Digitalized analysis of philtral anatomy for planning individual treatment.

OBJECTIVE: Restoration of the philtral region following traumatic, cleft, and tumor surgeries is often difficult due to influence of this feature to whole facial beauty. The aim of this study is to investigate the types and measurements of the philtrum and its relationship with the upper lip using a software. METHODS: Standard personal photographs of the philtral region were obtained from 200 young adults participated in this study. Linear analyses (the lengths of philtral column and dimple; the philtral width) and angular analyses (apex and central angles of Cupid's bow) were measured as reference points. As for the shape of the philtral column, it was categorized as four distinct types: parallel, triangular, concave, and unclear type. RESULTS: The philtral width was 11.37 ± 1.9 mm in males, 10.21 ± 1.80 mm in females. The length of the philtral dimple was 18.16 ± 3.6 mm in males, 18.16 ± 3.6 mm in females. Compared with women, both of the measured average philtral reference lengths displayed a significantly greater value in men. In the meanwhile, compared to women, the angular measurements of Cupid's bow (i.e., the apex and central angle of Cupid's bow) were smaller in men. It was 127.47 ± 12.74° mm in males, 134.1 ± 11.38° mm in females. The triangular and concave types were associated with a substantial fraction in men, whereas the triangular and parallel types were predominant in women. There were significant gender differences in the esthetic rankings of philtral column shapes. CONCLUSIONS: These results suggest digitalized reference values relative to the philtral column which may increase the success of the individual reconstructive treatment of the surgical procedures and reduce possible asymmetrical appearance. With the help of certain software, this research has made possible to investigate the ideal parameters of philtral construction in defining the best surgical solution for the patient.

Formation of Philtral Column using AlloDerm(R) in Secondary Cleft Lip Deformity

It is essential to reconstruct philtral column correctly during cheiloplasty because philtrum has an important role in facial contouring and cosmetics of the human face. Regarding to the appropriate time of the philtral reconstruction, it is generally accepted that Millard rotation- advancement flap at the primary cheiloplasty has the advantages of decreasing tension and obtaining a remnant skin. But, many surgeons still have a tendency to reconstruct the philtrum during secondary cheiloplasty. From June 2000 to June 2001, at department of plastic and reconstructive surgery of Chonnam National University Hospital, 20 patients of secondary cleft lip and nasal deformity who previously received primary cheiloplasty were reconstructed the philtral column with acelluar human dermis(AlloDerm(R)) In conclusion, this technique have the several advantages such as simplicity, shorter operation time, absent donor site scar and effectiveness, compared with other surgical methods.