Systematic contact-free 3D topometry of the soft tissue profile in cleft lips

OBJECTIVE: To evaluate the clinical application of three-dimensional (3D) imaging for the analysis of a broad variety of cleft lips and to conduct a systematic analysis. DESIGN: This was a prospective study using a noncontact 3D laser scanner to acquire the preoperative 3D facial profiles. The data sets were analyzed qualitatively and quantitatively. The data were expressed by ratios and scores. PATIENTS: Forty nonsedated patients (1 to 39 years, average age 2.7 years) with unilateral cleft lip, cleft lip and alveolus, or complete unilateral cleft in Cambodia. RESULTS: The acquired 3D data sets (mean acquisition time: 2.5 seconds) from facial surfaces were of diagnostic quality in 27 of 40 patients (average age, 14.2 years). In these cases all anatomical structures could be mapped precisely by means of landmark positioning in the range of millimeters. A new method of systematic analysis could be elaborated, allowing for data set expression independent of size and growth factors. In children under age 3, the measuring procedure was of limited value because of motion artifacts and was successful in only 6% (1 of 15) of these patients. CONCLUSION: The system offers a solid and precise tool for 3D imaging of the complex cleft lip anatomy in compliant patients and is useful for preoperative cleft assessment and follow-up. However, the application is limited in moving infants or uncooperative adults because of scanning time and acquisition method. The development of motion tracking and faster devices could eliminate motion artifacts.