The use and reliability of SymNose for quantitative measurement of the nose and lip in unilateral cleft lip and palate patients

David Mosmuller; Robin Tan; Frans Mulder; Yara Bachour; Henrica de Vet; Peter Don Griot

doi:10.1016/j.jcms.2016.07.022

The use and reliability of SymNose for quantitative measurement of the nose and lip in unilateral cleft lip and palate patients

J Craniomaxillofac Surg. 2016 Oct;44(10):1515-1521. doi: 10.1016/j.jcms.2016.07.022. Epub 2016 Jul 28.

Authors

David Mosmuller¹, Robin Tan², Frans Mulder³, Yara Bachour⁴, Henrica de Vet⁵, Peter Don Griot⁶

Affiliations

¹ Department of Plastic, Reconstructive and Hand Surgery (Head: Prof. Marco Ritt), VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: davidmosmuller@hotmail.com.
² Department of Plastic, Reconstructive and Hand Surgery (Head: Prof. Marco Ritt), VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: robintan100@gmail.com.
³ Department of Plastic, Reconstructive and Hand Surgery (Head: Prof. Marco Ritt), VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: f.j.mulder@student.vu.nl.
⁴ Department of Plastic, Reconstructive and Hand Surgery (Head: Prof. Marco Ritt), VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: y.bachour@vumc.nl.
⁵ Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands. Electronic address: hcw.devet@vumc.nl.
⁶ Department of Plastic, Reconstructive and Hand Surgery (Head: Prof. Marco Ritt), VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: dongriot@vumc.nl.

PMID: 27562104
DOI: 10.1016/j.jcms.2016.07.022

Abstract

Introduction: It is essential to have a reliable assessment method in order to compare the results of cleft lip and palate surgery. In this study the computer-based program SymNose, a method for quantitative assessment of the nose and lip, will be assessed on usability and reliability.

Methods: The symmetry of the nose and lip was measured twice in 50 six-year-old complete and incomplete unilateral cleft lip and palate patients by four observers. For the frontal view the asymmetry level of the nose and upper lip were evaluated and for the basal view the asymmetry level of the nose and nostrils were evaluated.

Results: A mean inter-observer reliability when tracing each image once or twice was 0.70 and 0.75, respectively. Tracing the photographs with 2 observers and 4 observers gave a mean inter-observer score of 0.86 and 0.92, respectively. The mean intra-observer reliability varied between 0.80 and 0.84.

Conclusions: SymNose is a practical and reliable tool for the retrospective assessment of large caseloads of 2D photographs of cleft patients for research purposes. Moderate to high single inter-observer reliability was found. For future research with SymNose reliable outcomes can be achieved by using the average outcomes of single tracings of two observers.

Keywords: Assessment; Cleft lip and palate; Nasolabial appearance; SymNose; Symmetry.

MeSH terms

Child
Cleft Lip / diagnosis*
Cleft Lip / pathology
Cleft Palate / diagnosis*
Cleft Palate / pathology
Diagnosis, Computer-Assisted / methods*
Female
Humans
Imaging, Three-Dimensional
Lip / pathology*
Male
Nose / pathology*
Observer Variation
Photography
Reproducibility of Results