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Analysis of Labial Aesthetics Following Lefort I Maxillary Advancement in Cleft Patients Using Three-Dimensional Imaging
Anisha Konanur, Erin Anstadt MD, Lucas Dvoracek MD, Paul Marji MD, Jesse Goldstein MD
UPMC
2020-02-12
Presenter: Anisha Konanur
Affidavit:
The work on this project represents the original work of the medical student and residents on the team.
Director Name: Jesse Goldstein
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction
Nasal changes in the cleft patient after orthognathic surgery have been well-documented, however, lip aesthetic changes after cleft orthognathic surgery remain understudied. This study aims to assess labial changes in cleft patients after a LeFort I advancement.
Methods
A retrospective review was performed of patients with cleft-related maxillary hypoplasia who underwent LeFort I osteotomy. Pre- and post-operative measurements of the following metrics were made using three-dimensional images: labial width/height, philtrum height, upper and total vermillion height, crista philtra superior/inferior width, labial superius/inferius projection). Statistical analysis using Student's paired T-test for means was performed.
Results
Nine cleft patients underwent either single piece Le Fort I osteotomy with advancement (1 bilateral, 5 unilateral cleft pts), or distraction (2 bilateral, 1 unilateral). Mean age at surgery was 16.8 years. Post-operative images were taken on average at 14 months. Average distraction and advancement distance from the central maxillary incisor was 12.5mm and 6.7mm, respectively. There were statistically significant increases in the means of upper labial height (1.60mm, p=0.006), upper vermillion height (1.46mm, p=0.008), superior crista philtra width (1.13mm, p=0.004), inferior crista philtra width (1.16mm, p=0.003), labial superius projection from the stomion (1.18mm, p=0.018), and ratio of vermillion to entire upper lip (0.05mm, p=0.037), as well as a decrease in labial inferiorus projection from the stomion (-3.63mm, p=0.001).
Conclusion
Our study describes several significant labial aesthetic changes in cleft patients which can be used to guide post-operative expectations.
