Kirsten Mølsted1, Kirsti Humerinta2, Annelise Küseler3, Pål Skaare4, Haydn Bellardie5, William Shaw6, Agneta Karsten7, Paul Kåre Sæle8, Sara Rizell9, Agneta Marcusson10, Philip Eyres5, Gunvor Semb4,11,12. 1. a Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Copenhagen , Denmark. 2. b Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland. 3. c Cleft Palate Center , Aarhus , Denmark. 4. d Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway. 5. e Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens' Hospital , Manchester , UK. 6. f Dental School, University of Manchester , Manchester , UK. 7. g Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine , Karolinska Institutet , Stockholm , Sweden. 8. h Oral Health Center of Expertise/Western Norway , Bergen , Norway. 9. i Department of Odontology , Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden. 10. j Department of Dentofacial Orthopedics, Maxillofacial Unit , University Hospital , Linköping , Sweden. 11. k Dental School, University of Manchester , Manchester , UK. 12. l Statped Sørøst , Oslo , Norway.
Abstract
BACKGROUND AND AIM: Facial appearance is one of the most relevant measures of success in cleft lip and palate treatment. The aim was to assess nasolabial appearance at 5 years of age in all children in the project. In this part of the project the local protocol for lip closure continued to be used because the primary lip and nose operations were not part of the randomisation. The great majority of the surgeons used Millard's technique together with McComb's technique for the nose. One center used Tennison-Randalls technique and in one center the centers own technique as well as nose plugs were used. METHODS: Three hundred and fifty-nine children participated in this part of the project. Standardised photos according to a specific protocol developed for the Scandcleft project were taken. Only the nasolabial area was shown, the surrounding facial features were masked. Three components were scored using a 5-point ordinal scale. A new developed Scandcleft Yardstick was used. RESULTS: The reliability of the method was tested using the weighted kappa statistics. Both the interrater and intrarater reliability scores were good to very good. There were statistically significant differences between the three trials. CONCLUSION: The Millard procedure combined with McComb technique had been used in the majority of the cases in all three trials. There were statistically significant differences between the three trials concerning upper lip, nasal form, and cleft side profile. TRIAL REGISTRATION: ISRCTN29932826.
BACKGROUND AND AIM: Facial appearance is one of the most relevant measures of success in cleft lip and palate treatment. The aim was to assess nasolabial appearance at 5 years of age in all children in the project. In this part of the project the local protocol for lip closure continued to be used because the primary lip and nose operations were not part of the randomisation. The great majority of the surgeons used Millard's technique together with McComb's technique for the nose. One center used Tennison-Randalls technique and in one center the centers own technique as well as nose plugs were used. METHODS: Three hundred and fifty-nine children participated in this part of the project. Standardised photos according to a specific protocol developed for the Scandcleft project were taken. Only the nasolabial area was shown, the surrounding facial features were masked. Three components were scored using a 5-point ordinal scale. A new developed Scandcleft Yardstick was used. RESULTS: The reliability of the method was tested using the weighted kappa statistics. Both the interrater and intrarater reliability scores were good to very good. There were statistically significant differences between the three trials. CONCLUSION: The Millard procedure combined with McComb technique had been used in the majority of the cases in all three trials. There were statistically significant differences between the three trials concerning upper lip, nasal form, and cleft side profile. TRIAL REGISTRATION: ISRCTN29932826.
Authors: Isabelle Citron; Ingrid Ganske; Benjamin B Massenburg; Michael Doyle; John G Meara; Carolyn R Rogers-Vizena Journal: Plast Reconstr Surg Glob Open Date: 2018-08-16