Facial Soft Tissue Dynamics before and after Primary Lip Repair

OBJECTIVES: (1) To collect three-dimensional, dynamic facial images from two groups of infants: one group born with cleft lip and palate slated to have a primary lip repair and a second, age-matched, noncleft control group. (2) To develop analyses to determine differences in facial movement between infants with cleft lip and/or palate and noncleft control infants and to determine changes in facial movement before and after primary lip repair. DESIGN: Longitudinal, prospective case-control study. SETTING: Facial Animation Laboratory at the University of North Carolina School of Dentistry. PARTICIPANTS: Two groups of infants: one group with unrepaired cleft lip and/or palate slated to have primary lip repair (n = 15) and a second group of age-matched, noncleft controls (n = 15). INTERVENTIONS: Movement testing before and 4 months after primary lip repair in infants with cleft lip and/or palate and at similar time points in noncleft infants. MAIN OUTCOME MEASURES: Seven measures of facial movement. RESULTS: The range of facial movements increased by 17% for all infants during the 4-month period. Compared with the noncleft group (1) infants with unilateral cleft lip and/or palate had 50% less nasolabial movement, and this difference did not change due to the lip repair; and (2) infants with unilateral or bilateral cleft lip and/or palate had 58% and 118% greater lateral upper lip movement, respectively, and 3.67 and 3.56 times greater asymmetry of movement, respectively, before lip repair. The procedure almost entirely removed these problems. CONCLUSIONS: Primary surgical lip repair decreased hypermobility and improved asymmetry of upper lip movement