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A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair.
Plast Reconstr Surg 2017; 140(4):757-764PR

Abstract

BACKGROUND

Cleft lip repair aims to create symmetric nasolabial morphology with minimal scarring. Poor aesthetic outcomes may have damaging psychosocial implications. Determining the optimal method of recreating lip symmetry is a major goal of applied cleft clinical research. This study aims to determine whether subjective assessment could differentiate aesthetic outcome between two surgeons who use two different surgical techniques for unilateral cleft lip repair.

METHODS

Surgeon A uses a modified rotation-advancement technique incorporating a supra-white roll flap and Noordhoff-style vermilion flap. Surgeon B uses an upper and lower triangle technique. Neither surgeon used presurgical orthopedics. Five-year postoperative frontal photographs (cropped according to the Asher-McDade aesthetic index) were analyzed by a panel of 40 blinded surgical and lay reviewers using a five-point Likert scale. The assessments were repeated after a 2-week interval to assess intrarater reliability.

RESULTS

Thirty-nine consecutive complete unilateral cleft lip and palate patients were assessed for each surgeon. The mean Likert score for surgical/lay assessors was 3.07/3.00 for surgeon A and 2.67/2.61 for surgeon B. This difference was statistically significant (p < 0.05). The interrater reliability was excellent and the intrarater reliability was fair. There was good correlation between lay and surgical assessors.

CONCLUSION

Subjective assessment of clinical photography provides a reliable method of differentiating aesthetic outcome after unilateral cleft lip repair and presents a rapid and straightforward clinically relevant method of comparing surgical outcomes.

Authors+Show Affiliations

Oxford and Salisbury, United Kingdom From Spires Cleft Centre, Oxford University Hospitals NHS Trust, John Radcliffe Hospital; and the Spires Cleft Centre, Salisbury Foundation NHS Trust.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28953726

Citation

Phillips, Georgina S A., et al. "A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair." Plastic and Reconstructive Surgery, vol. 140, no. 4, 2017, pp. 757-764.
Phillips GSA, Swan MC, Sawyer AR, et al. A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair. Plast Reconstr Surg. 2017;140(4):757-764.
Phillips, G. S. A., Swan, M. C., Sawyer, A. R., Goodacre, T. E. E., & Cadier, M. (2017). A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair. Plastic and Reconstructive Surgery, 140(4), pp. 757-764. doi:10.1097/PRS.0000000000003685.
Phillips GSA, et al. A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair. Plast Reconstr Surg. 2017;140(4):757-764. PubMed PMID: 28953726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair. AU - Phillips,Georgina S A, AU - Swan,Marc C, AU - Sawyer,Adam R, AU - Goodacre,Tim E E, AU - Cadier,Michael, PY - 2017/9/28/entrez PY - 2017/9/28/pubmed PY - 2017/10/13/medline SP - 757 EP - 764 JF - Plastic and reconstructive surgery JO - Plast. Reconstr. Surg. VL - 140 IS - 4 N2 - BACKGROUND: Cleft lip repair aims to create symmetric nasolabial morphology with minimal scarring. Poor aesthetic outcomes may have damaging psychosocial implications. Determining the optimal method of recreating lip symmetry is a major goal of applied cleft clinical research. This study aims to determine whether subjective assessment could differentiate aesthetic outcome between two surgeons who use two different surgical techniques for unilateral cleft lip repair. METHODS: Surgeon A uses a modified rotation-advancement technique incorporating a supra-white roll flap and Noordhoff-style vermilion flap. Surgeon B uses an upper and lower triangle technique. Neither surgeon used presurgical orthopedics. Five-year postoperative frontal photographs (cropped according to the Asher-McDade aesthetic index) were analyzed by a panel of 40 blinded surgical and lay reviewers using a five-point Likert scale. The assessments were repeated after a 2-week interval to assess intrarater reliability. RESULTS: Thirty-nine consecutive complete unilateral cleft lip and palate patients were assessed for each surgeon. The mean Likert score for surgical/lay assessors was 3.07/3.00 for surgeon A and 2.67/2.61 for surgeon B. This difference was statistically significant (p < 0.05). The interrater reliability was excellent and the intrarater reliability was fair. There was good correlation between lay and surgical assessors. CONCLUSION: Subjective assessment of clinical photography provides a reliable method of differentiating aesthetic outcome after unilateral cleft lip repair and presents a rapid and straightforward clinically relevant method of comparing surgical outcomes. SN - 1529-4242 UR - https://www.unboundmedicine.com/medline/citation/28953726/A_Comparative_Study_of_the_Aesthetic_Outcome_of_Two_Techniques_for_Unilateral_Complete_Cleft_Lip_Repair_ L2 - http://Insights.ovid.com/pubmed?pmid=28953726 DB - PRIME DP - Unbound Medicine ER -