Implementation of standardized medical photography for cleft lip and palate audit

Abstract

Much has been published relating to the treatment and surgical outcome of cleft lip and palate disorders. Clinical audit is one of the most important tools for assessing the quality of care provided, with medical photography an invaluable component of this process. The Clinical Standards Advisory Group Report 1998 recommended that cleft lip and palate patients should be audited when 0 (under 1 year of age), and then at the ages of 5, 10, 15 and 20 years. For both audit and research purposes, medical photographs need to be accurate and of a consistently high standard. This paper describes the development of a standardized photographic protocol for cleft patients of audit age, to the benefit of both the multidisciplinary team and the patients.

Standards for digital photography in cranio-maxillo-facial surgery – Part II: Additional picture sets and avoiding common mistakes

“…Although there is a variety of recommendations for picture sets in the literature for different medical fields (Sandler and Murray, 2001;Galdino et al, 2002;Jones and Cadier, 2004) the authors have endeavoured to minimize the picture set as far as possible. Overall 19 facial and five intraoral views in five categories are incorporated within the sets.…”

“…For example the Institute of Medical Illustrators in the UK presents some baseline guides related to the treatment and surgical outcome of cleft lip, alveolus and palate disorders (Jones and Cadier, 2004). For documentation of facial nerve weakness, still and moving digital imaging is described in patients undergoing skull base surgery at an otological and neurological clinic (Barrs et al, 2001).…”

“…Other authors have described specific problems, for example the appearance of skin lesions being dependent on illumination (Ikeda et al, 2003) or dramatic changes of appearance of the face and jaw line with extension of the neck, and protrusion of the head which can misrepresent surgical outcome (Jones and Cadier, 2004;Sommer and Mendelsohn, 2004). In addition, the possibility of altering brightness, focal length, patient's position and selective softening or sharpening with computer programs can be used to change the authentic appearance of the surgical outcome.…”

Photographic protocol for image acquisition in craniofacial microsomia

“…Such distraction devices include bubbles, toys with soft sounds and/or lights, or a children's video. We have created a template "Making Faces for the CFM Photo Protocol" (Figure 2) to show participants the types of facial expressions included in this protocol [16]. …”

“…Several photographic protocols exist for assessment of craniofacial surgical outcomes [11-13], including cleft lip repair [14-16]. To our knowledge, a published image acquisition protocol intended to capture the unique craniofacial features associated with CFM does not exist.…”