Esthetic evaluation of the treated unilateral cleft lip using photographs and image analysis software: a...

The aim of this study was to objectively evaluate the surgical outcome of unilateral cleft lip patients treated by Dr. Adenwalla's modification of Millards rotation advancement technique using image analysis software.

Of the unilateral cleft lip cases done by a single surgeon using Dr. Adenwalla's modification of Millard's rotation advancement technique, only 11 cases satisfied the photographic standardization criteria (frontal view with both ears visible to minimize rotation and least nostril show to minimize tilt) and were included in this study. These photographs were acquired into the imageJ Software and Farkas cleft-related landmarks were marked on the lip area. The values of treated cleft side and the normal side were used to work out a Cleft Lip Component Symmetry Index. A value of 100 would indicate perfect symmetry of the lip. A value of either less or more would mean a degree of asymmetry.

The horizontal lip length, vertical lip length from the top of the Cupid's bow to subnasale and nostril floor width were slightly increased on treated side of the lip and the vertical lip length from the top of the Cupid's bow to the alar base, the Cupid's bow width and vermilion length on the treated side were slightly decreased when compared to the normal side. Even though there were some differences, it was not statistically significant. The horizontal and vertical lip lengths, the Cupid's bow width, vermilion length and nostril floor width were almost symmetrical.

Computer assisted anthropometric analysis of photographs using imageJ software demonstrates that Dr. Adenwalla's modification of Millard's rotation and advancement technique produces esthetic lip symmetry consistently.