Dobbie Allison M, Ward Ralph C, Oyer Samuel L, Overton Lewis J, Hill Elizabeth G, Patel Krishna G
1 Department of Otolaryngology, University of Colorado School of Medicine, Colorado Springs, CO, USA.
2 Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Cleft Palate Craniofac J. 2018 Feb;55(2):213-219. doi: 10.1177/1055665617718824.
Lip asymmetry after a unilateral cleft lip repair can be perceived as an unsatisfactory result. The objective of this study is to determine the degree of upper lip asymmetry and/or nasal alar hooding required for recognition of asymmetry in a simulated model of unilateral cleft lip.
A model of unilateral cleft lip was created using digital morphing software to simulate asymmetries in vermilion height and nasal hooding in photographs of children. Volunteers were shown photographs for different time intervals and with varying degrees of asymmetry. Ability to detect facial asymmetry was recorded and analyzed.
This study was conducted by surveying layperson volunteers in public community settings.
108 layperson volunteers were randomly surveyed.
The primary outcome measure was a reported lip or nose asymmetry by the volunteers. Proportions and corresponding 95% confidence intervals were obtained to estimate the probability of reporting an asymmetry at 3- and 10-second intervals.
After 3- and 10-second exposure, labial asymmetry was perceived by ≥50% of subjects at 2 mm (62%, P = .001) and 1 mm (89%, P < .0001), respectively. Nasal asymmetry was detected by <50% of subjects at 3 seconds, but ≥50% perceived a 3-mm alteration at 10 seconds (64%, P < .0001). Photographs with combined nasal and labial modification did not lower the threshold for asymmetry perception compared to either deformity alone.
This study is the first to determine a predictable millimeter threshold for perceived asymmetry in cleft lip deformity using a digital model.
单侧唇裂修复术后唇部不对称可能被视为不理想的结果。本研究的目的是确定在单侧唇裂模拟模型中，识别不对称所需的上唇不对称程度和/或鼻翼遮盖程度。
使用数字变形软件创建单侧唇裂模型，以模拟儿童照片中唇红高度和鼻翼遮盖的不对称。向志愿者展示不同时间间隔和不同程度不对称的照片。记录并分析检测面部不对称的能力。
本研究通过在公共社区环境中对非专业志愿者进行调查来进行。
随机调查了108名非专业志愿者。
主要观察指标是志愿者报告的唇部或鼻部不对称情况。获得比例及相应的95%置信区间，以估计在3秒和10秒间隔时报告不对称的概率。
暴露3秒和10秒后，分别有≥50%的受试者在唇裂2mm（62%，P = 0.001）和1mm（89%，P < 0.0001）时察觉到唇部不对称。3秒时，<50%的受试者检测到鼻部不对称，但10秒时≥50%的受试者察觉到3mm的改变（64%，P < 0.0001）。与单独任何一种畸形相比，合并鼻部和唇部改变的照片并未降低不对称感知阈值。
本研究首次使用数字模型确定了唇裂畸形中可预测的毫米级不对称感知阈值。
