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Developing a visual rating chart for the esthetic outcome of unilateral cleft lip and palate repair
A Olusanya Adeola1, A Akadiri Oladimeji2
1Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Oyo State, Nigeria.
Introduction:
Aesthetic impairment is a major concern for the cleft lip/palate patient. Thus, auditing of postsurgical esthetic outcome needs to be further explored as till date no universally accepted protocol exists. The study objective was to propose a new visual rating chart (VRC) for the aesthetic outcome of cleft lip and palate (CLP) surgery.
Materials And Methods:
In a retrospective review of 200 repaired clefts, the common esthetic deficiencies were identified, categorized and ranked in the order of severity. A chart of the illustrative diagram with textual description of the defects was produced and used as a basis for rating outcome by two groups of raters (familiar raters and recruited raters). Intra- and inter-raters reliability was estimated using Cohen's kappa statistics and intra-class correlation coefficient (ICC). Comparison between mean group coefficient was achieved with Kendall's correlation coefficient of concordance.
Results:
The intra- and inter-rater reliability for familiar raters was found to be strong with kappa values range of 0.80-0.87 (P < 0.001). Similarly, inter-raters' reliability by recruited judges was very strong using ICC at both single (0.768) and average measures (0.982).
Conclusion:
The VRC is a reliable tool for assessing the esthetic outcome of CLP repairs.
