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Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients: Do the assessment methods measure the same outcome?
J Craniomaxillofac Surg. 2017 Aug; 45(8):1220-1226.JC

Abstract

OBJECTIVE

For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments.

METHODS

The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients.

RESULTS

The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38-0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08-0.17).

CONCLUSION

Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients.

Authors+Show Affiliations

Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: davidmosmuller@hotmail.com.The 3D - Facial Imaging Research Group, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: Thomas.Maal@radboudumc.nl.Department of Orthodontics, Academic Center for Dentistry of Amsterdam, The Netherlands. Electronic address: C.prahl@acta.nl.Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: robintan100@gmail.com.Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: fjmulder@outlook.com.Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: r.schwirtz@vumc.nl.Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: hcw.devet@vumc.nl.The 3D - Facial Imaging Research Group, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: Stefaan.Berge@radboudumc.nl.Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: Dongriot@vumc.nl.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28552202

Citation

Mosmuller, David G M., et al. "Comparison of Two- and Three-dimensional Assessment Methods of Nasolabial Appearance in Cleft Lip and Palate Patients: Do the Assessment Methods Measure the Same Outcome?" Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery, vol. 45, no. 8, 2017, pp. 1220-1226.
Mosmuller DGM, Maal TJ, Prahl C, et al. Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients: Do the assessment methods measure the same outcome? J Craniomaxillofac Surg. 2017;45(8):1220-1226.
Mosmuller, D. G. M., Maal, T. J., Prahl, C., Tan, R. A., Mulder, F. J., Schwirtz, R. M. F., de Vet, H. C. W., Bergé, S. J., & Don Griot, J. P. W. (2017). Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients: Do the assessment methods measure the same outcome? Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery, 45(8), 1220-1226. https://doi.org/10.1016/j.jcms.2017.04.004
Mosmuller DGM, et al. Comparison of Two- and Three-dimensional Assessment Methods of Nasolabial Appearance in Cleft Lip and Palate Patients: Do the Assessment Methods Measure the Same Outcome. J Craniomaxillofac Surg. 2017;45(8):1220-1226. PubMed PMID: 28552202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients: Do the assessment methods measure the same outcome? AU - Mosmuller,David G M, AU - Maal,Thomas J, AU - Prahl,Charlotte, AU - Tan,Robin A, AU - Mulder,Frans J, AU - Schwirtz,Roderic M F, AU - de Vet,Henrica C W, AU - Bergé,Stefaan J, AU - Don Griot,J P W, Y1 - 2017/04/19/ PY - 2017/01/16/received PY - 2017/01/31/revised PY - 2017/04/11/accepted PY - 2017/5/30/pubmed PY - 2018/6/1/medline PY - 2017/5/30/entrez KW - 2D assessment KW - 3D assessment KW - Aesthetic assessment KW - Asymmetry assessment KW - Cleft lip and palate KW - Nasolabial appearance SP - 1220 EP - 1226 JF - Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery JO - J Craniomaxillofac Surg VL - 45 IS - 8 N2 - OBJECTIVE: For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments. METHODS: The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients. RESULTS: The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38-0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08-0.17). CONCLUSION: Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients. SN - 1878-4119 UR - https://www.unboundmedicine.com/medline/citation/28552202/Comparison_of_two__and_three_dimensional_assessment_methods_of_nasolabial_appearance_in_cleft_lip_and_palate_patients:_Do_the_assessment_methods_measure_the_same_outcome L2 - https://linkinghub.elsevier.com/retrieve/pii/S1010-5182(17)30136-1 DB - PRIME DP - Unbound Medicine ER -