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Asymmetric lip-closing forces in children with repaired unilateral cleft lip and/or palate
K Nakatsuka1, T Adachi, T Kato
1Matsumoto Dental University Department of Orthodontics, Shiojiri, Nagano, Japan.
Insights
Children with repaired cleft lip and/or palate (CLP) show impaired directional lip-closing forces (LCF). This suggests altered motor control after surgery, potentially contributing to secondary deformities in CLP patients.
Area of Science:
- Craniofacial surgery
- Pediatric plastic surgery
- Biomechanics of lip function
Background:
- Cleft lip and/or palate (CLP) repair aims to restore function, but secondary deformities can occur.
- Lip-closing forces (LCF) are crucial for speech and facial aesthetics.
- Understanding the impact of CLP repair on lip motor control is essential.
Purpose of the Study:
- To estimate the effects of cleft lip and/or palate (CLP) repair on multidirectional lip-closing forces (LCF).
- To assess directional specificity of LCF during maximum voluntary pursing-like lip-closing movement in children.
- To investigate potential links between LCF alterations and secondary deformities in CLP patients.
Main Methods:
- Thirty Japanese children were divided into control and repaired unilateral CLP (RUCL) groups.
- RUCL group was further subdivided into unilateral cleft lip and/or alveolus (UCLA) and unilateral cleft lip and cleft palate (UCLP) groups.
- Maximum voluntary LCF were measured in eight directions to assess directional specificity.
Main Results:
- No significant differences in total LCF were found between RUCL and control groups.
- Repaired CLP (RUCL) showed significantly greater oblique LCF on the non-cleft side compared to the cleft side.
- UCLP group exhibited greater vertical LCF in the lower direction than the upper direction, unlike controls and UCLA groups.
Conclusions:
- Children with repaired CLP demonstrate impaired directional specificity of lip-closing function.
- Altered directional LCF may contribute to the development of secondary deformities after primary CLP surgery.
- Quantitative assessment of directional LCF offers insights into lip-closing dysfunction in CLP patients.
Abstract:
The objectives of this study were to estimate the effects of cleft lip and/or palate (CLP) repair on the multidirectional lip-closing forces (LCF) produced during maximum voluntary pursing-like lip-closing movement in children. Thirty Japanese children were divided into the control group and repaired unilateral CLP (RUCL) group, which was subdivided into the unilateral cleft lip and/or alveolus (UCLA) and the unilateral cleft lip and cleft palate (UCLP) groups. The maximum voluntary LCF were recorded in eight directions. No significant differences in any of the directional LCF (DLCF) or total LCF were observed between RUCL and control groups. Symmetrical DLCF were seen in the oblique directions on both sides of the upper lip in the control group, while the oblique DLCF on the non-cleft side was significantly greater than that on the cleft side in RUCL group. Furthermore, symmetrical vertical DLCF were observed in the upper and lower directions in control and UCLA groups, while the vertical DLCF obtained from the lower direction was significantly greater than that obtained from the upper direction in UCLP group. These results indicate that children with repaired CLP display impaired directional specificity, which may cause secondary deformities. These findings aid our understanding of the pathology of secondary deformities in CLP patients after primary surgery for cleft lip or palate. We propose that quantitative assessments of lip-closing function based on the directional specificity of the multidirectional LCF produced during maximum voluntary pursing-like lip-closing movement are useful for assessing the nature of lip-closing dysfunctions.
