Comparison of the morphology of the "cleft face" and the normal face: Defining the anthropometric differences

Morphological characteristics of the "cleft face" were analyzed by calculat ing proportion indices in young adults who had undergone surgery in childho od for cleft lip and/or palate: 592 in 37 subjects with unilateral clefts a nd 432 in 27 with bilateral clefts. Three areas of the face with 16 indices based on 12 projective linear measurements were analyzed in each subject: 5 indices in the general face, 6 in the upper face, and 5 in the lower. Alt hough a balanced relationship was found in two thirds of the indices assess ed, severe disproportions, which greatly influence appearance, were noted i n about one quarter. In the general face, the most frequent abnormal anthro pometric findings contributing to severe disproportions were small upper-fa ce height and a severely high or moderately narrow mandible. In the soft ti ssues, disproportions included wide nose, small nasal tip protrusion, and s hort or long columella. Deviations from normality were rarely noted in the nose and upper-lip height, mouth width, total facial height, and width of t he upper face. In the upper face, severe disproportions occurred much more frequently in bilateral cleft subjects (67.6%) than in unilateral clefts (3 0.3%). In the lower face, however, severe disproportions were twice as freq uent among unilateral clefts (39.4%) than bilateral (14.7%). The results, a lthough interesting, require complementary preoperative data for reliable a nalysis of the adult "cleft face."