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

## TL;DR

The study evaluates how patients and medical professionals assess the facial aesthetics of young CLP patients in Thailand and finds differences in their ratings.

## Contribution

The study compares aesthetic evaluations by experienced and inexperienced medical professionals and includes patient self-assessment for CLP aesthetics.

## Key findings

- Inexperienced evaluators gave higher aesthetic scores than experienced ones (p=0.01).
- Patients reported high satisfaction with their nasolabial appearance despite lower scores from experienced evaluators.
- Inexperienced evaluators showed high reliability in their assessments (p<0.05).

## 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.