Functional Outcomes of Cleft Lip Surgery

Univ Of North Carolina Chapel Hill, Chapel Hill NC

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Abstract

DESCRIPTION: This application is in response to NOT-OD-09-058, titled "NIH announces the availability of Recovery Act Funds for Competitive Revision Applications". The goal of this application, which is related to an NIDCR R01 grant (DE13814) titled "Functional Outcomes of Cleft Lip Surgery", is to extend the analysis of facial function (movement) and form to babies (<6 months) born with a cleft lip. Presently, surgical results after an initial or primary lip repair are highly variable. Many patients require additional lip 'revision'surgeries. In the parent grant, approaches were developed to objectively determine patient-specific impairment and disfigurement of the circumoral region for after revision surgeries in patients 5 to 21 years of age. It would be of great value to surgeons to know the functional capability of the circumoral region before the initial surgical repair of the cleft defect so that they may be better informed about the biological effects of the repair, and as a result, gain information to improve the surgical outcome and limit the need for additional surgeries. We will explore the use of novel measures developed in the parent grant for the assessment of facial soft tissue functional characteristics in a group of cleft babies followed longitudinally and tested before and after primary lip surgery. A second group of age-matched, non-cleft babies will serve as controls and will be tested at similar time points. The Specific Aims of the application are as follows. 1) To collect 3D dynamic and static facial images from a group of babies born with a cleft lip (with or without a cleft palate) before and after primary lip repair;and from a group of age- and sex-matched non-cleft control babies. 2) To develop and refine objective measures of facial function and form that will be applicable for babies with facial disability;and 3) To explore the use of preliminary analyses to determine differences in facial function and form between babies with and without a cleft lip;and for those babies with a cleft lip, before and after primary lip repair. PUBLIC HEALTH RELEVANCE: The esthetic results after an initial or primary lip repair in patients with a cleft lip tend to be highly variable. Many patients remain with an obvious facial disability, and may require additional 'revision'surgeries. In the parent grant, we developed methods and analyses to objectively quantify facial form and movement characteristics in patients 5 to 21 years of age. The intent of this application is to apply our methods and explore analyses to assess dynamic facial movements and static facial form that are present in babies at an early age of 6 months, and to determine how the form is affected and whether the facial movement is still apparent after the primary lip surgery. Such information can help determine how early in age longitudinal observations need to be obtained for a comparison of treatment intervention methods.