Effects of lip revision surgery on long-term orosensory function in patients with cleft lip/palate

Abstract

OBJECTIVE : To determine whether secondary lip revision surgery impacts sensitivity of the upper lip. DESIGN : A three-group, parallel, prospective, nonrandomized clinical trial. SETTING : University of North Carolina School of Dentistry. PATIENTS, PARTICIPANTS : Three groups: (1) patients with repaired cleft lip/palate who were scheduled for lip revision (revision; N = 20); (2) patients with repaired cleft lip/palate who did not receive a lip revision (non-revision; N = 13); and (3) non-cleft control subjects (non-cleft; N = 22). Interventions : Lip revision surgery. MAIN OUTCOME MEASURES : Measures of (1) two-point perception threshold (two-point), (2) warmth detection threshold (warm), and (3) cool detection threshold (cool) were obtained from two sites on the upper lip vermilion. The revision participants were tested approximately 1 week before surgery and then approximately 3 and 12 months after surgery. The non-revision and non-cleft participants were tested at similar times. RESULTS : There were no significant differences among the three groups at baseline for two-point, warm, or cool. The main effects of group, age, sex, and time were not statistically significant for the two-point or warm (p > .05). The mean differences between the 3- and 12-month follow-up visits and baseline for two-point and warm were small for all three groups. For cool, group was statistically significant (p = .04), the difference in the non-revision group between follow-up and baseline was 31% to 34% higher than in the non-cleft group (p = .01). CONCLUSIONS : Although at postsurgery revision participants exhibited threshold values comparable to presurgical values, the sensory differences observed among subgroups of participants with cleft lip are complex.

Figures

FIGURE 1

Estimated two-point perception impairment by group. Shown are the ratios of the geometric mean thresholds from each of the follow-up visits to the baseline visit, separately for male and female patients at the mean age at enrollment (15.84 years).

FIGURE 2

Estimated warmth detection threshold impairment by group. Shown are the ratios of the geometric mean thresholds from each of the follow-up visits to the baseline visit, separately for male and female patients at the mean age at enrollment (15.84 years).

FIGURE 3

Estimated cool detection threshold impairment by group. Shown are the ratios of the geometric mean thresholds from each of the follow-up visits to the baseline visit, separately for male and female patients at the mean age at enrollment (15.84 years).