Development of a method for rating nasal appearance after cleft lip repair

The aim of this study was to develop a new method for evaluation of nasal appearance in patients after cleft lip repair. A method is described in which the nasal region is evaluated without the influence of the labial repair. Frontal, submental and profile view photographs of 45 patients after cleft lip repair were obtained. For each patient, two sets of images, one of the entire nasolabial region and one of the nasal complex in isolation, were assessed with a five-point scale by a panel of seven judges. Repeat evaluation at 1 week allowed calculation and comparison of intra-judge and inter-judge reproducibility. The interclass correlation coefficient (ICC) values were higher in the assessment of the isolated nasal complex when compared to the nasolabial region with the exception of the cleft side lateral view. The ICC value of the assessment based on all three views was the highest. The level of intra-judges and inter-judges was good, thus the reliability and sensibility of this new method is acceptable. This method is credible because acceptable pooled levels of reliability were obtained. In the future, this rating system may be used to assess nasal appearance after different treatments for cleft lip patients. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.