Restricted accessResearch articleFirst published online 2005-1
The Eurocleft Study: Intercenter Study of Treatment Outcome in Patients with Complete Cleft Lip and Palate. Part 2: Craniofacial Form and Nasolabial Appearance
To compare craniofacial morphology and nasolabial appearance up to age 17 in individuals with repaired complete unilateral cleft lip and palate (UCLP) treated at five European centers.
Design
Longitudinal cohort study.
Setting
Multidisciplinary cleft services in Northern Europe.
Subjects
127 consecutively treated individuals with repaired complete UCLP.
Main outcome measures
Cephalometric variables, 14 angular and 2 ratio variables, and panel ratings of nasolabial appearance, 4 variables.
Results
The results revealed that at ages 12 and 17, two centers had a flatter profile (gs-sn-pgs) and retrognathic maxilla (sss-ns-sms). Additionally, one of the two centers had increased lower face height. Ratings of nasolabial appearance showed more similarity between the centers.
Conclusion
The results confirm that systematic differences in craniofacial morphology and nasolabial appearance may occur between different cleft centers, but do not allow specific caused factors to be identified.
Asher-McDadeC., BrattströmV., DahlE., McWilliamJ., MølstedK., PlintD.A., Prahl-AndersenB., SembG., ShawW.C., TheR.P.S.. A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 4. Assessment of nasolabial appearance.Cleft Palate Craniofac J.1992; 29: 409–412.
2.
Asher-McDadeC., RobertsC.T., ShawW.C., GallagerC.. Development of a method for rating nasolabial appearance in patients with clefts of the lip and palate.Cleft Palate Craniofac J.1991; 28: 385–391.
3.
BeckerM., SvenssonH.. Morphometry in digital photographs: a promising technique for assessing cleft lip and palate patients.Scand J Plast Reconstr Hand Surg.1998; 32: 295–299.
4.
BrattströmV., McWilliamJ., LarsonO., SembG.. Craniofacial development in children with unilateral clefts of the lip, alveolus, and palate treated according to four different regimes. I. Maxillary development.Scand J Plast Reconstr Hand Surg.1991; 25: 259–267.
5.
CoccaroP.J., PruzanskyS.. Longitudinal study of skeletal and soft tissue profile in children with unilateral cleft lip and cleft palate.Cleft Palate J.1965; 2: 1–12.
6.
DahlbergG.. Statistical Methods for Medical and Biological Students.London: Georg Allen & Unwin Ltd;1940.
7.
EnemarkH., BolundS., JørgensenI.. Evaluation of unilateral cleft lip and palate treatment: long term results.Cleft Palate J.1990; 27: 354–361.
8.
EnemarkH., FriedeH., PaulinG., SembG., ÅbyholmF., BolundS., LiljaJ., ÖstrupL.. Lip and nose morphology in patients with unilateral cleft lip and palate from four Scandinavian centres.Scand J Plast Reconstr Hand Surg.1993; 27: 41–47.
9.
FriedeH., JohansonB.. A follow-up study of cleft children treated with primary bone grafting. 1. Orthodontic aspects.Scand J Plast Reconstr Surg.1974; 8: 88–103.
10.
FriedeH., JohansonB.. Adolescent facial morphology of early bone-grafted cleft lip and palate patients.Scand J Plast Reconstr Surg.1982; 16: 41–53.
11.
FriedeH., LiljaJ.. Dentofacial morphology in adolescent or early adult patients with cleft lip and palate after a treatment regimen that included vomer flap surgery and pushback palatal repair.Scand J Plast Reconstr Hand Surg.1994; 28: 113–121.
12.
FriedeH., EnemarkH., SembG., PaulinG., ÅbyholmF.. Bolund S, Lilja J, Östrup L. Craniofacial and occlusal characteristics in unilateral cleft lip and palate patients from four Scandinavian centres.Scand J Plast Reconstr Hand Surg.1991; 25: 269–276.
GrunwellP., BrønstedK., HenningsonG., JansoniusK., KarlingJ., MeijerM., OrdingU., WyattR., Vermeij-ZieverinkE., SellD.. A six-center international study of the outcome of treatment in patients with clefts of the lip and palate: the results of a cross-linguistic investigation of cleft palate speech.Scand J Plast Reconstr Hand Surg.2000; 34: 219–229.
15.
KerrW.J.S., FordI.. A comparison of facial form in three western European male groups.Eur J Orthod.1986; 8: 106–111.
16.
KramerC.Y.. Extension of multiple range test to group means with unequal numbers of replications.Biometrics.1956; 12: 307–310.
17.
LaitungJ.K., CoghlanB.A., PigottR.W.. A comparison of computer versus panel assessment of two groups of patients with cleft lip and palate.Br J Plast Surg.1993; 46: 18–21.
18.
LandisJ.R., KochG.G.. The measurement of observer agreement for categorical data.Biometrics.1977; 33: 159–174.
19.
MorrantD.G., ShawW.C.. Use of standardized video recordings to assess cleft surgery outcome.Cleft Palate Craniofac J.1996; 33: 134–142.
20.
MølstedK., Asher-McDadeC., BrattströmV., DahlE., MarsM., McWilliamJ., PlintD.A., Prahl-AndersenB., SembG., ShawW.C., TheR.P.S.. A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 2. Craniofacial form and soft tissue profile.Cleft Palate Craniofac J.1992; 29: 398–404.
21.
MølstedK., BrattströmV., Prahl-AndersenB., ShawW.C., SembG.. The Eurocleft Study. Longitudinal follow-up of patients with complete unilateral cleft lip and palate: Part 3. Dental arch relationships.Cleft Palate Craniofac J.2004; 42: 78–82.
22.
NordinK-E. Treatment of primary total cleft palate deformity. Preoperative orthopedic correction of the displaced components of the upper jaw in infants followed by bone grafting to the alveolar process clefts.Trans Europ Orthod Soc.1957; 333–339.
23.
PalmerC.R., HamlenM., RossR.B., LindsayW.K.. Cleft palate repair: comparison of the results of two surgical techniques.Can J Surg.1969; 12: 32–39.
24.
PaulinG., ThilanderB.. Dentofacial relations in young adults with unilateral complete cleft lip and palate.Scand J Plast Reconstr Hand Surg.1991; 25: 63–72.
25.
RossR.B.. Treatment variables affecting facial growth in complete unilateral cleft lip and palate: Part 1. Treatment affecting growth.Cleft Palate J.1987; 24: 5–23.
26.
SembG.. A study of facial growth in patients with unilateral cleft lip and palate treated by the Oslo CLP Team.Cleft Palate Craniofac J.1991; 28: 1–21.
27.
SembG., BrattströmV., MølstedK., Prahl-AndersenB., ShawW.C.. The Eurocleft Study: longitudinal follow-up of patients with complete unilateral cleft lip and palate. Part 1. Introduction and treatment experience.Cleft Palate Craniofac J.2004; 42: 64–68.
28.
ShawW.C., BrattströmV., MølstedK., Prahl-AndersenB., SembG.. The Eurocleft Study: longitudinal follow-up of patients with complete unilateral cleft lip and palate. Part 5. Discussion and conclusions.Cleft Palate Craniofac J.2004; 42: 93–98.
29.
ShawW.C., DahlE., Asher-McDadeC., BrattströmV., DahlE., MarsM., Mc-WilliamJ., MølstedK., PlintD.A., Prahl-AndersenB., RobertsC., SembG., TheR.P.S.. A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 5. General discussion and conclusions.Cleft Palate Craniofac J.1992; 29: 413–418.
30.
ŠmahelZ., Müllerová. Effects of primary periosteoplasty on facial growth in unilateral cleft lip and palate: 10-year follow-up.Cleft Palate J.1988; 25: 356–361.
31.
ŠmahelZ., Müllerová, NejedlyA., HorakI.. Changes in craniofacial development due to modifications of the treatment of unilateral cleft lip and palate.Cleft Palate Craniofac J.1998; 35: 240–247.
TrenouthM.J., DaviesP.H., JohnsonJ.S.. A statistical comparison of three sets of normative data from which to derive standards for craniofacial measurement.Eur J Orthod.1985; 7: 193–200.
