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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 8. Assessing naso-labial appearance in 5-year-olds - a preliminary study.
J Plast Surg Hand Surg. 2017 Feb; 51(1):64-72.JP

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.

Authors+Show Affiliations

a Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Copenhagen , Denmark.b Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.c Cleft Palate Center , Aarhus , Denmark.d Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.e Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens' Hospital , Manchester , UK.f Dental School, University of Manchester , Manchester , UK.g Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine , Karolinska Institutet , Stockholm , Sweden.h Oral Health Center of Expertise/Western Norway , Bergen , Norway.i Department of Odontology , Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.j Department of Dentofacial Orthopedics, Maxillofacial Unit , University Hospital , Linköping , Sweden.e Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens' Hospital , Manchester , UK.d Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway. k Dental School, University of Manchester , Manchester , UK. l Statped Sørøst , Oslo , Norway.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Review

Language

eng

PubMed ID

28218555

Citation

Mølsted, Kirsten, et al. "Scandcleft Randomised Trials of Primary Surgery for Unilateral Cleft Lip and Palate: 8. Assessing Naso-labial Appearance in 5-year-olds - a Preliminary Study." Journal of Plastic Surgery and Hand Surgery, vol. 51, no. 1, 2017, pp. 64-72.
Mølsted K, Humerinta K, Küseler A, et al. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 8. Assessing naso-labial appearance in 5-year-olds - a preliminary study. J Plast Surg Hand Surg. 2017;51(1):64-72.
Mølsted, K., Humerinta, K., Küseler, A., Skaare, P., Bellardie, H., Shaw, W., Karsten, A., Kåre Sæle, P., Rizell, S., Marcusson, A., Eyres, P., & Semb, G. (2017). Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 8. Assessing naso-labial appearance in 5-year-olds - a preliminary study. Journal of Plastic Surgery and Hand Surgery, 51(1), 64-72. https://doi.org/10.1080/2000656X.2016.1266492
Mølsted K, et al. Scandcleft Randomised Trials of Primary Surgery for Unilateral Cleft Lip and Palate: 8. Assessing Naso-labial Appearance in 5-year-olds - a Preliminary Study. J Plast Surg Hand Surg. 2017;51(1):64-72. PubMed PMID: 28218555.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 8. Assessing naso-labial appearance in 5-year-olds - a preliminary study. AU - Mølsted,Kirsten, AU - Humerinta,Kirsti, AU - Küseler,Annelise, AU - Skaare,Pål, AU - Bellardie,Haydn, AU - Shaw,William, AU - Karsten,Agneta, AU - Kåre Sæle,Paul, AU - Rizell,Sara, AU - Marcusson,Agneta, AU - Eyres,Philip, AU - Semb,Gunvor, PY - 2017/2/21/entrez PY - 2017/2/22/pubmed PY - 2017/12/16/medline KW - 5 years KW - RCT studies KW - Scandcleft KW - facial esthetics KW - multicenter study KW - nasolabial appearance KW - unilateral cleft lip and palate SP - 64 EP - 72 JF - Journal of plastic surgery and hand surgery JO - J Plast Surg Hand Surg VL - 51 IS - 1 N2 - 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. SN - 2000-6764 UR - https://www.unboundmedicine.com/medline/citation/28218555/Scandcleft_randomised_trials_of_primary_surgery_for_unilateral_cleft_lip_and_palate:_8__Assessing_naso_labial_appearance_in_5_year_olds___a_preliminary_study_ L2 - http://www.tandfonline.com/doi/full/10.1080/2000656X.2016.1266492 DB - PRIME DP - Unbound Medicine ER -