Effects of Lip Revision Surgery in Patients with Cleft Lip & Palate

The facial animations presented here refer to the article: Effects of Lip Revision Surgery in Patients with Cleft Lip & Palate by Carroll-Ann Trotman, Julian J. Faraway, Ceib Phillips, John van Aalst. Please see this article for details.

Abstract

The decision for lip revision surgery in patients with repaired cleft lip/palate is based on surgeons' subjective evaluation of lip disability. An objective evaluation would be highly beneficial for the assessment of surgical outcomes. In this study, the effects of lip revision on the circumoral movements were objectively quantified. The hypothesis was that lip revision increases scarring and impairment. The study was a non-randomized clinical trial that included patients with cleft lip who had revision, patients with cleft lip that did not, and non-cleft control subjects. Three-dimensional facial movements were measured. Revision patients were measured before and after surgery. Other subjects were measured at similar intervals. Regression models were fit to summary measurements and changes were modeled. Patients with repaired cleft lip/palate had less mean movements than controls. Lip revision did not worsen mean movements; however, individual patients' movements varied from "improvement" to "no change" to "worse" relative to controls.

Averages over groups

  1. In the cleft vs. control comparisons, only pre-surgery visits are considered. The cleft average includes both the revision and the non-revision group. The controls are denoted by the black circles and the clefts by the red dots. The clefts have been adjusted to have the same initial shape as the controls.
  2. In the longitudinal comparisons, the average over the pre-surgery visits is shown by the black circles while the 12 month visit average is shown in red. The initial positions have been adjusted to be the same for the two.
Cheek Puff
Cleft vs. Control| Revision longitudinal

Lip Purse
Cleft vs. Control| Revision longitudinal

Mouth Open
Cleft vs. Control| Revision longitudinal

Grimace
Cleft vs. Control| Revision longitudinal

Natural Smile
Cleft vs. Control| Revision longitudinal

Max Smile
Cleft vs. Control| Revision longitudinal

Individual Changes

Controls are in black, individuals in red. The individuals have been adjusted to have the same initial shape as the controls.
RR05, Max smile
Before| After
RR07, Max smile
Before| After
RR08, Max smile
Before| After
RR28, Max smile
Before| After
RR40, Max smile
Before| After
RR47, Max smile
Before| After

RR08, Natural smile
Before| After