The shape of philtrum column in Jordanian population for its application in geometric

الملخص EN

Background : The definitive goal of plastic surgery in congenital craniofacial anomalies is to create symmetry and reach near normal aesthetic appearance.

Comprehensive knowledge of normal facial shape and aesthetic subunits will help surgeons in their preoperative strategies for success.

Lips are the cornerstone in facial appearance and the philtrum represents its central aesthetic subunit.

Since measures and topography of normal facial appearance vary among different races and communities, several studies have delineated the variations in philtral morphology in different communities.

In this prospective study, performed by pediatric dentists and plastic surgeons, we delineate the different morphologies of philtrum in normal Jordanian pediatric population which will have practical applications in cleft lip surgery.

Methods : This was a prospective study in 200Jordanian children (106 males, 94 females)of less than 14 years of age presented to dental pediatric clinic at King Hussein Medical Center, without any craniofacial anomalies or trauma.

The ethical committee approved the study, and consent forms were signed by the parents before taking photos of the children.

All medical photographs of each participant in 3 views (frontal, basal and lateral)were taken using a Samsung S6 edge plus digital 16-megapixel camera (Samsung South Korea).

The photographs were analyzed blindly by three plastic surgeons, to determine the shape of philtrum for each participant using the following points: 1.

The peaks of the Cupid’s bow (cphi–cphi) 2.

Origin of philtral column at each side(cphs-cphs) Photos were analyzed using MS Paint program for photos (Microsoft Paint for Windows 7).

Our classification of the morphology of the philtrum was based on modifications of A.

Mori et al.ˡ in Japanese children : Type 1 triangular, type 2 parallel, type 3 concave and type 4 flat(Fig.2).

Limitations to this study include The quality and limitations of two-dimensional photographic assessments compared to three-dimensional photogrammetric systems, its sensitivity to the angle at which the photograph is captured and the position of the subject, however, it’s cost-effective and noninvasive in terms of facial shape evaluation especially if high-resolution medical photography is used.

Also, another limitation is the need for three-dimensional photogrammetry or lasers system for accurate anthropometric distance measurements, and if there are true morphological changes in correlation with the age of each subject.

Results: The most common morphology of philtrum was type 1- triangular, observed in 92/200 (46 %)children.

The least common morphology of philtrum was type 4-flat, observed in 7/200 (3.5 %) children.

Conclusion: The definitive goal of cleft lip surgery is to obtain near normalcy in function and aesthetics, keeping in mind that facial morphology varies among different races, we hope that the results of our study delineate the different morphologies of philtrum shape in Jordanian children and will be a synergistic tool for our surgeons in their preoperative markings and planning.