xRead - Treatment of Cleft Lip and Cleft Palate (May 2025)

Plastic and Reconstructive Surgery • March 2023

Table 3. Objective Outcome Assessment Measures

Patients, n

Follow-Up, Years

Article

Objective Measures

Comparison Group

Gawrych and Janiszewska Olszowska 22 (2011) Gosla-Reddy et al. 23 (2011) Yoshimura et al. 24 (2015) Morselli et al. 25 (2012)

91 Septal deviation measured by Z angle, assessed by midface reference points

10 to 14 Cleft repair without septoplasty

76 2D, five indirect anthropometric measurements divided by noncleft side 14 Lateral cephalogram, five vertical points marked, ratios calculated, assessed nasal length and columella height 20 Analysis of symmetry using caliper measurements: nostril thickness,

2

Cleft repair without septoplasty

10 Cleft repair without rhinoplasty or age-matched norms

6.2 Cleft repair without rhinoplasty

diameter, minor diameter, columellar width, length, nasal width, tip projection, nasolabial angle

Tse et al. 10 (2020) 102 3D images, anthropometric measurements

5

Age-matched norms

32 Anthropometric measurements: nostril

1.9 Study group

Rossell-Perry 32 (2017) Lu et al. 18 (2017)

dome height, columella length, alar width

97 2D photographs, anthropometric measurements

4.9 Cleft repair and rhinoplasty with graft ( n = 38) versus cleft repair and rhinoplasty without graft ( n = 59) Cleft repair without overcorrection 5 to 6 Closed rhinoplasty ( n = 21) versus bilateral rim incision ( n = 25) versus Tajima incision cleft side and rim incision noncleft side ( n = 20) 78 months Cleft repair without rhinoplasty or age-matched norms 1

19 2D photographs, anthropometric measurements, compared with noncleft side 20 2D photographs, indirect anthropometric measurements; ratio of cleft side to noncleft side

Lonic et al. 26 (2016)

Lu et al. 17 (2012)

Kim et al. 27 (2004) 30 2D photographs, anthropometric measurements

20 Nasal endoscopy assessing septal deviation (Mladina classification), turbinate size 0 (normal) to 3 (severe enlargement)

5

Cleft repair without rhinoseptoplasty

Pinto et al. 16 (2018)

Seo et al. 13 (2020) 52 3D photographs, eight linear, four angular, five proportional, one surface area, and one volume measurement performed by two evaluators

>17 Age-matched norms

10 2D photographs, indirect anthropometric measurements 20 2D photography traced onto paper then measured 28 2D photography and computer analysis of symmetry; morbidity as determined by number of additional operations before age 9 42 Direct caliper measurements of nostril height and floor width 27 Angles measured from 2D photographs 44 3D photographs with length and volumetric measures

18 Age-matched norms or cleft repair without rhinoplasty

McComb and Coghlan 11 (1996) James et al. 28 (1991) Brusse et al. 29 (1999)

10 Age-matched norms

9

Age-matched norms, cleft repair without rhinoplasty

9 months NA

Tang et al. 33 (2016)

1

Farkas norms

Bschorer et al. 30 (2018) van Loon et al. 31 (2011)

1

Volunteers without cleft

2D, two-dimensional; 3D, three-dimensional; NA, not applicable.

methods to take anthropometric measurements, 3D imaging is most useful. Its use is growing quickly in plastic surgery. Newer studies in this review 10,13,31 incorporated this technology, demonstrating the multiple distinctive anthropometric and mor phometric measurements that can be possible. However, the majority of the included studies used conventional 2D photography. 11,17,18,23,24,26–29,32 2D photography requires rigorous standardiza tion and can suffer from differences in lighting,

camera distance, and focal length. This makes 2D photography a more challenging medium to use for objective measurements. However, the use of older technologies is inherent in long-term stud ies: when a PR result is not considered complete until 18 years of follow-up, there will certainly be changes in technology during those nearly 2 decades. Further work should continue to use all available technology in order to more completely answer questions regarding PR.

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