Assessment of Bilateral Cleft Lip Nose Deformity: A Comparison of Results as Judged by Cleft Surgeons and Laypersons

Lo, Lun-Jou; Wong, Fen-Hwa; Mardini, Samir; Chen, Yu-Ray; Noordhoff, Samuel M.

doi:10.1097/01.prs.0000019707.07149.da

Cited by 15 publications

(23 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was heterogeneity in the assessment panel which included a lay person, an adult with a cleft and professionals (cleft orthodontist, cleft speech and language therapist, cleft surgeon, cleft psychologist). Elsewhere, similar groups have evaluated facial appearance in adults with repaired UCLP with no correlation between professional and lay assessments of nasolabial appearance, perhaps not surprisingly given that the evaluation of facial appearance on cropped photographs is not a task familiar to the lay person . Professionals consistently rate the appearance as being ‘better’ than lay assessors .…”

Section: Discussionmentioning

confidence: 99%

Structural outcomes in the Cleft Care UK study. Part 2: dento‐facial outcomes

Al-Ghatam

Jones

Ireland

et al. 2015

Orthod Craniofacial Res

View full text Add to dashboard Cite

Structured AbstractObjectivesTo compare facial appearance and dento-alveolar relationship outcomes from the CSAG (1998) and CCUK (2013) studies.Setting and sample populationFive-year-olds born with non-syndromic unilateral cleft lip and palate. Those in the original CSAG were treated in a dispersed model of care with low-volume operators. Those in CCUK were treated in a more centralized, high-volume operator model.Materials and methodsWe compared facial appearance using frontal view photographs (252 CCUK, 239 CSAG) and dental relationships using study models (198 CCUK, 223 CSAG). Facial appearance was scored by a panel of six assessors using a standardized and validated outcome tool. Dento-alveolar relationships were scored by two assessors using the 5-Year-Olds’ Index. Ordinal regression was used to compare results between surveys.ResultsExcellent or good facial appearance was seen in 36.2% of CCUK compared with 31.9% in CSAG. In CCUK, 21.6% were rated as having poor or very poor facial appearance compared with 27.6% in CSAG. The percentage rated as having excellent or good dento-alveolar relationships was 53.0% in CCUK compared with 29.6% in CSAG. In CCUK, 19.2% were rated as having poor or very poor dento-alveolar relationships compared to 36.3% in CSAG. The odds ratios for improved outcome in CCUK compared to CSAG were 1.43 (95% CI 1.03, 1.97) for facial appearance and 2.29 (95% CI 1.47, 3.55) for dento-alveolar relationships.ConclusionsFacial and dento-alveolar outcomes were better in CCUK children compared to those in CSAG.

show abstract

Section: Discussionmentioning

confidence: 99%

Structural outcomes in the Cleft Care UK study. Part 2: dento‐facial outcomes

Al-Ghatam

Jones

Ireland

et al. 2015

Orthod Craniofacial Res

View full text Add to dashboard Cite

show abstract

“…A large proportion of adults with clefts expressed the need for further surgical treatment ( Marcusson et al , 2002 ). In terms of a third party perspective regarding bilateral cleft lip nasal deformity correction, no signi cant differences have been found between the aesthetic ratings of professional and lay raters ( Lo et al , 2002 ).…”

Section: Ofmentioning

confidence: 99%

Facial aesthetics and perceived need for further treatment among adults with repaired cleft as assessed by cleft team professionals and laypersons

Foo¹,

Sampson²,

Roberts³

et al. 2011

The European Journal of Orthodontics

View full text Add to dashboard Cite

The objectives of this study were to compare the ratings of professionals and laypeople with and without a cleft regarding the facial aesthetics of adult patients previously treated for orofacial clefting. The necessity for further treatment, as perceived by the respective groups, is also compared. The design of the study was a cross-sectional study. Professionals (two plastic surgeons, one dentist, one orthodontist, and one psychologist) and laypeople (one male and one female adult without a cleft and one male and one female adult with a cleft) were recruited to rate photographs of 80 non-syndromic cleft patients treated by the Australian Craniofacial Unit from 1975 to 2009. Facial aesthetics were measured by a visual analogue scale (VAS; 0-100 mm). High values indicated good aesthetics. Necessity for further treatment was also measured by a VAS (0-100 mm). High values indicated high perceived need for further treatment. The professionals rated facial aesthetics significantly lower and had a lower perception of need for further treatment than the raters with and without a cleft. The laypeople with a cleft rated facial aesthetics significantly higher and had a lower perceived need for further treatment than laypeople without a cleft. The non-surgical professionals rated facial aesthetics significantly lower and had a lower perceived need for further treatment than the surgical professionals. Differences exist in the facial aesthetics ratings and perceived need for further surgery between professionals and laypeople with and without a cleft. This should be considered when managing cleft treatment expectations.

show abstract

“…Interestingly, the post-OGS panel assessment-based results revealed that raters appraised the patients treated with 3D simulation as more symmetrical than 2D planning-treated patients, proposing that the facial changes after OGS treatment impacted the raters' perceptions. The subjective results from lay raters are clinically plausible as it acts as a simulated environment of social interactions in daily life and also symbolizes the external validity in terms of the public members' observations of facial deformity and its surgical management 50,51 .…”

Section: Lateral Lower Chin N (%)mentioning

confidence: 98%

Outcome of facial contour asymmetry after conventional two-dimensional versus computer-assisted three-dimensional planning in cleft orthognathic surgery

Hsu

Denadai

Pai

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

Computer-assisted 3D planning has overcome the limitations of conventional 2D planning-guided orthognathic surgery (OGS), but difference for facial contour asymmetry outcome has not been verified to date. This comparative study assessed the facial contour asymmetry outcome of consecutive patients with unilateral cleft lip and palate who underwent 2D planning (n = 37)-or 3D simulation (n = 38)-guided OGS treatment for correction of maxillary hypoplasia and skeletal Class III malocclusion between 2010 and 2018. Normal age-, gender-, and ethnicity-matched individuals (n = 60) were enrolled for comparative analyses. 2D (n = 60, with 30 images for each group) and 3D (n = 43, with 18 and 25 images for 2D planning and 3D simulation groups, respectively) photogrammetric-based facial contour asymmetry-related measurements were collected from patients and normal individuals. The facial asymmetry was further verified by using subjective perception of a panel composed of 6 blinded raters. On average, the facial contour asymmetry was significantly (all p < 0.05) reduced after 3D virtual surgery planning for all tested parameters, with no significant differences between post-OGS 3D simulation-related values and normal individuals. No significant differences were observed for pre-and post-OGS values in conventional 2D planning-based treatment, with significant (all p < 0.05) differences for all normal individuals-related comparisons. This study suggests that 3D planning presents superior facial contour asymmetry outcome than 2D planning.Orthognathic surgery (OGS) plays a key role for successful management of a myriad of facial deformities associated with malocclusion, with facial asymmetry feature being most frequently associated with skeletal class III malocclusion 1-3 . Particularly, patients with unilateral cleft lip and palate differ from the noncleft population, because they have a congenital orofacial defect compromising both the bone and soft tissues on the lesion side 4-6 , which may be expressed as facial asymmetry 7-15 . Skeletal mature patients with clefts frequently presents with maxillomandibular disharmony (maxillary hypoplasia and skeletal class III malocclusion) which requires OGS treatment 7-15 . As residual facial asymmetry after OGS treatment may negatively impact patients' perceptions about outcome requiring further revisionary surgical interventions [16][17][18][19] , the significance of preoperative prediction of this deformity should not be underestimated 15,16,20 . Therefore, it is of paramount that an accurate diagnosis of asymmetry is accomplished preoperatively for that a precise surgical planning and execution is performed 7,15,16,20 .In this setting, OGS planning has evolved over the past decades 15-24 . Traditionally, OGS planning has been constructed on two-dimensional (2D) cephalometry, 2D photographic analysis, articulators, and dental models 21,22 . However, this planning modality presents limitations for challenging clinical scenarios such as patients with clefts associated with malocclusion a...

show abstract

Assessment of Bilateral Cleft Lip Nose Deformity: A Comparison of Results as Judged by Cleft Surgeons and Laypersons

Cited by 15 publications

References 0 publications

Structural outcomes in the Cleft Care UK study. Part 2: dento‐facial outcomes

Structural outcomes in the Cleft Care UK study. Part 2: dento‐facial outcomes

Facial aesthetics and perceived need for further treatment among adults with repaired cleft as assessed by cleft team professionals and laypersons

Outcome of facial contour asymmetry after conventional two-dimensional versus computer-assisted three-dimensional planning in cleft orthognathic surgery

Contact Info

Product

Resources

About