Upper lip asymmetry perception using three-dimensional anthropometry in patients with unilateral cleft lip deformity

Conventional anthropometry using photographs has been widely used, but it does not provide accurate length. For upper lip asymmetry analysis, three-dimensional photographic system (3D VECTRA; Canfield, Fairfield, NJ) was used to calculate the ratio of cleft-side and noncleft-side curvature lengths. Thirty patients with unilateral cleft lip were analyzed. Three-dimensional photographic system was used to calculate the length ratio of upper lip of cleft and noncleft sides. In addition, two-dimensional photographs were analyzed by 10 plastic surgeons, and upper lip asymmetry was scored using a visual analog scale (VAS). Pearson analysis was used to identify relations between the ratios and the VAS scores. Intrarater reliability for the VAS scores ranged from 0.653 to 0.925, and interrater reliability was 0.611. Pearson correlation coefficients for each ratio and the VAS score were 0.412 (P = 0.024) for cleft-side to noncleft-side curvature length ratio of Cupid’s bow, 0.250 (P = 0.182) for cleft-side to noncleft-side curvature length ratio from the commissure to the lowest point of the nasal ala, 0.214 (P = 0.018) for linear length ratio of Cupid’s bow, and 0.356 (P = 0.153) for linear length ratio from the commissure to the lowest point of the nasal ala. Analysis of upper lip asymmetry in unilateral cleft lip patients using the three-dimensional photographic system is more accurate than two-dimensional anthropometry. Horizontal curvature length ratio was the most strongly correlated with VAS score.