Date: May 2020.
Source: Thesis. Master of Science, The Faculty of Graduate and Postdoctoral Studies, Craniofacial Science, The University of British Columbia.
Background: Prior to operative correction of a cleft lip, presurgical orthopaedics (PSO) with facial taping is used to improve pre-maxillary and soft tissue alignment. Two commercially available taping systems, Dynacleft and 3MTM taping are used at the British Columbia Children’s Hospital for this purpose. The aim of this study was to evaluate 3MTM and Dynacleft tape, for their ability to impact nasolabial shape during the treatment of the cleft lip deformity.
Methods: A retrospective cohort study of 93 cleft lip +/- palate patients (69 unilateral, 24 bilateral) that had received either Dynacleft or 3MTM facial taping was conducted. 3D stereophotogrammetry images were obtained at three time-points: prior to treatment, after receiving taping but prior to surgery and after surgical repair. 3D photos were annotated with landmarks on the nasolabial region using 3dMDvultus software. The landmarks were then used in conventional morphometric analysis with previously validated facial measurements to describe and compare the two cohorts at each stage. Geometric morphometrics using Procrustes ANOVA analysis was also conducted to compare the nasolabial shape between the two taping groups. Unilateral cleft patients were additionally compared by their presenting cleft severity using both morphometric analyses to evaluate the impact of presenting severity on cleft outcomes.
Results: Both taping devices demonstrated progressive improvement in multiple facial metrics after taping and after surgery. Although variability in the degree of improvement was noted in the evaluated facial metrics after pre-surgical orthopedics between the two taping groups, no differences were found between these metrics after surgery. ANOVA comparison of the
nasolabial region after Procrustes analysis also found no significant difference between the two taping cohorts after surgical cleft lip repair (p-value =0.57). Unilateral cleft patients classified as severe at presentation had residual facial shape differences after lip repair compared to milder presenting clefts (p-value=0.005).
Conclusions: PSO with facial taping reduces the cleft facial deformity prior to surgical correction across multiple facial measurements. However, both 3M and Dynacleft taping devices result in similar facial alignment post-operatively suggesting either can be successfully utilized and that differences prior to surgery have limited influence on the post-operative result.
Thesis: Outcome assessment of facial orthopedics with taping for cleft lip deformities using 3D stereophotogrammetry.
Author: Peter Mankowski.