{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:29:25Z","timestamp":1791502165125,"version":"4.3.4"},"reference-count":41,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T00:00:00Z","timestamp":1601424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Surgical outcomes for patients with complete cleft lips are not as ideal as those achieved for milder phenotypes. We hypothesized that in addition to the greater width of the cleft, patients with complete cleft lip and palate exhibit a greater degree of hypoplasia and asymmetry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Stereophotographs of 14 infants with unrepaired unilateral complete and 14 with incomplete cleft lips were measured using Vectra imaging software (Canfield Imaging). Unpaired t tests were used to compare measured asymmetry between groups. Measurements included nasion to endocathion, sn-sbal, subnasale to alare (sn-al), subnasale to crista philtra, subalare to crista philtra (sbal-cphi), chelion to crista philtra, lateral lip element fullness, medial lip element fullness (mef), and non-cleft lip fullness. Duplicate measurements allowed Pearson correlation to be used to determine intra-rater reliability. Statistical significance was set at P &lt; .05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Degree of asymmetry of the nasal base, sn-al, and sn-sbal was significantly greater for patients with complete clefts ( P = .0001, P = .0001). Hypoplasia of the lateral lip element was seen when comparing lateral and mef ( P = .04, P = .004) and lateral lip height (sbal-cphi\u2019\u2019; P = .002). The degree of cupid\u2019s bow asymmetry did not differ between groups ( P = .23). Intrarater reliability was high for all facial measures, ranging from 0.70 to 0.99.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>More severe, complete cleft lips demonstrate statistically significant greater asymmetry in surgically relevant dimensions. There was greater width of the nasal base. Vertical asymmetry of cupid\u2019s bow was unaffected by cleft severity, but that asymmetry was greater in patients with complete clefts due to hypoplasia of the lateral lip element. This may contribute to the less favorable results in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665620962365","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T05:52:29Z","timestamp":1601445149000},"page":"539-545","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Degree of Asymmetry Between Patients With Complete and Incomplete Cleft Lips"],"prefix":"10.1177","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8812-5147","authenticated-orcid":false,"given":"Diana S.","family":"Jodeh","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Cray","sequence":"additional","affiliation":[{"name":"Department of Biomedical Education & Anatomy, The Ohio State University College of Medicine, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Alex","family":"Rottgers","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,9,30]]},"reference":[{"key":"bibr1-1055665620962365","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.30959"},{"key":"bibr2-1055665620962365","first-page":"372751","volume":"2013","author":"Alonso N","year":"2013","journal-title":"Plast Surg Int"},{"key":"bibr3-1055665620962365","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3182(81)73469-8"},{"key":"bibr4-1055665620962365","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2016.00067"},{"key":"bibr5-1055665620962365","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002083"},{"key":"bibr6-1055665620962365","first-page":"502","volume-title":"Plastic Surgery: Volume 3: Craniofacial, Head and Neck Surgery and Pediatric 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