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Lay People Esthetic Evaluation of Primary Surgical Repair on Three-Dimensional Images of Cleft Lip and Palate Patients.
Medicina (Kaunas). 2019 Sep 08; 55(9)M

Abstract

Background and Objectives:

Previous literature has disclosed that facial attractiveness affects the esthetic evaluation of nose and lip deformity on frontal and lateral photographs. However, it has never been debated if the removal of the external facial features on three-dimensional (3D) models ("cropped assessment bias") could provide a considerable usefulness in the interpretation and comparison of the results. Additionally, it has been assumed on two-dimensional (2D) studies that esthetic assessment biases with respect to observer gender, and it is not acknowledged if and to the extent that "gender assessment bias" may be influenced by a three-dimensional layout. The aim of this study is to investigate if facial traits and observers' gender may affect the esthetic ratings of unilateral cleft lip and palate (UCLP) patients after soft tissue reconstruction. Materials and

Methods:

Three-dimensional images of ten UCLP patients' images were acquired before the intervention (T0), one-month (T1) and six-months (T2) postoperative. Geomagic® software (version 2014; 3D Systems, Rock Hill, SC, USA) was used to remove the external facial features of 3D surface models. Five-point scale developed by Asher-McDade et al. was used to rate both nasolabial attractiveness and impairment for full-face (FF) and cropped-face (CF) 3D images. Forty-three judges (21 males, 22 females) were enrolled for the esthetic evaluation. Intraclass correlation coefficient (ICC) was used to test intra- and inter-examiner reliability; a value of 0.7 was set as the minimum acceptable level of reliability.

Results:

When comparing the 2 sets of observations (FF and CF), the ICC ranged from 0.654 to 0.823. Concerning gender assessment bias, the ICC ranged from 0.438 to 0.686 and from 0.722 to 0.788 for males and females, respectively. Concerning inter-examiner reliability, ICC for questions 2-7 ranged from 0.448 to 0.644 and from 0.659 to 0.817 at T0 and T2, respectively.

Conclusions:

The removal of external facial features provides subtle differences on the esthetic assessment of UCLP patients. Moreover, based on our data, examiners' gender differences may affect esthetic assessment of UCLP patients. Despite the subjectivity of esthetic judgments, a reliable, validated and reproducible scoring protocol should consider the influence of gender differences on 3D esthetic assessment of UCLP patients.

Authors+Show Affiliations

Institute of Dentistry and Maxillo-Facial Surgery, IRCCS Fondazione Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, 00168 Rome, Italy. edoardo.staderini@yahoo.it.Institute of Dentistry and Maxillo-Facial Surgery, IRCCS Fondazione Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, 00168 Rome, Italy. accefadino@hotmail.it.Institute of Dentistry and Maxillo-Facial Surgery, IRCCS Fondazione Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, 00168 Rome, Italy. ettore.candida@gmail.com.Craniofacial Centre-Plastic and Maxillofacial Surgery Unit of the Children's Hospital Bambino Gesù, IRCCS, 00165 Rome, Italy. mariaidarizzo@gmail.com.Craniofacial Centre-Plastic and Maxillofacial Surgery Unit of the Children's Hospital Bambino Gesù, IRCCS, 00165 Rome, Italy. oriana.rajab@gmail.com.Craniofacial Centre-Plastic and Maxillofacial Surgery Unit of the Children's Hospital Bambino Gesù, IRCCS, 00165 Rome, Italy. daria.bucci@gmail.com.Craniofacial Centre-Plastic and Maxillofacial Surgery Unit of the Children's Hospital Bambino Gesù, IRCCS, 00165 Rome, Italy. mario.zama@opbg.net.Institute of Dentistry and Maxillo-Facial Surgery, IRCCS Fondazione Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, 00168 Rome, Italy. carlo.lajolo@unicatt.it.Institute of Dentistry and Maxillo-Facial Surgery, IRCCS Fondazione Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, 00168 Rome, Italy. massimo.cordaro@unicatt.it.Institute of Dentistry and Maxillo-Facial Surgery, IRCCS Fondazione Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, 00168 Rome, Italy. patrizia.gallenzi@unicatt.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31500380

Citation

Staderini, Edoardo, et al. "Lay People Esthetic Evaluation of Primary Surgical Repair On Three-Dimensional Images of Cleft Lip and Palate Patients." Medicina (Kaunas, Lithuania), vol. 55, no. 9, 2019.
Staderini E, De Luca M, Candida E, et al. Lay People Esthetic Evaluation of Primary Surgical Repair on Three-Dimensional Images of Cleft Lip and Palate Patients. Medicina (Kaunas). 2019;55(9).
Staderini, E., De Luca, M., Candida, E., Rizzo, M. I., Rajabtork Zadeh, O., Bucci, D., Zama, M., Lajolo, C., Cordaro, M., & Gallenzi, P. (2019). Lay People Esthetic Evaluation of Primary Surgical Repair on Three-Dimensional Images of Cleft Lip and Palate Patients. Medicina (Kaunas, Lithuania), 55(9). https://doi.org/10.3390/medicina55090576
Staderini E, et al. Lay People Esthetic Evaluation of Primary Surgical Repair On Three-Dimensional Images of Cleft Lip and Palate Patients. Medicina (Kaunas). 2019 Sep 8;55(9) PubMed PMID: 31500380.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lay People Esthetic Evaluation of Primary Surgical Repair on Three-Dimensional Images of Cleft Lip and Palate Patients. AU - Staderini,Edoardo, AU - De Luca,Marilisa, AU - Candida,Ettore, AU - Rizzo,Maria Ida, AU - Rajabtork Zadeh,Oriana, AU - Bucci,Daria, AU - Zama,Mario, AU - Lajolo,Carlo, AU - Cordaro,Massimo, AU - Gallenzi,Patrizia, Y1 - 2019/09/08/ PY - 2019/06/24/received PY - 2019/09/04/revised PY - 2019/09/04/accepted PY - 2019/9/11/entrez PY - 2019/9/11/pubmed PY - 2020/3/24/medline KW - cleft lip and palate KW - growth and development KW - outcome assessment KW - photogrammetry KW - reconstructive surgical procedures KW - soft tissue KW - therapy KW - treatment outcome JF - Medicina (Kaunas, Lithuania) JO - Medicina (Kaunas) VL - 55 IS - 9 N2 - Background and Objectives: Previous literature has disclosed that facial attractiveness affects the esthetic evaluation of nose and lip deformity on frontal and lateral photographs. However, it has never been debated if the removal of the external facial features on three-dimensional (3D) models ("cropped assessment bias") could provide a considerable usefulness in the interpretation and comparison of the results. Additionally, it has been assumed on two-dimensional (2D) studies that esthetic assessment biases with respect to observer gender, and it is not acknowledged if and to the extent that "gender assessment bias" may be influenced by a three-dimensional layout. The aim of this study is to investigate if facial traits and observers' gender may affect the esthetic ratings of unilateral cleft lip and palate (UCLP) patients after soft tissue reconstruction. Materials and Methods: Three-dimensional images of ten UCLP patients' images were acquired before the intervention (T0), one-month (T1) and six-months (T2) postoperative. Geomagic® software (version 2014; 3D Systems, Rock Hill, SC, USA) was used to remove the external facial features of 3D surface models. Five-point scale developed by Asher-McDade et al. was used to rate both nasolabial attractiveness and impairment for full-face (FF) and cropped-face (CF) 3D images. Forty-three judges (21 males, 22 females) were enrolled for the esthetic evaluation. Intraclass correlation coefficient (ICC) was used to test intra- and inter-examiner reliability; a value of 0.7 was set as the minimum acceptable level of reliability. Results: When comparing the 2 sets of observations (FF and CF), the ICC ranged from 0.654 to 0.823. Concerning gender assessment bias, the ICC ranged from 0.438 to 0.686 and from 0.722 to 0.788 for males and females, respectively. Concerning inter-examiner reliability, ICC for questions 2-7 ranged from 0.448 to 0.644 and from 0.659 to 0.817 at T0 and T2, respectively. Conclusions: The removal of external facial features provides subtle differences on the esthetic assessment of UCLP patients. Moreover, based on our data, examiners' gender differences may affect esthetic assessment of UCLP patients. Despite the subjectivity of esthetic judgments, a reliable, validated and reproducible scoring protocol should consider the influence of gender differences on 3D esthetic assessment of UCLP patients. SN - 1648-9144 UR - https://www.unboundmedicine.com/medline/citation/31500380/Lay_People_Esthetic_Evaluation_of_Primary_Surgical_Repair_on_Three_Dimensional_Images_of_Cleft_Lip_and_Palate_Patients_ L2 - http://www.mdpi.com/resolver?pii=medicina55090576 DB - PRIME DP - Unbound Medicine ER -