Facial shape and asymmetry in 5-year-old children with repaired unilateral cleft lip and/or palate: an exploratory study using laser scanning

To investigate the feasibility of facial laser scanning in pre-school children and to demonstrate landmark-independent three-dimensional (3D) analyses for assessment of facial deformity in 5-year-old children with repaired non-syndromic unilateral cleft lip and/or cleft palate (UCL/P). Faces of twelve 5-year-old children with UCL/P (recruited from university hospitals in Cardiff and Swansea, UK) and 35 age-matched healthy children (recruited from a primary school in Cardiff) were laser scanned. Cleft deformity was assessed by comparing individual faces against the age and gender-matched average face of healthy children. Facial asymmetry was quantified by comparing original faces with their mirror images. All facial scans had good quality. In a group of six children with isolated cleft palate coincidence with the average norm ranged from 18.8 to 26.4 per cent. There was no statistically significant difference in facial asymmetry when compared with healthy children (P > 0.05). In a group of six children with UCL with or without cleft palate coincidence with the average norm ranged from 14.8 to 29.8 per cent. Forehead, midface and mandibular deficiencies were a consistent finding, ranging from 4 to 10mm. The amount of 3D facial asymmetry was higher in this group (P < 0.05). Facial laser scanning can be a suitable method for 3D assessment of facial morphology in pre-school children, provided children are well prepared. Landmark-independent methods of 3D analyses can contribute to understanding and quantification of facial soft tissue cleft deformity and be useful in clinical practice.