Three-Dimensional Nasolabial Displacement during Movement in Repaired Cleft Lip and Palate Patients

Trotman, Carroll Ann; Faraway, Julian J.; Essick, Greg K.

doi:10.1097/00006534-200004000-00003

Cited by 28 publications

(60 citation statements)

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“…For example, after primary lip repair, many patients have a residual impairment in movement and the facial esthetics is compromised. [67][68][69] The ability to supplement and/or generate tissue in the cleft area may be of significant advantage for both the surgeon and the patient. Moreover, as discussed earlier, the method described here has the potential to be of benefit for many other patients with both congenital and acquired muscle deficiencies and disorders.…”

Section: Discussionmentioning

confidence: 99%

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Section: Discussionmentioning

confidence: 99%

Fast-Degradable Microbeads Encapsulating Human Umbilical Cord Stem Cells in Alginate for Muscle Tissue Engineering

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“…Regarding the first mechanism, the effects of scarring, objective measurements confirmed that patients with a cleft of the lip have impairments in the maximum extent to which they can move their facial tissues Trotman et al, 2000). Relevant to the second mechanism, muscle force dynamics, a number of studies have demonstrated that measures of lip force can be used to characterize both the strength and fine motor control of facial muscles in normal individuals and in patients with somatomotor disorders of the central nervous system (Barlow and Abbs, 1983, 1984Barlow and Rath, 1985;Barlow and Netsell, 1986).…”

Section: Abstract Clinical Trial; Functional Outcomes; Lip Revision Smentioning

confidence: 90%

“…Estimates of variability and mean differences for facial movement during the smile and cheek-puff animations between children with and without cleft lip were obtained from nine children with complete unilateral and bilateral cleft lip and 50 noncleft subjects. These children were studied prior to the initiation of this clinical trial (Trotman et al, 2000). The pilot data indicated considerable variability in asymmetry and magnitude of displacement among the participants with cleft lip and palate; however, the primary focus was the difference in the change in movement measures between participants who had a lip revision and the noncleft healthy children.…”

Section: Surgerymentioning

confidence: 99%

“…These children were studied prior to the initiation of this clinical trial (Trotman et al, 2000). The pilot data indicated considerable variability in asymmetry and magnitude of displacement among the participants with cleft lip and palate; however, the primary focus was the difference in the change in movement measures between participants who had a lip revision and the noncleft healthy children.…”

Section: Sample Sizementioning

confidence: 99%

“…Facial movement Three-dimensional measures of facial tissues during facial animations such as smile, lip purse, cheek puff, grimace, and mouth opening (Trotman et al, 2000;Weeden et al, 2001;Trotman et al, 2003) Lip force Force measures made at the midline of the upper and lower lips (Barlow, 1998) Sensory Perception thresholds Two-point perception thresholds measured on the right and left sides of both the upper and lower vermilion (Chen et al, 1995;Feldman et al, 1997;Essick et al, 2001) Temperature thresholds Warmth-detection and cool-detection thresholds measured on the right and left sides of both the upper and lower vermilion (Martinez, 1996;Essick et al, 2004) Sensorimotor integration…”

Section: Measure Descriptionmentioning

confidence: 99%

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Functional Outcomes of Cleft Lip Surgery. Part I: Study Design and Surgeon Ratings of Lip Disability and Need for Lip Revision

Trotman

Phillips

Essick

et al. 2007

The Cleft Palate Craniofacial Journal

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Objective-Children with a cleft of the upper lip exhibit obvious facial disfigurement. Many require multiple lip surgeries for an optimal esthetic result. However, because the decision for lip revision is based on subjective clinical criteria, clinicians may disagree on whether these surgeries should be performed. To establish more reliable, functionally relevant outcome criteria for evaluation and treatment planning, a clinical trial currently is in progress. In this article, the design of the clinical trial is described and results of a study on subjective evaluations of facial form by surgeons for or against the need for lip revision surgery are presented.Design-Parallel, three-group, nonrandomized clinical trial and subjective evaluations/ratings of facial views by surgeons.Subjects-For the clinical trial, children with repaired cleft lip and palate scheduled for a secondary lip revision, children with repaired cleft lip and palate who did not have lip revision, and noncleft children. For the subjective evaluations, surgeons' facial ratings of 21 children with repaired cleft lip.Address correspondence to: Dr. Carroll-Ann Trotman, CB #7450, 275 Brauer Hall, Chapel Hill, NC 27599-7450. carrollann_trotman@dentistry.unc.edu.. NIH Public Access Author ManuscriptCleft Palate Craniofac J. Author manuscript; available in PMC 2013 May 07. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAnalysis-Descriptive and Kappa statistics assessing the concordance of surgeons' ratings of (a) repeated facial views and (b) a recommendation of revision on viewing the prerevision and postrevision views.Results-The surgeons' consistency in rating repeated views was moderate to excellent; however, agreement among the surgeons when rating individual participants was low to moderate.Conclusions-The findings suggest that the agreement among surgeons was poor and support the need for more objective measures to assess the need for revision surgery. Keywords clinical trial; functional outcomes; lip revision surgeryFor a child with a cleft of the lip with or without a cleft palate, the decision to surgically revise the lip is based on a subjective evaluation of lip form and function that is made by the surgeon either independently or in conjunction with the patient and parents (Marsh, 1990). Subjective evaluation defines the current standard of care for patients who are candidates for lip revision; however, recent research has demonstrated many limitations with the use of subjective assessments. Of particular concern are the lack of agreement among clinicians (Asher-McDade et al., 1991;Tobiason et al., 1991;Ritter et al., 2002;Morrant and Shaw, 1996) and a tendency for the assessment of lip form to confound the assessment of lip function (Ritter et al., 2002). For example, when the severity of the deformity of static faces (i.e., faces at rest) was rated subjectively by clinicians, interexaminer agreement ranged from low (Asher-McDade et al., 1991) to good (Tobiason et al., 1991;Ritter et al., 2002), whi...

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Faces in 4 dimensions: Why do we care, and why the fourth dimension?

Trotman

2011

American Journal of Orthodontics and Dentofacial Orthopedics

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Three-Dimensional Nasolabial Displacement during Movement in Repaired Cleft Lip and Palate Patients

Cited by 28 publications

References 0 publications

Fast-Degradable Microbeads Encapsulating Human Umbilical Cord Stem Cells in Alginate for Muscle Tissue Engineering

Fast-Degradable Microbeads Encapsulating Human Umbilical Cord Stem Cells in Alginate for Muscle Tissue Engineering

Functional Outcomes of Cleft Lip Surgery. Part I: Study Design and Surgeon Ratings of Lip Disability and Need for Lip Revision

Faces in 4 dimensions: Why do we care, and why the fourth dimension?

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