Lack of correlation between objective and subjective evaluation of residual stigmata in cleft patients

The multidisciplinary cleft team of the Academisch Ziekenhuis Vrije Universiteit treats cleft patients until they are 18 years old, when treatment is supposedly complete, with patients having a minimum of residual facial stigmata. The authors evaluated the relationship between objective residual facial deformities present and the patients' subjective judgment of the result of treatment by interviewing 50 patients (age range, 19-25 years) regarding their facial appearance and possible remaining wishes for secondary correction. All patients were subjected to 13 in vivo anthropometric measurements, and 5 inclinations were assessed on lateral facial photographs. The results of these measurements were compared with normal values to establish possible objective deformities. The subjective and the objective results were compared for each individual. Anthropometric evaluation revealed an average of 5.3 divergent measurement values per patient (range, 1-8 divergent values). No correlation was found between objective judgment and the patient's subjective judgment. A weak negative correlation could be demonstrated between the score on a visual analog scale and the wish for secondary correction. Surgeons should be aware that cleft patients have no anthropometric interest in their facial appearance.