Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands.
The 3D - Facial Imaging Research Group, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J Craniomaxillofac Surg. 2017 Aug;45(8):1220-1226. doi: 10.1016/j.jcms.2017.04.004. Epub 2017 Apr 19.
For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments.
The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients.
The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38-0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08-0.17).
Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients.
对于唇裂患者的鼻唇外观评估，目前尚无广泛认可且可靠的评分系统。本研究比较了四种不同的评估方法，包括 2D 和 3D 不对称性评估以及美学评估。
本研究将先前使用 Asher-McDade 美学指数对 3D 照片进行的评估数据和评分，与 2D 美学评估（Cleft Aesthetic Rating Scale）和 SymNose（一种计算机化的 2D 不对称性评估技术）的结果进行了比较。使用 79 例患者的样本测试了这四种评估技术的可靠性和相关性。
3D 不对称性评估具有最高的可靠性，仅一位观察者即可进行（组内相关系数（ICC）：0.99）。仅一位观察者进行的鼻 2D 不对称性评估具有很高的可靠性（ICC：0.89）。然而，对于唇 2D 不对称性评估，需要更多的观察者。对于 2D 美学评估，需要 3 位观察者。四种技术中，3D 美学评估的单观察者可靠性最低（ICC：0.38-0.56）。不同评估方法之间的一致性很差到很差。2D 和 3D 美学评估之间的相关性最高（R：0.48）。值得注意的是，2D 和 3D 不对称性评估之间的相关性最低（0.08-0.17）。
不同的评估方法不一致，似乎测量的是鼻唇的不同方面。需要进一步研究以确定每种评估技术测量的内容以及哪些测量结果或结果与患者相关。
