S.Y.) between 2007 and 2017. Interventions: The foxtail-shaped vermilion flap was applied at the time of the primary nasolabial repair. This flap is similar to Noordhoff laterally based triangular vermilion flap but with modifications to the shape and length. The body of the flap is wider than the pedicle to add tissue to the center of the vermilion, and the length is sufficiently elongated to reach the lesser side. Main Outcome Measure: Lip shape was graded on a 4-point scale when patients were 1 year old. Results: Twenty-two patients were treated with the foxtail-shaped vermilion flap (group A) and 27 patients with Noordhoff triangular vermilion flap (group B). Group A had a better lip shape than group B ( P = .006). Conclusions: The foxtail-shaped vermilion flap is useful to reconstruct the median tubercle in asymmetric bilateral cleft lip repair with contralateral lesser form defects.

Reconstruction of Major Dehiscence After Bilateral Cleft Lip Repair

2018 ◽  
Vol 29 (8) ◽  
pp. 2211-2213
Author(s):  
Elva Lim ◽  
Betty C.J. Pai ◽  
Daniel Getachew ◽  
Soyeon Jung ◽  
Lun-Jou Lo
Keyword(s):  
Cleft Lip ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Repair
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