Publication: Developing severity classification of cleft lip nose anatomical deformity in Malaysian population. A multicentre study
Loading...
Date
2022
Authors
Yap, Pauline
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction The primary unilateral cleft lip/nose (UCL/N) anatomical deformity severity is hypothesized to have a significant impact on post-surgical complications, cosmetic outcome, and the necessity for additional surgery. There is no established and commonly recognized system for classifying the severity of primary UCL/N anatomical deformity. The goal of this study is to verify the Nasal Deformity Rating Scale created is a reliable objective tool for assessing preoperative UCL/N anatomical deformity and repair outcome in cleft lip patients by both surgeons and plastic surgery residents. Method A rating system based on three variables of nasal deformity, which includes alar facial symmetry ratio, nostril width ratio, and columellar angle, is developed. We add the individual measurement results into a total score of minimum 3 and maximum 9. Severity score is classified into mild, moderate, and severe, while postoperative patients are classified into excellent, good, and fair. Six participants (3 consultant plastic surgeons and 3 plastic surgery residents) had assessed 50 sets of preoperative standardized twoand three-dimensional photographs of UCL/N patients. Each participant had been taken measurements of difference of the alar facial grooves, nasal length, nostril widths, and columellar angle. Based on the measurement, the alar facial symmetry ratio, nostril width ratio, and columellar angle were calculated and scored on a scale of 1–3 using the Nasal Deformity Rating Scale developed. The intraclass correlation coefficient was used to measure the interrater reliability of surgeons and residents. The results of ratio comparisons between surgeons and residents for preoperative and postoperative assessments were analyzed. Results Interrater reliability for all variable was classified as "good" determined by intraclass correlation coefficients value ranged from 0.64 (good) to 0.79 (excellent) for all participants and both 2D and 3D specific photographs (p<0.05). These findings demonstrate a high degree of interrater between surgeons and residents and that both can reliably grade cleft lip nasal anatomical severity using the Nasal Deformity Rating Scale. Conclusion This study establishes the Nasal Deformity Rating Scale as a robust objective tool for assessing the degree of preoperative severity of cleft lip and nose anatomical deformity in individuals with UCL/N. Thus, the Nasal Deformity Rating Scale can be used to classify individuals with primary UCL/N deformity and to categorize them for future outcome studies.
Description
Keywords
-