Martinková Katarína, Kožejová Jaklová Lenka, Kočandrlová Karolina, Borský Jiří, Dupej Ján, Morávek Alexander, Velemínská Jana
Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Viničná 7, Prague, 128 00, Czech Republic.
Department of Histology and Embryology, Third Faculty of Medicine, Charles University, Ruská 2411, 100 00, Prague, Czech Republic.
Clin Oral Investig. 2025 Aug 2;29(8):394. doi: 10.1007/s00784-025-06484-1.
This study investigates facial directional asymmetry (DA) in early childhood. Using 3D imaging, it aims to assess the DA progression in healthy controls and children with unilateral cleft lip (CL) and unilateral cleft lip and palate (UCLP) following early neonatal cheiloplasty and palatoplasty.
MATERIALS & METHODS: The sample consisted of 105 children (groups: cleft 42, control 63) aged 0.2-2 years. DA was analysed using geometric morphometrics, including 3D landmark-based and polygonal mesh analyses. Multivariate statistics were used for assessing DA significance and age group differences.
Controls showed no DA in landmarks and only mild protrusion of the right hemiface, increasing with age. In groups with cleft, DA was more pronounced in UCLP and especially in the middle of the face. While older UCLP children showed more asymmetrical faces, DA in children with CL became more comparable to that in controls with increasing age. Older children showed no statistical difference between control and CL in the landmark and polygonal maps parts.
After surgical treatment, a DA pattern was identified, and it was specific for both cleft types and age categories. For both diagnoses, the most notable feature is the protrusion at the cleft site, likely related to post-surgical scarring, but in the UCLP group, it is also the hypoplastic nasal wing and a growth insufficiency of the cheek on the cleft side.
3D methodologies provide insight into asymmetry progression and surgical outcomes, supporting improved cleft management for enhanced aesthetic and functional results.
本研究调查幼儿面部方向不对称（DA）情况。利用三维成像技术，旨在评估健康对照组以及单侧唇裂（CL）和单侧唇腭裂（UCLP）患儿在早期新生儿唇裂修复术和腭裂修复术后DA的进展情况。
样本包括105名年龄在0.2至2岁的儿童（分组：唇裂组42名，对照组63名）。使用几何形态测量学分析DA，包括基于三维地标和多边形网格分析。采用多变量统计评估DA的显著性和年龄组差异。
对照组在地标处未显示DA，仅右半脸有轻度突出，且随年龄增长而增加。在唇裂组中，UCLP组的DA更明显，尤其是在面部中部。虽然年龄较大的UCLP患儿面部不对称更明显，但CL患儿的DA随年龄增长与对照组更具可比性。在年龄较大的儿童中，对照组和CL组在地标和多边形图部分无统计学差异。
手术治疗后，确定了一种DA模式，且该模式对两种唇裂类型和年龄类别均具有特异性。对于这两种诊断，最显著的特征是裂隙部位的突出，可能与手术瘢痕有关，但在UCLP组中，还包括患侧鼻翼发育不全和脸颊生长不足。
三维方法有助于深入了解不对称进展和手术效果，支持改进唇裂治疗以提高美学和功能效果。
