Primary surgical repair of a cleft lip has significant potential for scarring and disfigurement of the upper lip and nose that requires further correction. Patients, their parents, and the operating surgeons must decide whether the benefits of a secondary lip revision following primary correction of a cleft lip outweigh the risks. Until recently, quantitative data on the benefits of revision surgery have been lacking, and the clinical recommendations for or against revision surgery have necessarily been based on subjective and, therefore, variable evaluations. In the initial grant period, a non-randomized clinical trial was conducted that resulted in significant progress towards the development and characterization of objective quantitative outcomes of revision surgery in patients with cleft lip and palate. The database so established is now the only one in the world that has extensive objective measures of three-dimensional facial soft-tissue movement and morphology, lip force, lip sensation, and sensory-integrative function. The investigations proposed here represent an expansion of this research. Thus, the goals of this continuing project are as follows. 1) To determine how surgeons might use the newly-developed objective measures of lip function in the decision-making process for or against lip revision surgery. 2) To establish """"""""parameters of care"""""""" criteria for secondary lip revision treatment based on standardized, systematic subjective evaluations, and objective measurements. 3) To investigate the long- term functional outcomes of lip revision surgery. This information will be obtained by continuing the present clinical trial and by enrolling an additional cohort of 30 new patients who will receive lip revision surgery. The central hypothesis continues to be that """"""""although contemporary lip revision surgery may improve lip form at rest, function may be further impaired"""""""". This research will enable surgeons to address the following outcomes, and in doing so provide improved patient care: 1) measure the specific functional deficits that are present post-primary lip repair;2) assess the effectiveness of current primary and secondary lip operations;3) assess the long-term effects of lip repair on the maintenance of the circumoral milieu;4) determine whether secondary lip surgery results in significant improvement in lip form and function;and 5) determine whether additional surgery is really warranted. In the future, these evaluations can be used to determine the outcomes of different surgical techniques forlip- revision surgery.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
5R01DE013814-09
Application #
7747972
Study Section
Special Emphasis Panel (ZDE1-RR (71))
Program Officer
Atkinson, Jane C
Project Start
2000-07-01
Project End
2012-12-31
Budget Start
2010-01-01
Budget End
2012-12-31
Support Year
9
Fiscal Year
2010
Total Cost
$603,469
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Dentistry
Type
Schools of Dentistry
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Chu, Shin Ying; Barlow, Steven M; Lee, Jaehoon (2015) Face-referenced measurement of perioral stiffness and speech kinematics in Parkinson's disease. J Speech Lang Hear Res 58:201-12
Mercado, A M; Phillips, C; Vig, K W L et al. (2014) The effects of lip revision surgery on nasolabial esthetics in patients with cleft lip. Orthod Craniofac Res 17:216-25
Trotman, Carroll-Ann; Phillips, Ceib; Faraway, Julian J et al. (2013) Influence of objective three-dimensional measures and movement images on surgeon treatment planning for lip revision surgery. Cleft Palate Craniofac J 50:684-95
Liu, Jun; Xu, Hockin H K; Zhou, Hongzhi et al. (2013) Human umbilical cord stem cell encapsulation in novel macroporous and injectable fibrin for muscle tissue engineering. Acta Biomater 9:4688-97
Essick, Greg; Phillips, Ceib; Chung, Yunro et al. (2013) Effects of lip revision surgery on long-term orosensory function in patients with cleft lip/palate. Cleft Palate Craniofac J 50:507-12
Barlow, Steven M; Trotman, Carroll-Ann; Chu, Shin-Ying et al. (2012) Modification of perioral stiffness in patients with repaired cleft lip and palate. Cleft Palate Craniofac J 49:524-9
Faraway, Julian J; Trotman, Carroll-Ann (2011) Shape change along geodesics with application to cleft lip surgery. J R Stat Soc Ser C Appl Stat 60:743-755
Trotman, Carroll-Ann (2011) Faces in 4 dimensions: Why do we care, and why the fourth dimension? Am J Orthod Dentofacial Orthop 140:895-9
Trotman, C-A; Faraway, J J; Phillips, C et al. (2010) Effects of lip revision surgery in cleft lip/palate patients. J Dent Res 89:728-32
Tanikawa, Chihiro; Takada, Kenji; van Aalst, John et al. (2010) Objective 3D Assessment of Lip Form in Patients with Repaired Cleft Lip. Cleft Palate Craniofac J :

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