Perth scoring system for assessment of the cleft lip

**Background**: Currently, there is no standardised assessment tool to assess facial aesthetics in cleft lip and palate surgery. Inter-centre comparison is hampered by the use of different aesthetic indices with low intra- and inter-rater reliability. **Aim**: The Perth scoring system is a new asse...

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Main Authors: Linda Monshizadeh, Vijith Vijayasekaran
Format: Article
Language:English
Published: Australian Society of Plastic Surgeons 2020-03-01
Series:Australasian Journal of Plastic Surgery
Online Access:https://doi.org/10.34239/ajops.v3n1.133
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author Linda Monshizadeh
Vijith Vijayasekaran
author_facet Linda Monshizadeh
Vijith Vijayasekaran
author_sort Linda Monshizadeh
collection DOAJ
description **Background**: Currently, there is no standardised assessment tool to assess facial aesthetics in cleft lip and palate surgery. Inter-centre comparison is hampered by the use of different aesthetic indices with low intra- and inter-rater reliability. **Aim**: The Perth scoring system is a new assessment tool for unilateral cleft lip which scores four key components of the cleft lip/nose repair: lip length, white roll, alar insertion point and vermillion. The aim of this study was to validate the Perth scoring system as a reliable and useful new assessment tool and to demonstrate the use of the scoring system to measure improvements after cleft lip revision. **Method**: Nineteen patients who underwent cleft lip revision by the senior author were selected. Pre- and postoperative photos were presented to a panel of raters to score. Scores were analysed to determine the intra-and inter-rater reliability and to compare outcomes. **Results**: Almost all patients (15/16) had improvement in scores (range 1.09–5.59) after cleft lip revision. Intra raters’ agreement scores from lowest to highest were: lip length (0.65), white roll (0.7), alar insertion point (0.78) and vermillion (0.78). The total intra-class correlation coefficient was 0.96 (0.94–0.98, 95% CI, P<0.000). **Conclusion**: This new scoring system is a valid and useful tool for assessment of the unilateral cleft lip. The high rate of intra- and inter-rater reliability allow it to serve as a useful tool to compare surgical outcomes both within and between centres. Further field testing with a larger cohort of patients is required.
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spelling doaj-art-6971d7d0e7c64dc3a33efcd3a227d7f72025-08-20T03:20:46ZengAustralian Society of Plastic SurgeonsAustralasian Journal of Plastic Surgery2209-170X2020-03-013110.34239/ajops.v3n1.133Perth scoring system for assessment of the cleft lipLinda MonshizadehVijith Vijayasekaran**Background**: Currently, there is no standardised assessment tool to assess facial aesthetics in cleft lip and palate surgery. Inter-centre comparison is hampered by the use of different aesthetic indices with low intra- and inter-rater reliability. **Aim**: The Perth scoring system is a new assessment tool for unilateral cleft lip which scores four key components of the cleft lip/nose repair: lip length, white roll, alar insertion point and vermillion. The aim of this study was to validate the Perth scoring system as a reliable and useful new assessment tool and to demonstrate the use of the scoring system to measure improvements after cleft lip revision. **Method**: Nineteen patients who underwent cleft lip revision by the senior author were selected. Pre- and postoperative photos were presented to a panel of raters to score. Scores were analysed to determine the intra-and inter-rater reliability and to compare outcomes. **Results**: Almost all patients (15/16) had improvement in scores (range 1.09–5.59) after cleft lip revision. Intra raters’ agreement scores from lowest to highest were: lip length (0.65), white roll (0.7), alar insertion point (0.78) and vermillion (0.78). The total intra-class correlation coefficient was 0.96 (0.94–0.98, 95% CI, P<0.000). **Conclusion**: This new scoring system is a valid and useful tool for assessment of the unilateral cleft lip. The high rate of intra- and inter-rater reliability allow it to serve as a useful tool to compare surgical outcomes both within and between centres. Further field testing with a larger cohort of patients is required.https://doi.org/10.34239/ajops.v3n1.133
spellingShingle Linda Monshizadeh
Vijith Vijayasekaran
Perth scoring system for assessment of the cleft lip
Australasian Journal of Plastic Surgery
title Perth scoring system for assessment of the cleft lip
title_full Perth scoring system for assessment of the cleft lip
title_fullStr Perth scoring system for assessment of the cleft lip
title_full_unstemmed Perth scoring system for assessment of the cleft lip
title_short Perth scoring system for assessment of the cleft lip
title_sort perth scoring system for assessment of the cleft lip
url https://doi.org/10.34239/ajops.v3n1.133
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