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Nasolabial Aesthetics Following Cleft Repair: An Objective Evaluation of Subjective Assessment.
Cleft Palate Craniofac J 2019; 56(9):1157-1163CP

Abstract

OBJECTIVE

Assess the weight and contribution of each of the parameters of the Asher-McDade Scale to overall subjective assessment of nasolabial aesthetics following cleft lip repair.

DESIGN

Retrospective cohort evaluation.

SETTING

Cleft and craniofacial center.

PARTICIPANTS

Forty-one patients who underwent unilateral cleft lip repair.

INTERVENTIONS

Unilateral cleft lip repair.

MAIN OUTCOME MEASURES

Nasolabial rating using the Asher-McDade scale and overall subjective assessment of nasolabial aesthetics using a rank score following unilateral cleft lip repair.

RESULTS

Strong interrater reliability was observed between the 3 raters. Significant association was determined on bivariate analysis between nasal form score (β = 27.06; P < .001), nasal symmetry score (β = 26.41; P < .001), nasal profile score (β = 28.75; P < .001), vermilion border score (β = 13.40; P = .012), and the ranking score. Adjusted β coefficients obtained from multivariate regression analysis were used to develop a modified nasolabial appearance score (over 5), that is, weighted for each of the 4 parameters: nasal form (over 8, adjusted β = 14.33), nasal symmetry (over 5, adjusted β = 7.96), nasal profile (over 5, adjusted β = 9.44), and vermilion (over 2, adjusted β = 3.31). Regression analysis between our modified nasolabial appearance score and patient ranking score demonstrated superior goodness of fit when compared to the Asher-McDade overall nasolabial appearance score (R2 = .80; P < .001 vs R2 = .69; P < .001).

CONCLUSION

The parameters evaluated in the Asher-McDade scale have different weights and contribute differently to overall subjective assessment of nasolabial aesthetic outcomes following cleft lip repair. Adjusting for their weights results in a modified score that demonstrates superior correlation with overall subjective assessment of nasolabial aesthetic outcomes.

Authors+Show Affiliations

1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31117813

Citation

Kantar, Rami S., et al. "Nasolabial Aesthetics Following Cleft Repair: an Objective Evaluation of Subjective Assessment." The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, vol. 56, no. 9, 2019, pp. 1157-1163.
Kantar RS, Maliha SG, Alfonso AR, et al. Nasolabial Aesthetics Following Cleft Repair: An Objective Evaluation of Subjective Assessment. Cleft Palate Craniofac J. 2019;56(9):1157-1163.
Kantar, R. S., Maliha, S. G., Alfonso, A. R., Wang, M. M., Ramly, E. P., Eisemann, B. S., ... Flores, R. L. (2019). Nasolabial Aesthetics Following Cleft Repair: An Objective Evaluation of Subjective Assessment. The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, 56(9), pp. 1157-1163. doi:10.1177/1055665619851432.
Kantar RS, et al. Nasolabial Aesthetics Following Cleft Repair: an Objective Evaluation of Subjective Assessment. Cleft Palate Craniofac J. 2019;56(9):1157-1163. PubMed PMID: 31117813.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nasolabial Aesthetics Following Cleft Repair: An Objective Evaluation of Subjective Assessment. AU - Kantar,Rami S, AU - Maliha,Samantha G, AU - Alfonso,Allyson R, AU - Wang,Maxime M, AU - Ramly,Elie P, AU - Eisemann,Bradley S, AU - Shetye,Pradip R, AU - Grayson,Barry H, AU - Flores,Roberto L, Y1 - 2019/05/22/ PY - 2019/5/24/pubmed PY - 2019/5/24/medline PY - 2019/5/24/entrez KW - craniofacial morphology KW - facial morphology KW - lip form KW - nasal morphology SP - 1157 EP - 1163 JF - The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association JO - Cleft Palate Craniofac. J. VL - 56 IS - 9 N2 - OBJECTIVE: Assess the weight and contribution of each of the parameters of the Asher-McDade Scale to overall subjective assessment of nasolabial aesthetics following cleft lip repair. DESIGN: Retrospective cohort evaluation. SETTING: Cleft and craniofacial center. PARTICIPANTS: Forty-one patients who underwent unilateral cleft lip repair. INTERVENTIONS: Unilateral cleft lip repair. MAIN OUTCOME MEASURES: Nasolabial rating using the Asher-McDade scale and overall subjective assessment of nasolabial aesthetics using a rank score following unilateral cleft lip repair. RESULTS: Strong interrater reliability was observed between the 3 raters. Significant association was determined on bivariate analysis between nasal form score (β = 27.06; P < .001), nasal symmetry score (β = 26.41; P < .001), nasal profile score (β = 28.75; P < .001), vermilion border score (β = 13.40; P = .012), and the ranking score. Adjusted β coefficients obtained from multivariate regression analysis were used to develop a modified nasolabial appearance score (over 5), that is, weighted for each of the 4 parameters: nasal form (over 8, adjusted β = 14.33), nasal symmetry (over 5, adjusted β = 7.96), nasal profile (over 5, adjusted β = 9.44), and vermilion (over 2, adjusted β = 3.31). Regression analysis between our modified nasolabial appearance score and patient ranking score demonstrated superior goodness of fit when compared to the Asher-McDade overall nasolabial appearance score (R2 = .80; P < .001 vs R2 = .69; P < .001). CONCLUSION: The parameters evaluated in the Asher-McDade scale have different weights and contribute differently to overall subjective assessment of nasolabial aesthetic outcomes following cleft lip repair. Adjusting for their weights results in a modified score that demonstrates superior correlation with overall subjective assessment of nasolabial aesthetic outcomes. SN - 1545-1569 UR - https://www.unboundmedicine.com/medline/citation/31117813/Nasolabial_Aesthetics_Following_Cleft_Repair:_An_Objective_Evaluation_of_Subjective_Assessment_ L2 - http://journals.sagepub.com/doi/full/10.1177/1055665619851432?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -