Functional outcomes of cleft lip surgery. Part I

Study design and surgeon ratings of lip disability and need for lip revision

Carroll Ann Trotman, Ceib Phillips, Greg K. Essick, Julian J. Faraway, Steven M Barlow, H. Wolfgang Losken, John Van Aalst, Lyna Rogers

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective: Children with a cleft of the upper lip exhibit obvious facial disfigurement. Many require multiple lip surgeries for an optimal esthetic result. However, because the decision for lip revision is based on subjective clinical criteria, clinicians may disagree on whether these surgeries should be performed. To establish more reliable, functionally relevant outcome criteria for evaluation and treatment planning, a clinical trial currently is in progress. In this article, the design of the clinical trial is described and results of a study on subjective evaluations of facial form by surgeons for or against the need for lip revision surgery are presented. Design: Parallel, three-group, nonrandomized clinical trial and subjective evaluations/ratings of facial views by surgeons. Subjects: For the clinical trial, children with repaired cleft lip and palate scheduled for a secondary lip revision, children with repaired cleft lip and palate who did not have lip revision, and noncleft children. For the subjective evaluations, surgeons' facial ratings of 21 children with repaired cleft lip. Analysis: Descriptive and Kappa statistics assessing the concordance of surgeons' ratings of (a) repeated facial views and (b) a recommendation of revision on viewing the prerevision and postrevision views. Results: The surgeons' consistency in rating repeated views was moderate to excellent; however, agreement among the surgeons when rating individual participants was low to moderate. Conclusions: The findings suggest that the agreement among surgeons was poor and support the need for more objective measures to assess the need for revision surgery.

Original languageEnglish (US)
Pages (from-to)598-606
Number of pages9
JournalCleft Palate-Craniofacial Journal
Volume44
Issue number6
DOIs
StatePublished - Nov 1 2007

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Cleft Lip
Lip
Clinical Trials
Cleft Palate
Reoperation
Plastic Surgery
Surgeons

Keywords

  • Clinical trial
  • Functional outcomes
  • Lip revision surgery

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology

Cite this

Functional outcomes of cleft lip surgery. Part I : Study design and surgeon ratings of lip disability and need for lip revision. / Trotman, Carroll Ann; Phillips, Ceib; Essick, Greg K.; Faraway, Julian J.; Barlow, Steven M; Losken, H. Wolfgang; Van Aalst, John; Rogers, Lyna.

In: Cleft Palate-Craniofacial Journal, Vol. 44, No. 6, 01.11.2007, p. 598-606.

Research output: Contribution to journalArticle

Trotman, Carroll Ann ; Phillips, Ceib ; Essick, Greg K. ; Faraway, Julian J. ; Barlow, Steven M ; Losken, H. Wolfgang ; Van Aalst, John ; Rogers, Lyna. / Functional outcomes of cleft lip surgery. Part I : Study design and surgeon ratings of lip disability and need for lip revision. In: Cleft Palate-Craniofacial Journal. 2007 ; Vol. 44, No. 6. pp. 598-606.
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