European Journal of Plastic Surgery

, Volume 41, Issue 2, pp 129–136 | Cite as

Difference in nasolabial features between awake and asleep infants with bilateral cleft lip: Anthropometric measurements using three-dimensional stereophotogrammetry

  • Nirina Adrien J. V. Mandrano
  • Daichi Morioka
  • Yasuyoshi Tosa
  • Nobuhiro Sato
  • Erica Masuda
  • Fumio Ohkubo
  • Shinya Yoshimoto
Original Paper



Facial soft tissue anthropometric values change according to a patient’s body position. We compared the facial soft tissue shape between the upright and the supine operative positions in infants with bilateral cleft lip.


Twenty-five infants with bilateral cleft lip were photographed in two different positions. Twenty-three anthropometric landmarks were selected and used for the analysis. Wilcoxon signed rank test was used for comparing the obtained values.


Lip width was significantly broader (3.0 mm in average, p < 0.01) in the supine operative position, whereas no significant differences were found in both lip length and height between the two positions. The cleft width was significantly broader (1.18 mm, p < 0.05) after setting the operative position. No significant changes were observed for the nose elements.


The lip and the cleft width became broader, while the nose elements did not change after setting the operative position. We believe these changes are due to the effects of both gravity and the relaxation of the musculature under general anesthesia. This data could be useful in providing more complete information for surgeons planning bilateral cleft lip treatment.

Level of Evidence: Level IV, diagnostic study.


Cleft lip Three-dimensional anthropometry Body position Facial soft tissue 


Compliance with ethical standards

Conflict of interest

Nirina A. J.V. Mandrano, Daichi Morioka, Yasuyoshi Tosa, Nobuhiro Sato, Erica Masuda, Fumio Ohkubo, and Shinya Yoshimoto declare that they have no conflict of interest.

Patient consent

Parents provided written consent before patient’s inclusion in this study. Additional consent was provided for the use of their images.

Ethical approval

This study was approved by the ethical committee of Showa University and therefore has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


This study did not receive any forms of funding.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Nirina Adrien J. V. Mandrano
    • 1
  • Daichi Morioka
    • 1
  • Yasuyoshi Tosa
    • 1
  • Nobuhiro Sato
    • 1
  • Erica Masuda
    • 1
  • Fumio Ohkubo
    • 1
  • Shinya Yoshimoto
    • 1
  1. 1.Department of Plastic and Reconstructive SurgeryShowa UniversityTokyoJapan

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