Parents of Children with Cleft Lip Exhibit Heightened Visual Attention to the Perioral Area

Abstract

Background: Following high-quality surgical repair, children born with a cleft lip anomaly may still display lasting visual differences. We exposed control adults and parents of affected children to images of children with cleft deformity and compared their visual tracking patterns. The protocol investigated whether parental exposure to secondary cleft deformity heightens or diminishes visual attraction to this type of structural facial variation. Method: Twenty participants (10 control adults, 10 parents of affected children) assessed 40 colored images of children's faces while their eye movements were tracked. Twenty-four control images and 16 repaired cleft lip images were displayed to observers. Nine bilateral facial aesthetic zones were considered as regions of interest. Percentage of time visually fixating within each region, and statistical differences in fixation duration percentage between the two participant groups and across the bilateral regions of interest were analyzed. Results: While both groups of observers directed more visual attention to the nasal and oral regions of the cleft images than control images, parents of children with cleft lip spent significantly more time fixating on these areas (25% and 24% of the time, respectively) than did unaffected adults (14.6% and 19.3%; P < 0.001). Conclusions: These results demonstrate that parents of cleft lip children exhibit heightened attention to this type of facial difference relative to the naive observer. These findings highlight that observer profile can meaningfully influence the perception of a facial deformity. Awareness of this information may enhance communication between surgeon and parents of an affected child by providing added insight into parental perspective.

Correlation of Orthognathic Surgical Movements to Perception of Facial Appearance in Patients With Cleft Lip and Palate

“…Previous reports have demonstrated that cleft-repaired faces were rated as less attractive than non-cleft controls, with greater visual attention to the cleft-affected look-zones 13 . In addition, parents of children with clefts demonstrate heightened attention to these facial differences compared with the naïve observer 14 . Patient-reported outcome metrics have not previously been linked to specific orthognathic surgical movements.…”

“…13 In addition, parents of children with clefts demonstrate heightened attention to these facial differences compared with the naïve observer. 14 Patientreported outcome metrics have not previously been linked to specific orthognathic surgical movements. Here, we demonstrate correlations between skeletal orthognathic movements and both observer perceptions, as well as PROs in patients with CLP.…”