Morphometric assessment of facial morphology in infants with unilateral cleft lip/palate up to two years of age using 3D stereophotogrammetry

Abstract Objectives: To assess modelled facial development of infants with unilateral cleft lip (CL)/cleft lip and palate (UCLP) compared to controls for up to two years.Materials and methods: A total of 201 facial images of children (clefts, controls) were obtained in 4 different age categories (in years; T0: 0.2–0.5; T1: 0.6–1.0; T2: 1.1–1.5; T3: 1.6–2.0); they were evaluated using 3D stereophotogrammetry and geometric morphometrics.Results: In the CL patients, the forehead was significantly retracted (p ≤ 0.001), while the supraorbital and ocular regions were prominent (p ≤ 0.001). The oronasal region appeared convex compared to controls (p ≤ 0.001). The lower lip and chin were non-significantly protruded. In UCLP patients, a significantly retracted forehead and prominent supraorbital region were also apparent (p ≤ 0.001). The most striking deviations were observed in the middle face with a markedly retrusive oronasal region (p ≤ 0.001). The chin was significantly protruded anteriorly (p ≤ 0.01). In both clefts, no progression of deviations was confirmed with increasing age. After the first year, a slight improvement in the morphological features appeared due to the patients' growth potential and surgical method. The shape variability of the clefts and controls overlapped, suggesting comparable modelled facial development.Conclusions: The facial morphology of cleft individuals was comparable to the norm with marked shape deviation in the oronasal region, forehead, and chin, which minimised with increasing age even in complete clefts.Clinical relevance Visualising the facial surface through 3D stereophotogrammetry may improve early childhood surgical planning and postoperative therapy.