title: A Reliable Method to Measure Lip Height Using Photogrammetry in Unilateral Cleft Lip Patients.
abstract: There is still no reliable tool to determine the outcome of the repaired unilateral cleft lip (UCL). The aim of this study was therefore to develop an accurate, reliable tool to measure vertical lip height from photographs. The authors measured the vertical height of the cutaneous and vermilion parts of the lip in 72 anterior-posterior view photographs of 17 patients with repairs to a UCL. Points on the lip's white roll and vermillion were marked on both the cleft and the noncleft sides on each image. Two new concepts were tested. First, photographs were standardized using the horizontal (medial to lateral) eye fissure width (EFW) for calibration. Second, the authors tested the interpupillary line (IPL) and the alar base line (ABL) for their reliability as horizontal lines of reference. Measurements were taken by 2 independent researchers, at 2 different time points each. Overall 2304 data points were obtained and analyzed. Results showed that the method was very effective in measuring the height of the lip on the cleft side with the noncleft side. When using the IPL, inter- and intra-rater reliability was 0.99 to 1.0, with the ABL it varied from 0.91 to 0.99 with one exception at 0.84. The IPL was easier to define because in some subjects the overhanging nasal tip obscured the alar base and gave more consistent measurements possibly because the reconstructed alar base was sometimes indistinct. However, measurements from the IPL can only give the percentage difference between the left and right sides of the lip, whereas those from the ABL can also give exact measurements. Patient examples were given that show how the measurements correlate with clinical assessment. The authors propose this method of photogrammetry with the innovative use of the IPL as a reliable horizontal plane and use of the EFW for calibration as a useful and reliable tool to assess the outcome of UCL repair.
authors.affiliation: *North Thames Cleft Service, Great Ormond Street Hospital, London †St Andrews Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, United Kingdom ‡Department of Plastic and Reconstructive Surgery, University of Amsterdam, Amsterdam §Department of Statistics, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands.
authors.forename: Frederique
authors.initials: F
authors.lastname: van der Zeeuw
authors.forename: Amera
authors.initials: A
authors.lastname: Murabit
authors.forename: Johnny
authors.initials: J
authors.lastname: Volcano
authors.forename: Bart
authors.initials: B
authors.lastname: Torensma
authors.forename: Brijesh
authors.initials: B
authors.lastname: Patel
authors.forename: Norman
authors.initials: N
authors.lastname: Hay
authors.forename: Guy
authors.initials: G
authors.lastname: Thorburn
authors.forename: Paul
authors.initials: P
authors.lastname: Morris
authors.forename: Brian
authors.initials: B
authors.lastname: Sommerlad
authors.forename: Maria
authors.initials: M
authors.lastname: Gnarra
authors.forename: Chantal
authors.initials: C
authors.lastname: van der Horst
authors.forename: Loshan
authors.initials: L
authors.lastname: Kangesu
mesh_terms: D000293:Adolescent; D000328:Adult; D059925:Anatomic Landmarks / Q000473:pathology; D002138:Calibration; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D005123:Eye / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D008046:Lip / Q000473:pathology* / Q000601:surgery; D008297:Male; D055171:Nasal Cartilages / Q000473:pathology; D015588:Observer Variation; D010780:Photogrammetry / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D055815:Young Adult