Although efforts to improve access to care for patients with cleft lip in the developing world have grown tremendously, there is a dearth of data regarding aesthetic outcomes after cleft lip repairs in this setting. Defining severity-outcome relationships has the potential to improve efficiency of care delivery in resource-limited settings, and to improve overall results. In this study, we investigate the relationship between initial cleft lip severity and early aesthetic outcomes following surgical repair of primary unilateral cleft lip.
Using previously validated tools to assess unilateral cleft lip severity and aesthetic outcome after repair, we evaluated 1,823 consecutive patients who underwent primary unilateral cleft lip/nose (UCL/N) repair. Three separate evaluators scored each case for a total of 5,469 total independent evaluations.
Our results show that with increasing severity of UCL/N deformity, there is a corresponding decrease in early aesthetic outcome scores. Using our results, we established normative early aesthetic outcomes following repair for each severity grade of UCL/N deformity.
In conclusion, this study has achieved a standardized, timely, and cost-effective evaluation of 1,823 surgical cases of primary UCL/N repair. This data set provides a normal distribution of aesthetic results according to initial cleft severity and defines a standard of “expected” aesthetic results after primary UCL/N repair. Our results also show a clear correlation between initial severity and immediate aesthetic result after surgery, though we also show that excellent results are possible regardless of initial cleft severity.
From the *Division of Plastic Surgery, Penn State Hershey Medical Center, Hershey, Pa.
†Operation Smile, Virginia Beach, Va.
‡Premium Care Plastic Surgery, Cartagena, Colombia
§Division of Plastic Surgery, Northwestern University, Chicago, Ill.
¶MGM Dental College and Hospital, Navi Mumbai, India
‖Division of Plastic Surgery, Childrens Hospital of Philadelphia, Philadelphia, Pa.
**Division of Plastic Surgery, Skane University Hospital, Malmo, Sweden.
Published online 22 January 2019.
Received for publication August 13, 2018; accepted October 26, 2018.
Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.
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Alex Campbell, MD, Division of Plastic Surgery, Penn State Hershey Medical Center, 500 University Dr., PO Box 850, Hershey, PA 17033, E-mail: firstname.lastname@example.org
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