Evaluation of Facial Appearance in Patients with Cleft Lip and Palate by Laypeople and Professionals: A Systematic Literature Review

Abstract

Objective To identify whether laypeople and professionals rate the facial appearance of patients with cleft lip and palate (CLP) similarly based on viewing full facial images. Design Several electronic databases were searched. A hand search was performed among reference lists and relevant journals. Studies that assessed the full facial appearance of patients with CLP based on two-dimensional (2D) photographs, 3D images, or clinical examination by laypeople and professionals using a visual analog scale (VAS) or a categorical rating scale were included. Two authors independently assessed articles using methodologic-quality scoring protocol. Results Eleven articles were included in qualitative synthesis, including four high-level and seven moderate-level papers. Three studies found that laypeople were more critical than professionals, three found there was no significant difference between laypeople and professionals, and five reported that professionals were more critical than laypeople when assessing facial appearance of patients with CLP. Conclusions It still remains unknown whether laypeople are more or less critical than professionals when rating facial appearance of patients with repaired CLP. Professionals are more familiar with the esthetic outcomes and difficulties of treating patients. The opposite maybe true for laypeople; this disparity between what is achievable by professionals and what is expected by laypeople may be a source of dissatisfaction in facial appearance outcome. Further well-designed studies should be carried out to address this question and the clinical significance of the difference in rating scores for patients with CLP.

Facial Aesthetics in Young Adults after Cleft Lip and Palate Treatment over Five Decades

“…It is a matter of debate whether or not expert or lay raters reach different conclusions 14 . To account for possible differences attributable to the raters’ experience or gender, we analyzed the respective subgroups.…”

“…It is a matter of debate whether or not the face-perception differs between experts in the field or lay persons, between females and males 14 , 20 . Because an average of the scores of three raters appears to be sufficient for a substantial reliability in rating nasolabial appearance 21 , we recruited female and male raters, who were experts in the field or lay persons to form a panel of 12 raters altogether.…”

“…It is an open question whether the judgements of experts or lay persons are more relevant. There may be large differences between the judgement of experts in the field or lay raters 14 . In contrast, Meng et al .…”

A study to evaluate the reliability of using two-dimensional photographs, three-dimensional images, and stereoscopic projected three-dimensional images for patient assessment

“…Localization on a specific region, ignoring the pan-facial appearance, has recently been questioned 13 .…”

Comparison of professional and laypeople evaluation of nasolabial esthetics following unilateral cleft lip repair

“…[ 11 ] Notwithstanding, the opinion and support of laypeople such as friends and peers have been shown to also have an effect on the psychological well-being of an individual. [ 12 ] Similarly, clinicians’ opinion about facial appearance may have important implications for the management as they may affect patients’ and parents’ perceptions of the need for treatment.…”