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Philtral Height Discrepancy in Patients with Complete and Incomplete Cleft Lips + /-Palate - Results from a Single
C M Rivers1, D Drake1, M F Devlin1
1National Cleft Surgical Service for Scotland, Royal Hospital for Children, Glasgow, UK of Great Britain and Northern Ireland.
Summary
Children with incomplete or isolated cleft lip have less philtral height discrepancy (PHD) before surgery. This study of unilateral cleft lip repair in Scotland found incomplete clefts and lip-only clefts showed significantly lower PHD.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- Unilateral cleft lip repair aims to restore form and function, focusing on philtral height symmetry.
- Minimal asymmetry is expected in incomplete cleft lip cases, potentially leading to better outcomes.
- Philtral height discrepancy (PHD) is a key metric for assessing asymmetry.
Purpose of the Study:
- To investigate philtral height discrepancy (PHD) in children with unilateral cleft lip +/- palate.
- To compare PHD between different cleft types (incomplete vs. complete) and presentations (lip only vs. lip and palate).
- To analyze PHD data from a single-nation cohort in Scotland.
Main Methods:
- Prospective data collection of PHD measurements during unilateral cleft lip repair surgery.
- Study cohort includes children born between January 2017 and December 2020 in Scotland.
- Data analyzed using statistical software to determine mean PHD and significant differences.
Main Results:
- 102 patients with unilateral cleft lip were identified; 94 had documented PHD.
- Incomplete clefts (52.1%) were more frequent than complete clefts (47.9%).
- Mean PHD was 3.91mm. Incomplete clefts showed significantly lower mean PHD (3.4mm) than complete clefts (4.5mm, p<0.001). Lip-only clefts also had lower mean PHD (3.4mm) than lip and palate clefts (4.4mm, p<0.001).
Conclusions:
- The study statistically supports the observation that incomplete and isolated cleft lips present with lesser asymmetry.
- This cohort demonstrates a wider range of PHD than previously reported.
- Findings highlight the importance of assessing PHD in unilateral cleft lip management.
