A Proposed Nasal Deformity Classification System for Infants With Cleft Lip and Palate

This study aimed to validate a newly developed, anatomically based, classification system for nasal deformities in infants with cleft lip and palate (CLP). The goal was to standardize assessments, enhance diagnostic accuracy, and ultimately improve treatment outcomes for CLP patients.

A total of 15 craniofacial specialists, including 9 plastic surgeons and 6 orthodontists, participated in the study. Using a REDCap survey, the specialists evaluated the proposed nasal cleft classification system by reviewing 10 randomly selected presurgical photographs of patients with unilateral and bilateral cleft lip and/or palate treated at Nicklaus Children's Hospital between 2020 and 2023. Each specialist classified the nasal deformities using the proposed nasal cleft classification chart.

Interrater reliability was measured using the intraclass correlation coefficient (ICC), with results indicating "excellent" agreement: ICCs of 0.816 for unilateral and 0.743 for bilateral nasal clefts. These findings demonstrate strong consistency among specialists applying the classification system to photographs.

The study suggests that this new classification system can effectively categorize the severity of nasal deformities in CLP patients, leading to more consistent diagnoses and treatment plans. By providing a reliable tool for health care professionals, this system can improve the evaluation of deformity severity, enhance treatment outcome assessments, and contribute to the development of standardized treatment protocols for infants with CLP.