The Study of Facial and Nasal Symmetry in Patients with Unilateral Cleft Lip Achieved by Primary Cleft Lip Repair with Rhinoplasty Plus Postoperative Nasal Appliance “Nasoform”

Objective: To evaluate nose, lip, and face symmetry in patients with unilateral cleft lip who used “Nasoform” as a postoperative nasal appliance. Materials and Methods: The present cross-sectional study included twenty-two patients with unilateral cleft lip aged four to nine years. Their facial defects were surgically addressed in childhood, and Nasoform was used to preserve the surgical results for at least six months. Each volunteer’s face was photographed with a DSLR camera and macro lens. Five photographs were taken in frontal view during rest, social smile, big smile, lip purse, and cheek puff, and one was taken in submental view. The images were processed using Keynote software, and specific facial landmarks were identified and measured. The measurements on the cleft sides were divided by those on the non-cleft sides. A result of one indicated perfect symmetry. The conformity to the neoclassical canons of facial proportions was also considered. Results: In the frontal view, the calculated results of alar width, philtrum height, and vermillion height were close to one. In the submental view, the calculated results of columella length and nostril width were close to one. However, in some postures, the results deviated statistically from the ideal ratio. The inter-alar line and inter-commissure line were harmonized with the interpupillary line. The ratio of interocular width to alar width conforms to the neoclassical canons proportion. Conclusion: The protocol of using Nasoform after primary cleft lip repair with rhinoplasty for at least six months could provide balance and symmetry to the face.