Peanchitlertkajorn Supakit, Mercado Ana, Daskalogiannakis John, Hathaway Ronald, Russell Kathleen, Semb Gunvor, Shaw William, Lamichane Manish, Cohen Marilyn, Long Ross E
1 University of Texas Southwestern Medical Center, Dallas, TX, USA.
2 Baylor College of Dentistry, Dallas, TX, USA.
Cleft Palate Craniofac J. 2018 May;55(5):655-663. doi: 10.1177/1055665618754947. Epub 2018 Feb 15.
To compare nasolabial appearance outcomes of patients with complete unilateral cleft lip and palate (CUCLP) in preadolescence from 4 cleft centers including a center using nasoalveolar molding (NAM) and primary nasal reconstruction.
Retrospective cohort study.
Four cleft centers in North America.
135 subjects with repaired CUCLP.
Frontal and profile facial pictures were assessed using the Asher-McDade rating scale. Intra- and interrater reliability were tested using weighted Kappa statistics. Median scores by center were compared with Kruskal-Wallis statistics.
Intrarater reliability scores were moderate to good. Interrater reliability scores were moderate. Significant differences ( P < .05) among centers were found. For nasal form, center G (median = 2.83) had better scores than centers C and D (C median = 3.33, D median = 3.17). For nose symmetry, center G had better scores (median = 2.33) than all other centers (B median = 2.67, C median = 2.83, D median = 2.83). For vermillion border, center G had better scores (median = 2.58) than centers B and C (B median = 3.17, C median = 3.17). For nasolabial profile, center G (median score = 2.67) had better scores than center C (median = 3.00). For total nasolabial score, center G (median = 2.67) had better scores than all other centers (B median = 2.83, C median = 3, D median = 2.83).
The protocol followed by center G, the only center that performed NAM and primary nasal reconstruction, produced better results in all categories when compared to center C, the only center that did not perform presurgical orthopedics or lip/nose revisions. When compared to centers that performed traditional presurgical orthopedics and surgical revisions (B and D), center G was not consistently better in all categories. As with other uncontrolled, retrospective intercenter studies, it is not possible to attribute the outcomes to a specific protocol component.
比较包括采用鼻牙槽塑形术（NAM）和一期鼻再造术的中心在内的4个腭裂中心青春期前完全性单侧唇腭裂（CUCLP）患者的鼻唇外观效果。
回顾性队列研究。
北美4个腭裂中心。
135例接受修复的CUCLP患者。
使用阿舍-麦克戴德评分量表对正面和侧面面部照片进行评估。使用加权卡方统计量测试评分者内和评分者间的可靠性。采用Kruskal-Wallis统计量比较各中心的中位数得分。
评分者内可靠性得分中等至良好。评分者间可靠性得分中等。发现各中心之间存在显著差异（P <.05）。对于鼻形态，G中心（中位数 = 2.83）的得分高于C中心和D中心（C中心中位数 = 3.33，D中心中位数 = 3.17）。对于鼻对称性，G中心得分（中位数 = 2.33）高于所有其他中心（B中心中位数 = 2.67，C中心中位数 = 2.83，D中心中位数 = 2.83）。对于唇红缘，G中心得分（中位数 = 2.58）高于B中心和C中心（B中心中位数 = 3.17，C中心中位数 = 3.17）。对于鼻唇侧面轮廓，G中心（中位数得分 = 2.67）的得分高于C中心（中位数 = 3.00）。对于鼻唇总评分，G中心（中位数 = 2.67）的得分高于所有其他中心（B中心中位数 = 2.83，C中心中位数 = 3，D中心中位数 = 2.83）。
与唯一未进行术前正畸或唇/鼻修复的C中心相比，唯一进行NAM和一期鼻再造术的G中心在所有类别中均产生了更好的结果。与进行传统术前正畸和手术修复的B中心和D中心相比，G中心在所有类别中并非始终表现更好。与其他非对照的回顾性中心间研究一样，不可能将结果归因于特定的方案组成部分。
