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CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/s-0044-1792018
Original Article

Evaluation of Nasolabial Aesthetics and Self-Image Satisfaction among 16- to 20-Year-Old Patients with Cleft Lip and Palate in Northeast Thailand

Palakorn Surakunprapha 
1   Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
,
Suteera Pradubwong 
2   The Research Center of Cleft Lip-Palate and Craniofacial Deformities, Khon Kaen University, Khon Kaen, Thailand
,
Kamonwan Jenwitheesuk 
1   Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
,
Poonsak Pisek 
3   Divisions of Orthodontics, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
,
Bowornsilp Chowchuen 
1   Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
› Author Affiliations Funding This study received financial support from Khon Kaen University.
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Abstract

Background Cleft lip and palate (CLP) impact nasolabial appearance, influencing the physical, psychological, and quality of life (QoL) of affected individuals. Evaluations of the nasolabial aesthetics by patients and medical professionals (both experienced and inexperienced) are critical for enhancing patient care.

Methods This cross-sectional study enrolled 32 patients aged 16 to 20 years with CLP who underwent continuous treatment at a university hospital in Thailand. Participants were asked to complete the Thaicleft QoL questionnaire for nasolabial aesthetic self-assessment and had their two-dimensional facial images captured and then evaluated by two groups of medical evaluators: four experienced and four inexperienced professionals. Data are presented as means and percentages, with analysis including standard deviations, Cronbach's α for evaluator consistency, kappa for interrater reliability, and the Wilcoxon signed-rank test to compare aesthetic judgments between the experienced and inexperienced medical evaluators.

Results Among the 32 patients, 19 (59.37%) were females, and 22 (68.75%) had unilateral CLP and 10 (31.25%) had bilateral CLP, all reporting high nasolabial aesthetic satisfaction. Inexperienced evaluators assigned higher aesthetic scores than their experienced counterparts (p = 0.01), with statistically significant agreement among inexperienced evaluators in their assessments (p < 0.05). Both group of evaluators demonstrated high reliability in terms of the lip.

Conclusion Experienced evaluators assigned lower aesthetic scores than inexperienced evaluators did. The patients themselves expressed high levels of satisfaction with their nasolabial appearance, indicating that the treatment outcomes were favorable from the patients' perspective.

Keywords

evaluation - nasolabial appearance - cleft lip and palate - Thailand

Data Availability Statement

The data supporting the findings of this study are available upon request from the corresponding author. These data are not publicly accessible due to privacy and ethical restrictions.


Ethical Approval

This study was approved by the Center for Ethics in Human Research Committee, Khon Kaen University (ID no. HE651370). Written informed consent was obtained from all participants.


Informed Consent

Verbal and written informed consent was obtained from all individuals included in this study.


Authors' Contributions

P.S. was involved in conceptualization, supervision, and writing the original draft. S.P. was involved in collecting data and data curation, investigation, formal analysis, and writing the original draft. K.J. and P.P. were involved in data checking and writing, review, and editing the manuscript. B.C. was involved with data validation.




Publication History

Received: 22 August 2023

Accepted: 23 September 2024

Article published online:
24 December 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Ahmed MK, Bui AH, Taioli E. Epidemiology of cleft lip and palate. In: Almasri MA. ed. Designing Strategies for Cleft Lip and Palate Care. Loneon: IntechOpen; 2017
    Search in Google Scholar
  • 2 Fuangtharnthip P, Chonnapasatid W, Thiradilok S, Manopatanakul S, Jaruratanasirikul S. Registry-based study of prevalence of cleft lip/palate in Thailand from 2012 to 2015. Cleft Palate Craniofac J 2021; 58 (11) 1430-1437
    CrossrefPubMedSearch in Google Scholar
  • 3 Sinko K, Jagsch R, Prechtl V, Watzinger F, Hollmann K, Baumann A. Evaluation of esthetic, functional, and quality-of-life outcome in adult cleft lip and palate patients. Cleft Palate Craniofac J 2005; 42 (04) 355-361
    CrossrefPubMedSearch in Google Scholar
  • 4 Mikalsen SK, Folstad I, Yoccoz NG, Laeng B. The spectacular human nose: an amplifier of individual quality?. PeerJ 2014; 2: e357
    CrossrefPubMedSearch in Google Scholar
  • 5 Richman LC. Self-reported social, speech, and facial concerns and personality adjustment of adolescents with cleft lip and palate. Cleft Palate J 1983; 20 (02) 108-112
    PubMedSearch in Google Scholar
  • 6 Millard T, Richman LC. Different cleft conditions, facial appearance, and speech: relationship to psychological variables. Cleft Palate Craniofac J 2001; 38 (01) 68-75
    CrossrefPubMedSearch in Google Scholar
  • 7 Gkantidis N, Papamanou DA, Karamolegkou M, Dorotheou D. Esthetic, functional, and everyday life assessment of individuals with cleft lip and/or palate. BioMed Res Int 2015; 2015: 510395
    CrossrefPubMedSearch in Google Scholar
  • 8 Ravikumar A, Balan R, Venkatramanan P. Self-perceived health related quality of life in adolescents with repaired cleft lip and palate. Int J Contemp Pediatrics 2017; 4 (04) 1263-1266
    CrossrefSearch in Google Scholar
  • 9 Crerand CE, Sarwer DB, Kazak AE, Clarke A, Rumsey N. Body image and quality of life in adolescents with craniofacial conditions. Cleft Palate Craniofac J 2017; 54 (01) 2-12
    CrossrefPubMedSearch in Google Scholar
  • 10 Thittiwong R, Manosudprasit M, Wangsrimongkol T. et al. Evaluation of facial appearance among patients with repaired unilateral cleft lip and palate: comparison of patient- and clinician-ratings of satisfaction. J Med Assoc Thai 2015; 98 (Suppl. 07) S68-S76
    PubMedSearch in Google Scholar
  • 11 Klassen AF, Tsangaris E, Forrest CR. et al. Quality of life of children treated for cleft lip and/or palate: a systematic review. J Plast Reconstr Aesthet Surg 2012; 65 (05) 547-557
    CrossrefPubMedSearch in Google Scholar
  • 12 Trimetsuntorn K, Manosudprasit A, Manosudprasit A, Phaoseree N, Pisek A, Pisek P. Evaluation of postorthodontic changes in the treatment of cleft lip and palate patients using the PAR index. Cleft Palate Craniofac J 2020; 57 (01) 29-34
    CrossrefPubMedSearch in Google Scholar
  • 13 Patjanasoontorn N, Pradubwong S, Mongkoltawornchai S, Phetcharat T, Chowchuen B. Development and reliability of the THAICLEFT quality of life questionnaire for children with cleft lip/palate and families. J Med Assoc Thai 2010; 93 (Suppl. 04) S16-S18
    PubMedSearch in Google Scholar
  • 14 Surakunprapha P, Paggasang Y, Jenwitheesuk K, Pisek P, Chowchuen B, Pradubwong S. Treatment outcomes of quality of life and nasolabial appearance in patients with cleft lip and palate of 10-year-old group. Srinagarind Med J 2021; 36 (03) 340-346
    Search in Google Scholar
  • 15 Paiva TS, Andre M, Paiva WS, Mattos BS. Aesthetic evaluation of the nasolabial region in children with unilateral cleft lip and palate comparing expert versus nonexperience health professionals. BioMed Res Int 2014; 2014: 460106
    CrossrefPubMedSearch in Google Scholar
  • 16 Asher-McDade C, Roberts C, Shaw WC, Gallager C. Development of a method for rating nasolabial appearance in patients with clefts of the lip and palate. Cleft Palate Craniofac J 1991; 28 (04) 385-390 , discussion 390–391
    CrossrefPubMedSearch in Google Scholar