To describe the soft tissue profile of children with unilateral cleft lip and palate from profile photographs and assess the reliability of this method.
Design
Retrospective analysis of prospectively collected data.
Setting
A national study in the United Kingdom.
Subjects
Caucasian children born in the United Kingdom between April 1, 1982, and March 31, 1984, and aged between 12 and 14 years at data collection. A cleft side and noncleft side profile photograph was available for each of 175 children.
Method
Seven angular measurements were made using Dentofacial Planner Plus software, and the profile appearance was rated by an expert panel.
Results
Reliability for repeated measurement of the same photograph was acceptable for all but li-sms-pgs (labiomental fold). Similar levels of reliability were found when comparing measurements from the cleft side and non-cleft side photograph. Logistic regression showed that the variables nst-sn-ls (nasolabial angle), sss-ns-pgs (maxillary prominence), and gs-prn-pgs (facial convexity) were associated with the profile score.
Conclusions
Soft tissue profile analysis from photographs is reliable and robust under a range of conditions. Soft tissue profile measurements are associated with panel ratings of profile.
Asher-McDadeC., BrattstromV., DahlE., McWilliamJ., MolstedK., PlintD.A., Prahl-AndersonB., SembG., ShawW.C.. A six centre international study of treatment outcome in patients with clefts of the lip and palate: part 4. Assessment of nasolabial appearance.Cleft Palate Craniofac J.1992; 29: 409–412.
2.
Asher-McDadeC., RobertsC.T., ShawW.C., GallagherC.. The development of a method for rating nasolabial appearance in patients with clefts of the lip and palate.Cleft Palate Craniofac J.1991; 28: 385–391.
3.
BlandJ.M., AltmanD.G.. Statistical methods for assessing agreement between two methods of clinical measurement.Lancet.1986; 8: 307–310.
4.
BrattstromV.. Craniofacial development in cleft lip and palate children related to different treatment regimes.Scand J Plast Reconstr Surg Hand Surg Suppl.1991; 25: 1–31.
5.
BrattstromV., McWilliamJ., LarsonO., SembG.. Craniofacial development in children with unilateral clefts of the lip, alveolus, and palate treated according to four different regimes. III. The soft tissue profile at 16–18 years of age.Scand J Plast Reconstr Surg Hand Surg.1992a; 26: 197–202.
6.
BrattstromV., McWilliamJ., LarsonO., SembG.. Craniofacial development in children with unilateral clefts of the lip, alveolus, and palate treated according to three different regimes. Assessment of nasolabial appearance.Scand J Plast Reconstr Surg Hand Surg.1992b; 26: 313–319.
7.
ChaisrisookumpornN., StellaJ.P., EpkerB.N.. Anthropometric profile evaluation of the midface in patients with cleft lip and palate.Oral Surg Oral Med Oral Pathol.1995; 80: 127–136.
8.
CussonsP.D., MurisonM.S., FernandezA.E., PigottR.W.. A panel based assessment of early versus no nasal correction of the cleft lip nose.Br J Plast Surg.1993; 46: 7–12.
9.
FarkasL.G.. Accuracy of anthropometric measurements; past, present and future.Cleft Palate Craniofac J.1996; 33: 10–18.
10.
FarkasL.G.. Anthropometry of the Head and Face.New York: Raven Press;1994.
11.
FarkasL.G., BrysonW., KlotzJ.. Is photogrammetry of the face reliable?Plastic Reconstr Surg.1980; 66: 346–355.
12.
HorswellB.B., HolmesA.D., LevantB.A., BarnettJ.S.. Cephalometric and anthropomorphic observations of Binder's syndrome: a study of 19 patients.Plast Reconstr Surg.1988; 81: 325–335.
13.
HorswellB.B., LevantB.A.. Craniofacial growth in unilateral cleft lip and palate: skeletal growth from eight to eighteen years.Cleft Palate J.1988; 25: 114–121.
14.
HowellsD.J., ShawW.C.. The validity and reliability of ratings of dental and facial attractiveness for epidemiologic use.Am J Orthod.1985; 88: 402–408.
15.
MichielsG., SatherA.H.. Determinants of facial attractiveness in a sample of white women.Int J Adult Orthodon Orthognath Surg.1994; 9: 95–103.
16.
MolstedK., Asher-McDadeC., BrattstromV., DahlE., MarsM., McWilliamJ., PlintD.A., Prahl-AndersonB., SembG., ShawW.C., TheR.P.S.. A six centre international study of treatment outcome in patients with clefts of the lip and palate: part 2. Craniofacial form and soft tissue profile.Cleft Palate Craniofac J.1992; 29: 398–404.
17.
MorrantD.G.. A Method of Assessing Surgical Outcome in Unilateral Cleft Lip and Nose Repair Using Standardised Video Records.Manchester, England: University of Manchester;1992. Thesis.
18.
NegerM.. A quantitative method for the evaluation of the soft tissue facial profile.Am J Orthod.1959; 45: 738–751.
19.
RobertsC.T., SembG., ShawW.C.. Strategies for the advancement of surgical methods in cleft lip and palate.Cleft Palate Craniofac J.1991; 28: 141–149.
RossR.B., MacNameraM.C.. Effect of presurgical infant orthopedics on facial esthetics in complete bilateral cleft lip and palate.Cleft Palate Craniofac J.1994; 31: 68–73.
22.
SaxbyP.J., PalmerJ.H.. The use of an independent panel to assess the long term results of cleft lip repair.Br J Plast Surg.1986; 39: 373–378.
23.
ShawW.C.. The influence of children's dentofacial appearance on their social attractiveness as judged by peers and lay adults.Am J Orthod.1981; 79: 399–415.
24.
ShawW.C., RobertsC.T., SembG.. Evaluating treatment alternatives: measurement and design. In: TurveyT.A., VigK.W.L., FonsecaR.J., eds. Principles and Management of Facial Clefting Disorders and Craniosynostosis.Philadelphia: WB Saunders;1996.
25.
StonerM.M.. A photometric analysis of the facial profile: a method of assessing the facial change induced by orthodontic treatment.Am J Orthod.1955; 41: 453–465.
26.
TobiasenJ.M., HiebertJ.M.. Reliability of esthetic ratings of cleft impairment.Cleft Palate J.1988; 25: 313–317.
27.
VegterF., MulderJ.W., HageJ.J.. Major residual deformities in cleft patients: a new anthropometric approach.Cleft Palate Craniofac J.1997; 34: 106–110.
28.
WilliamsA., MildenhallS., SandyJ., MurphyT., BearnD., ShawW., SellD., DevlanB., MurrayJ.. The Clinical Standards Advisory Group (CSAG) Cleft Lip and Palate Study.Br J Orthod.1998; 25: 21–30.
29.
ZhuN.W., SenewiratneS., PigottR.W.. Lip posture and mouth width in children with unilateral cleft lip.Br J Plast Surg.1994; 47: 301–305.
