Measuring the Unilateral Cleft Lip Nasal Deformity: Lateral Deviation of Subnasale Is a Clinical and Morphologic Index of Unrepaired Severity.
Autor: | Tse RW; Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA., Sitzman TJ; Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA., Allori AC; Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospital, Durham, NC, USA., Ettinger RE; Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA., Fisher DM; Division of Plastic Surgery, The Hospital for Sick Children, Toronto, ON, Canada., Bezuhly M; Division of Plastic Surgery, IWK Health Center, Halifax, NS, Canada., Samson TD; Division of Plastic Surgery, Penn State Hershey Medical Center, Hershey, PA, USA., Beals SP; Phoenix Children's Cleft and Craniofacial Center, Phoenix, AZ, USA., Matic DB; Division of Plastic Surgery, London Health Sciences Centre, Western University, London, ON, Canada., Mercan E; Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA. |
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Jazyk: | angličtina |
Zdroj: | The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2025 Jan; Vol. 62 (1), pp. 69-78. Date of Electronic Publication: 2023 Oct 03. |
DOI: | 10.1177/10556656231202173 |
Abstrakt: | Objective: Objective measurement of pre-operative severity is important to optimize evidence-based practices given that the wide spectrum of presentation likely influences outcomes. The purpose of this study was to determine the correlation of objective measures of form with a subjective standard of cleft severity. Design: 3D images were ranked according to severity of nasal deformity by 7 cleft surgeons so that the mean rank could be used as the severity standard. Patients: 45 patients with unilateral cleft lip and 5 normal control subjects. Interventions: Each image was assessed using traditional anthropometric analysis, 3D landmark displacements, and shape-based analysis to produce 81 indices for each subject. Main Outcome: The correlation of objective measurements with the clinical severity standard. Results: Lateral deviation of subnasale from midline was the best predictor of severity (0.86). Other strongly-correlated anthropometric measurements included columellar angle, nostril width ratio, and lateral lip height ratio (0.72, 0.80, 0.79). Almost all shape-based measurements had tight correlation with the severity standard, however, dorsum deviation and point difference nasolabial symmetry were the most predictive (0.84, 0.82). Conclusions: Quantitative measures of severity transcend cleft type and can be used to grade clinical severity. Lateral deviation of subnasale was the best measure of severity and may be used as a surrogate of uncoupled premaxillary growth; it should be recorded as an index of pre-operative severity with every cleft lip repair. The correlation of other measures evaluated clarify treatment priorities and could potentially be used to grade outcomes. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
Databáze: | MEDLINE |
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