A detailed description of soft tissue morphology in unilateral cleft lip and palate cases--a study applying a new soft tissue analysis.

More than 1,500 CLP patients have been treated in Berne using a protocol which has always remained fundamentally the same. Even though--from birth to 20 years of age--the finest possible plastic surgery, orthodontics and prosthodontics were undertaken, the specialists involved considered that the patient, at the end of treatment, still possessed a CLP appearance to some extent. Neither the cephalometric analyses, nor the occlusal findings, however, provided any explanation for this, and a new method of soft tissue analysis was therefore developed to provide a detailed picture of the tissue overlying the skeletal profile. This involved taking sagittal cephalometric hard tissue landmarks and locating the equivalent points on the soft tissues. The corresponding hard and soft tissue points were then related to each other both horizontally and vertically. In this way, the soft tissue width along the entire profile could be defined together with the angles around the curvature of the face. Such an analysis makes it possible to describe the soft tissue profile in individual cases and to compare cleft and non-cleft populations. In the present study 25 males (mean age 18) and 23 females (mean age 16.7) with unilateral complete CLP were analysed to define in detail the criteria forming the "cleft palate face".