{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:17:45Z","timestamp":1789168665532,"version":"build-2803163510"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Herzzentrum G\u00f6ttingen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>The aim of the present study was to objectively assess the degree of residual facial asymmetry after primary treatment of non-syndromic unilateral cleft lip and palate (UCLP) in children and to correlate it with subjective ratings of facial appearance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>Stereophotometry was used to record the faces of 89 children with UCLP for comparison of cleft and non-cleft sides up to 5 years after primary cleft closure. Root mean square values were calculated to measure the difference between the shape of cleft and non-cleft sides of the face and were compared to controls without a cleft lip. The Asher-McDade Aesthetic Index (AMAI) was used for subjective rating of the nasolabial area through 12 laypersons.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Children with a cleft lip (CL) showed no significant difference in RMS values compared to controls. Significant differences occurred when the evaluation was limited to the nasolabial area, however only in patients with cleft lip alveolus (CLA) and cleft lip palate (CLAP)(<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In contrast, subjective ratings showed significantly higher values for all three cleft severity groups (CL, CLA, CLAP) compared to controls (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was a non-linear correlation between the RMS (root mean square) values and the AMAI score.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Even non-significant discrete objective deviations from facial symmetry in children after primary closure of UCLP are vigilantly registered in subjective ratings and implemented in the judgement of facial appearance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance<\/jats:title>\n                <jats:p>3D stereophotometry is a usefull tool in monitoring asymmetry in patients with a cleft.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00784-024-05839-4","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T21:05:15Z","timestamp":1722027915000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effect of facial and nasolabial asymmetry on perceived facial esthetics in children with non-syndromic cleft lip and palate"],"prefix":"10.1007","volume":"28","author":[{"given":"Philipp","family":"Kauffmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Kolle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Quast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Wolfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Schminke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Meyer-Marcotty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Schliephake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"key":"5839_CR1","first-page":"108","volume":"44","author":"A Quast","year":"2022","unstructured":"Quast A, Batschkus S, Brinkmann J, Schliephake H, Alpers GW, Meyer-Marcotty P, Gerdes ABM (2022) Effect of cleft lip on adolescent evaluation of faces: An Eye-Tracking Study. Pediatr Dent 44:108\u2013113","journal-title":"Pediatr Dent"},{"key":"5839_CR2","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1597\/08-244","volume":"48","author":"P Meyer-Marcotty","year":"2011","unstructured":"Meyer-Marcotty P, Gerdes AB, Stellzig-Eisenhauer A, Alpers GW (2011) Visual face perception of adults with unilateral cleft lip and palate in comparison to controls\u2013an eye-tracking study. Cleft Palate Craniofac J 48:210\u2013216. https:\/\/doi.org\/10.1597\/08-244","journal-title":"Cleft Palate Craniofac J"},{"key":"5839_CR3","doi-asserted-by":"publisher","unstructured":"Dindaroglu F, Dogan E, Dogan S (2022) Is the Nasolabial Region Symmetric in individuals with cleft lip and palate? Cleft palate Craniofac J:10556656221116535. https:\/\/doi.org\/10.1177\/10556656221116535","DOI":"10.1177\/10556656221116535"},{"key":"5839_CR4","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1016\/j.bjps.2012.04.001","volume":"65","author":"VP Sharma","year":"2012","unstructured":"Sharma VP, Bella H, Cadier MM, Pigott RW, Goodacre TE, Richard BM (2012) Outcomes in facial aesthetics in cleft lip and palate surgery: a systematic review. J Plast Reconstr Aesthet Surg 65:1233\u20131245. https:\/\/doi.org\/10.1016\/j.bjps.2012.04.001","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"5839_CR5","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1016\/j.ijom.2018.05.017","volume":"47","author":"LAM Thierens","year":"2018","unstructured":"Thierens LAM, De Roo NMC, De Pauw GAM, Brusselaers N (2018) Assessment modalities of non-ionizing three-dimensional images for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate: a systematic review. Int J Oral Maxillofac Surg 47:1095\u20131105. https:\/\/doi.org\/10.1016\/j.ijom.2018.05.017","journal-title":"Int J Oral Maxillofac Surg"},{"key":"5839_CR6","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1043\/0003-3219(1995)065<0233:Mfqfai>2.0.Co;2","volume":"65","author":"F Ras","year":"1995","unstructured":"Ras F, Habets LL, van Ginkel FC, Prahl-Andersen B (1995) Method for quantifying facial asymmetry in three dimensions using stereophotogrammetry. Angle Orthod 65:233\u2013239. https:\/\/doi.org\/10.1043\/0003-3219(1995)065%3C0233:Mfqfai%3E2.0.Co;2","journal-title":"Angle Orthod"},{"key":"5839_CR7","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1097\/00001665-200309000-00026","volume":"14","author":"VF Ferrario","year":"2003","unstructured":"Ferrario VF, Sforza C, Dellavia C, Tartaglia GM, Colombo A, Car\u00f9 A (2003) A quantitative three-dimensional assessment of soft tissue facial asymmetry of cleft lip and palate adult patients. J Craniofac Surg 14:739\u2013746. https:\/\/doi.org\/10.1097\/00001665-200309000-00026","journal-title":"J Craniofac Surg"},{"key":"5839_CR8","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.jcms.2006.03.001","volume":"34","author":"S Bilwatsch","year":"2006","unstructured":"Bilwatsch S, Kramer M, Haeusler G, Schuster M, Wurm J, Vairaktaris E, Neukam FW, Nkenke E (2006) Nasolabial symmetry following Tennison-Randall lip repair: a three-dimensional approach in 10-year-old patients with unilateral clefts of lip, alveolus and palate. J Craniomaxillofac Surg 34:253\u2013262. https:\/\/doi.org\/10.1016\/j.jcms.2006.03.001","journal-title":"J Craniomaxillofac Surg"},{"key":"5839_CR9","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1177\/1055665617726532","volume":"55","author":"I Bagante","year":"2018","unstructured":"Bagante I, Zepa I, Akota I (2018) 3D Assessment of Nasolabial Appearance in patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J 55:220\u2013225. https:\/\/doi.org\/10.1177\/1055665617726532","journal-title":"Cleft Palate Craniofac J"},{"key":"5839_CR10","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1177\/10556656211012858","volume":"59","author":"L Mancini","year":"2022","unstructured":"Mancini L, Avinoam S, Grayson BH, Flores RL, Staffenberg DA, Shetye PR (2022) Three-Dimensional Nasolabial Changes after Nasoalveolar Molding and primary Lip\/Nose surgery in infants with bilateral cleft lip and palate. Cleft Palate Craniofac J 59:475\u2013483. https:\/\/doi.org\/10.1177\/10556656211012858","journal-title":"Cleft Palate Craniofac J"},{"key":"5839_CR11","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.bjoms.2020.09.001","volume":"59","author":"RM Thomson","year":"2021","unstructured":"Thomson RM, Azzopardi E, Drake D (2021) Validating the Asher-McDade score to assess facial aesthetic outcomes in 22 consecutive complete bilateral cleft lip repairs. Br J Oral Maxillofac Surg 59:375\u2013379. https:\/\/doi.org\/10.1016\/j.bjoms.2020.09.001","journal-title":"Br J Oral Maxillofac Surg"},{"key":"5839_CR12","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1097\/scs.0000000000001784","volume":"26","author":"DG Mosmuller","year":"2015","unstructured":"Mosmuller DG, Bijnen CL, Kramer GJ, Disse MA, Prahl C, Kuik DJ, Niessen FB, Don Griot JP (2015) The Asher-McDade Aesthetic Index in Comparison with two Scoring systems in Nonsyndromic Complete Unilateral Cleft lip and palate patients. J Craniofac Surg 26:1242\u20131245. https:\/\/doi.org\/10.1097\/scs.0000000000001784","journal-title":"J Craniofac Surg"},{"key":"5839_CR13","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1093\/ejo\/cjv024","volume":"38","author":"A Stebel","year":"2016","unstructured":"Stebel A, Desmedt D, Bronkhorst E, Kuijpers MA, Fudalej PS (2016) Rating nasolabial appearance on three-dimensional images in cleft lip and palate: a comparison with standard photographs. Eur J Orthod 38:197\u2013201. https:\/\/doi.org\/10.1093\/ejo\/cjv024","journal-title":"Eur J Orthod"},{"key":"5839_CR14","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.ijom.2020.06.003","volume":"50","author":"MAR Kuijpers","year":"2021","unstructured":"Kuijpers MAR, Maal TJJ, Meulstee JW, Carels CEL, Bronkhorst EM, Berg\u00e9 SJ, Fudalej PS (2021) Nasolabial shape and aesthetics in unilateral cleft lip and palate: an analysis of nasolabial shape using a mean 3D facial template. Int J Oral Maxillofac Surg 50:267\u2013272. https:\/\/doi.org\/10.1016\/j.ijom.2020.06.003","journal-title":"Int J Oral Maxillofac Surg"},{"key":"5839_CR15","doi-asserted-by":"publisher","first-page":"2853","DOI":"10.1007\/s00784-019-03150-1","volume":"24","author":"SA Othman","year":"2020","unstructured":"Othman SA, Saffai L, Wan Hassan WN (2020) Validity and reproducibility of the 3D VECTRA photogrammetric surface imaging system for the maxillofacial anthropometric measurement on cleft patients. Clin Oral Investig 24:2853\u20132866. https:\/\/doi.org\/10.1007\/s00784-019-03150-1","journal-title":"Clin Oral Investig"},{"key":"5839_CR16","doi-asserted-by":"publisher","unstructured":"Asher-McDade C, Roberts C, Shaw WC, Gallager C (1991) Development of a method for rating nasolabial appearance in patients with clefts of the lip and palate. Cleft Palate Craniofac J 28:385\u2009\u2013\u200990; discussion 390-1. https:\/\/doi.org\/10.1597\/1545-1569_1991_028_0385_doamfr_2.3.co_2","DOI":"10.1597\/1545-1569_1991_028_0385_doamfr_2.3.co_2"},{"key":"5839_CR17","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s00056-007-0652-y","volume":"68","author":"J Hartmann","year":"2007","unstructured":"Hartmann J, Meyer-Marcotty P, Benz M, H\u00e4usler G, Stellzig-Eisenhauer A (2007) Reliability of a Method for Computing Facial Symmetry Plane and Degree of Asymmetry based on 3D-data. J Orofac Orthop 68:477\u2013490. https:\/\/doi.org\/10.1007\/s00056-007-0652-y","journal-title":"J Orofac Orthop"},{"key":"5839_CR18","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1016\/j.jcms.2016.07.017","volume":"44","author":"T Verhoeven","year":"2016","unstructured":"Verhoeven T, Xi T, Schreurs R, Berg\u00e9 S, Maal T (2016) Quantification of facial asymmetry: a comparative study of landmark-based and surface-based registrations. J Craniomaxillofac Surg 44:1131\u20131136. https:\/\/doi.org\/10.1016\/j.jcms.2016.07.017","journal-title":"J Craniomaxillofac Surg"},{"key":"5839_CR19","doi-asserted-by":"publisher","unstructured":"Shiigi A, Okawachi T, Kamiya T, Hosoki D, Nomoto N, Ratman MF, Amir MS, Ishihata K, Nakamura N (2022) Three-dimensional quantification of postoperative facial asymmetry in patients with unilateral cleft lip and palate using Facial Symmetry Plane. Cleft Palate Craniofac J 10556656221123276. https:\/\/doi.org\/10.1177\/10556656221123276","DOI":"10.1177\/10556656221123276"},{"key":"5839_CR20","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1007\/s00784-015-1445-0","volume":"19","author":"DJ Desmedt","year":"2015","unstructured":"Desmedt DJ, Maal TJ, Kuijpers MA, Bronkhorst EM, Kuijpers-Jagtman AM, Fudalej PS (2015) Nasolabial symmetry and esthetics in cleft lip and palate: analysis of 3D facial images. Clin Oral Investig 19:1833\u20131842. https:\/\/doi.org\/10.1007\/s00784-015-1445-0","journal-title":"Clin Oral Investig"},{"key":"5839_CR21","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1016\/j.jcms.2018.03.023","volume":"46","author":"D Al-Rudainy","year":"2018","unstructured":"Al-Rudainy D, Ju X, Stanton S, Mehendale FV, Ayoub A (2018) Assessment of regional asymmetry of the face before and after surgical correction of unilateral cleft lip. J Craniomaxillofac Surg 46:974\u2013978. https:\/\/doi.org\/10.1016\/j.jcms.2018.03.023","journal-title":"J Craniomaxillofac Surg"},{"key":"5839_CR22","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1046\/j.1365-263x.2003.00496.x","volume":"13","author":"CA Hood","year":"2003","unstructured":"Hood CA, Bock M, Hosey MT, Bowman A, Ayoub AF (2003) Facial asymmetry\u20133D assessment of infants with cleft lip & palate. Int J Paediatr Dent 13:404\u2013410. https:\/\/doi.org\/10.1046\/j.1365-263x.2003.00496.x","journal-title":"Int J Paediatr Dent"},{"key":"5839_CR23","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1177\/0022034509359488","volume":"89","author":"P Meyer-Marcotty","year":"2010","unstructured":"Meyer-Marcotty P, Gerdes AB, Reuther T, Stellzig-Eisenhauer A, Alpers GW (2010) Persons with cleft lip and palate are looked at differently. J Dent Res 89:400\u2013404. https:\/\/doi.org\/10.1177\/0022034509359488","journal-title":"J Dent Res"},{"key":"5839_CR24","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1097\/scs.0000000000005068","volume":"30","author":"CN Warne","year":"2019","unstructured":"Warne CN, Hallac RR, Kane AA, Derderian CA, Seaward JR (2019) Eye Tracking as a Proxy for Perceptual evaluation of repaired cleft lip. J Craniofac Surg 30:395\u2013399. https:\/\/doi.org\/10.1097\/scs.0000000000005068","journal-title":"J Craniofac Surg"},{"key":"5839_CR25","doi-asserted-by":"publisher","first-page":"29371","DOI":"10.1073\/pnas.1912343117","volume":"117","author":"CK Ryali","year":"2020","unstructured":"Ryali CK, Goffin S, Winkielman P, Yu AJ (2020) From likely to likable: the role of statistical typicality in human social assessment of faces. Proc Natl Acad Sci U S A 117:29371\u201329380. https:\/\/doi.org\/10.1073\/pnas.1912343117","journal-title":"Proc Natl Acad Sci U S A"},{"key":"5839_CR26","doi-asserted-by":"publisher","first-page":"168e1","DOI":"10.1016\/j.ajodo.2008.11.023","volume":"137","author":"P Meyer-Marcotty","year":"2010","unstructured":"Meyer-Marcotty P, Alpers GW, Gerdes AB, Stellzig-Eisenhauer A (2010) Impact of facial asymmetry in visual perception: a 3-dimensional data analysis. Am J Orthod Dentofac Orthop 137:168e1\u2013168e8. https:\/\/doi.org\/10.1016\/j.ajodo.2008.11.023","journal-title":"Am J Orthod Dentofac Orthop"},{"key":"5839_CR27","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s00056-018-0157-x","volume":"79","author":"A Quast","year":"2018","unstructured":"Quast A, Waschkau J, Saptschak J, Daratsianos N, Jordan K, Fromberger P, M\u00fcller JL, Meyer-Marcotty P (2018) Facial perception of infants with cleft lip and palate with\/without the NAM appliance. J Orofac Orthop 79:380\u2013388. https:\/\/doi.org\/10.1007\/s00056-018-0157-x","journal-title":"J Orofac Orthop"},{"key":"5839_CR28","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.1016\/j.jcms.2015.07.003","volume":"43","author":"O van Schijndel","year":"2015","unstructured":"van Schijndel O, Litschel R, Maal TJ, Berg\u00e9 SJ, Tasman AJ (2015) Eye tracker based study: perception of faces with a cleft lip and nose deformity. J Craniomaxillofac Surg 43:1620\u20131625. https:\/\/doi.org\/10.1016\/j.jcms.2015.07.003","journal-title":"J Craniomaxillofac Surg"},{"key":"5839_CR29","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1177\/1055665619868332","volume":"57","author":"E Karp","year":"2020","unstructured":"Karp E, Scott A, Martin K, Zavala H, Chinnadurai S, Roby B (2020) Developing an Eye-Tracking Protocol to determine children\u2019s visual perception of secondary cleft lip deformity. Cleft Palate Craniofac J 57:321\u2013326. https:\/\/doi.org\/10.1177\/1055665619868332","journal-title":"Cleft Palate Craniofac J"}],"container-title":["Clinical Oral Investigations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-024-05839-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-024-05839-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-024-05839-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T08:44:13Z","timestamp":1724402653000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00784-024-05839-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,26]]},"references-count":29,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["5839"],"URL":"https:\/\/doi.org\/10.1007\/s00784-024-05839-4","relation":{},"ISSN":["1436-3771"],"issn-type":[{"value":"1436-3771","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,26]]},"assertion":[{"value":"2 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This observational study was approved by the Ethics Committee of the University Medical Center Goettingen (21\/4\/20) in accordance with the Declaration of Helsinki. Informed Consent was Not Applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"449"}}