Influence of objective three-dimensional measures and movement images on surgeon treatment planning for lip revision surgery

Carroll-ann Trotman, Ceib Phillips, Julian J. Faraway, Terry Hartman, John A. Van Aalst

Research output: Contribution to journalArticlepeer-review

7 Citations (SciVal)

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.
Original languageEnglish
Pages (from-to)684-695
Number of pages12
JournalCleft Palate-Craniofacial Journal
Volume50
Issue number6
DOIs
Publication statusPublished - Nov 2013

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