The Slavcleft: a three-center study of the outcome of treatment of cleft lip and palate. Nasolabial appearance.

Stebel, Adam; Urbanová, Wanda; Klimova, Irena; Brudnicki, Andrzej; Dubovska, Ivana; Polackova, Petra; Kroupová, Daniela; Koťová, Magdalena; Fudalej, Piotr S. (2021). The Slavcleft: a three-center study of the outcome of treatment of cleft lip and palate. Nasolabial appearance. PeerJ, 9, e10631. PeerJ, Ltd 10.7717/peerj.10631

[img]
Preview
Text
peerj-10631.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (3MB) | Preview

Background

There is a multitude of protocols of treatment of cleft lip and palate (CLP) worldwide differing in number of operations, surgical techniques, and timings of surgeries. Despite, facial appearance in subjects with CLP is rarely ideal and residual stigmata are easy to notice in many patients irrespective of the protocol. The prospective controlled investigations are optimal for comparing effectiveness of treatment protocols. Because prospective studies are very challenging to perform in CLP field, it is reasonable to retrospectively assess different surgical protocols to identify the promising ones and then to test them in a prospective way.

Methods

Our objective was to assess the nasolabial appearance in a preadolescent Slavic population with unilateral cleft lip and palate (UCLP) by using the 0-200 numeric scale with reference photographs. Patients treated in Warsaw, Poland (n = 32), Prague, Czech Republic (n = 26) and Bratislava, Slovakia (n = 17) were included in this retrospective study. Each cleft center used a unique surgical protocol. Two panels of professional raters (n = 7) and laypeople (n = 10) scored blindly the nasolabial esthetics on cropped frontal and profile images with cropped reference photograph present on the same slide. Intra- and inter-rater agreement was assessed with Cronbach's alpha, intraclass correlation coefficients, t-tests, and Bland-Altman plots. Inter-group differences were evaluated with one-way ANOVA and regression analysis.

Results

The agreement within and between raters was acceptable. We found that patients treated in Warsaw, Prague, and Bratislava showed comparable nasolabial appearance on frontal and profile photographs when judged by both professional raters (p > 0.05) and laypeople (p > 0.05). Regression analysis did not identify influence of gender, group (i.e., Warsaw, Prague, and Bratislava), age at lip repair, surgeon, and age at photographic assessment on esthetic outcome (p > 0.05).

Conclusion

This study showed that none of the surgical protocols showed superiority to produce good nasolabial appearance.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Fudalej, Piotr

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2167-8359

Publisher:

PeerJ, Ltd

Language:

English

Submitter:

Renate Imhof-Etter

Date Deposited:

25 May 2021 08:47

Last Modified:

30 May 2021 03:02

Publisher DOI:

10.7717/peerj.10631

PubMed ID:

33614265

Uncontrolled Keywords:

Cleft lip and palate Esthetics Nasolabial appearance Slavs

BORIS DOI:

10.7892/boris.152942

URI:

https://boris.unibe.ch/id/eprint/152942

Actions (login required)

Edit item Edit item
Provide Feedback