Background: Surgical and orthodontic treatment of unilateral cleft lip +/– palate can produce dramatic changes in nasolabial form; however, the lack of ideal methods with which to objectively document three-dimensional form limits the ability to assess treatment outcomes. The purpose of this study was to determine the reliability of three-dimensional stereophotogrammetry for anthropometric assessment of the unilateral cleft lip +/– palate deformity in infants before cleft lip repair.
Methods: Preoperative three-dimensional images were acquired from 26 consecutive patients with unrepaired unilateral cleft lip +/– palate. Three raters performed indirect anthropometry on each image on two separate occasions, with at least 1 week between rating sessions. One rater performed direct measurements on participants before surgery while in the operating room. Twenty-six linear and angular measurements were considered, and intrarater, interrater, and intermethod reliability were assessed.
Results: Regarding intrarater and interrater reliability, most measurements had Pearson coefficients greater than 0.75, mean differences less than 0.8 mm, and mean proportional differences less than 0.1. For measurements involving vermilion height, nostril remnants, or Cupid’s bow width, Pearson coefficients ranged from 0.3 to 0.75, mean differences ranged from 0.4 to 0.9 mm, and mean proportional differences ranged from 0.1 to 0.3. Regarding intermethod reliability, correlation coefficients ranged from 0.4 to 0.75 for most measurements. The mean differences for nose and lip measurements were less than 1 mm and between 0.8 and 1.3 mm, respectively.
Conclusion: Three-dimensional stereophotogrammetry provides a reliable method for many anthropometric measurements of nasolabial form in infants with unrepaired unilateral cleft lip +/– palate.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, II.
From the Division of Plastic and Craniofacial Surgery and the Division of Craniofacial Medicine, Seattle Children’s Hospital; the Departments of Surgery and Pediatrics, University of Washington School of Medicine; and the University of Washington School of Dentistry.
Received for publication August 27, 2013; accepted October 16, 2013.
Presented at the 12th International Congress on Cleft Lip/Palate and Related Craniofacial Anomalies, in Orlando, Florida, May 5 through 10, 2013.
Disclosure: None of the authors has a financial interest in any of the products or devices mentioned in this article.
Raymond Tse, M.D., Division of Plastic and Craniofacial Surgery, Department of Surgery, Seattle Children’s Hospital, 4800 Sand Point Way NE, M/S OB.9.527, Seattle, Wash. 98105, email@example.com