Abstract
Objective: To determine whether a systematic evaluation of facial soft tissues of patients with cleft lip and palate, using facial video images and objective three-dimensional measurements of movement, change surgeons' treatment plans for lip revision surgery.
Design: Prospective longitudinal study.
Setting: The University of North Carolina School of Dentistry.
Patients, Participants: A group of patients with repaired cleft lip and palate (n = 21), a noncleft control group (n = 37), and surgeons experienced in cleft care.
Interventions: Lip revision.
Main Outcome Measures: (1) facial photographic images; (2) facial video images during animations; (3) objective three-dimensional measurements of upper lip movement based on z scores; and (4) objective dynamic and visual three-dimensional measurement of facial soft tissue movement.
Results: With the use of the video images plus objective three-dimensional measures, the operating surgeon changed the problem list of the surgical treatment plan for 86% of the patients (95% confidence interval, 0.64 to 0.97) and the surgical goals for 71% of the patients (95% confidence interval, 0.48 to 0.89). The surgeon group varied in the percentage of patients for whom the problem list was modified, ranging from 24% (95% confidence interval, 8% to 47%) to 48% (95% confidence interval, 26% to 70%) of patients, and the percentage for whom the surgical goals were modified, ranging from 14% (94% confidence interval, 3% to 36%) to 48% (95% confidence interval, 26% to 70%) of patients.
Conclusions: For all surgeons, the additional assessment components of the systematic valuation resulted in a change in clinical decision making for some patients.
Design: Prospective longitudinal study.
Setting: The University of North Carolina School of Dentistry.
Patients, Participants: A group of patients with repaired cleft lip and palate (n = 21), a noncleft control group (n = 37), and surgeons experienced in cleft care.
Interventions: Lip revision.
Main Outcome Measures: (1) facial photographic images; (2) facial video images during animations; (3) objective three-dimensional measurements of upper lip movement based on z scores; and (4) objective dynamic and visual three-dimensional measurement of facial soft tissue movement.
Results: With the use of the video images plus objective three-dimensional measures, the operating surgeon changed the problem list of the surgical treatment plan for 86% of the patients (95% confidence interval, 0.64 to 0.97) and the surgical goals for 71% of the patients (95% confidence interval, 0.48 to 0.89). The surgeon group varied in the percentage of patients for whom the problem list was modified, ranging from 24% (95% confidence interval, 8% to 47%) to 48% (95% confidence interval, 26% to 70%) of patients, and the percentage for whom the surgical goals were modified, ranging from 14% (94% confidence interval, 3% to 36%) to 48% (95% confidence interval, 26% to 70%) of patients.
Conclusions: For all surgeons, the additional assessment components of the systematic valuation resulted in a change in clinical decision making for some patients.
| Original language | English |
|---|---|
| Pages (from-to) | 684-695 |
| Number of pages | 12 |
| Journal | Cleft Palate-Craniofacial Journal |
| Volume | 50 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Nov 2013 |