%0 Comparative Study
%T Commissural symmetry in unilateral transverse facial cleft patients: an anthropometric study.
%A Li J
%A Liu K
%A Sbi J
%A Wang Y
%A Zbeng Q
%A Sbi B
%J J Oral Maxillofac Surg
%V 70
%N 9
%D Sep 2012
%M 22209106
%F 2.136
%R 10.1016/j.joms.2011.10.005
%X <B>OBJECTIVE: </B>To evaluate the commissural symmetry and commissural migration among patients with unilateral transverse facial cleft.<BR><B>METHODS: </B>From 2006 to 2009, 31 patients with unilateral transverse facial cleft were repaired with superiorly based vermillion-mucosal flap and orbicularis oris reconstruction. Linear closure and superiorly rotated and inferiorly rotated Z-plasty were randomly chosen for skin closure. An anthropometric method was used immediately after the repair and at the follow-up examination to evaluate the commissural symmetry in both horizontal and vertical directions.<BR><B>RESULTS: </B>A total of 21 patients was followed-up for 19 months on average. Satisfactory horizontal symmetry was obtained right after surgery; however, the new commissure was generally lower than the unaffected commissure. At the follow-up examination, no significant lateral commissural displacement was observed; however, the commissural droop on the cleft side became more noticeable.<BR><B>CONCLUSIONS: </B>The anthropometric method used was convenient and reliable for facial symmetry analysis. Rectangular vermillion-mucosal flap and proper muscle reconstruction could prevent the lateral commissural migration caused by skin scar contracture. Both horizontal and vertical symmetry should be considered for macrostomia repair.