Nasolabial appearance in adults with repaired unilateral cleft lip and palate: Relation between professional and lay rating and patients' satisfaction

Abstract

The aim of the current study was to evaluate the relation between professional and lay rating and patients' satisfaction with nasolabial appearance in adults with repaired unilateral cleft lip and palate (UCLP). A cross-sectional population study, long-term follow-up with controls matched for age and sex was performed. All patients with complete UCLP born between 1960 and 1987 (n = 109), treated at Uppsala University Hospital, Sweden were invited and 83 (76%) agreed to participate. Follow-up was 20-47 years after primary lip surgery. An age- and sex-matched control group of 65 people were evaluated in the same way. Ratings from professional and lay panels of cropped photographs using a 5 point categorical scale for 4 features of the nasolabial appearance and the satisfaction with appearance questionnaire (SWA) for self-assessment were used. Professional and lay ratings correlated positively but the professionals consistently rated nasolabial appearance as better than did the lay panel (p < 0.001). Self-assessment of nasolabial appearance with the SWA (by patients and controls) did not correlate with the judgement of lay or professional panels. Judgement of nasolabial appearance in adults with repaired UCLP differs among professionals, lay people, and patients. This should be considered when deciding about secondary surgical treatment of signs of clefts.

Key Words::

• Photography
• nasolabial appearance
• evaluation
• cleft lip and palate
• panel judgement
• patient satisfaction

Acknowledgements

We thank Lars Berglund and Lisa Wernroth at the Uppsala Clinical Research, Sweden, for valuable statistical advice. We thank the Uppsala Cleft Team for caring for patients with clefts over the years and for sharing their clinical experiences with us. We also thank the patients and controls who participated in the study, and the professional and lay members of the panels for their work. Financial support was received from the Thuréus Foundation, the Golje Foundation and The Swedish Society of Medicine, and from Research and Educational funds from Uppsala University Hospital.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.