An anatomical subunit-based outcome assessment scale for bilateral cleft lip and palate

Bonanthaya, K; Shetty, PN; Fudalej, Piotr; Rao, DD; Bitra, S; Pabari, M; Rachwalski, M (2017). An anatomical subunit-based outcome assessment scale for bilateral cleft lip and palate. International journal of oral & maxillofacial surgery, 46(8), pp. 988-992. Elsevier 10.1016/j.ijom.2017.03.021

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As there is currently no internationally accepted outcome measurement tool available for complete bilateral cleft lip and palate (CBCLP), the goal of this prospective study was to develop a numerical evaluation scale that allows reliable scoring of this cleft deformity. Our cohort comprised 121 Indian subjects with CBCLP who underwent surgical repair (mean age at time of surgery 6.53 months) using a modified Millard technique. A panel of three professionals evaluated each subject's outcome of bilateral cleft lip repair 6 months postoperatively on two-dimensional (2D) full-face photographs in the frontal view and worm's eye view. A simple two-point rating system was applied to separately analyse a total of 12 components of lip, nose, and scar. The results and mean scores for the analysed anatomical areas were 2.2±1.01 (max=3) for nose, 5.4±1.54 (max=8) for lip, and 1.9±1.3 (max=3) for scar, with a total score 7.7±2.21 (max=12) indicating a good surgical outcome. The inter-examiner ICC for nose, lip, scar, and total score was calculated at 0.836, 0.889, 0.723, and 0.927 respectively and indicated a strong level of repeatability and reliability that was highly significant (P<0.001). In conclusion, we were able to develop and test a scoring system for measuring outcomes in CBCLP that warrants simplicity of use, reliability and reproducibility.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Orthodontics

UniBE Contributor:

Fudalej, Piotr


600 Technology > 610 Medicine & health








Renate Imhof-Etter

Date Deposited:

28 Mar 2018 13:47

Last Modified:

24 Oct 2019 21:06

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

bilateral cleft lip, bilateral cleft lip and palate, binary scale, outcome assessment




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