Lack of correlation between objective and subjective evaluation of residual stigmata in cleft patients

The multidisciplinary cleft team of the Academisch Ziekenhuis Vrije Univers iteit treats cleft patients until they are 18 years old, when treatment is supposedly complete, with patients having a minimum of residual facial stig mata. The authors evaluated the relationship between objective residual fac ial deformities present and the patients' subjective judgment of the result of treatment by interviewing 50 patients (age range, 19-25 years) regardin g their facial appearance and possible remaining wishes for secondary corre ction. All patients were subjected to 13 in vivo anthropometric measurement s, and 5 inclinations were assessed on lateral facial photographs. The resu lts of these measurements were compared with normal values to establish pos sible objective deformities. The subjective and the objective results were compared for each individual, Anthropometric evaluation revealed an average of 5.3 divergent measurement values per patient (range, 1-8 divergent valu es). No correlation was found between objective judgment and the patient's subjective judgment, A weak negative correlation could be demonstrated betw een the score on a visual analog scale and the wish for secondary correctio n. Surgeons should be aware that cleft patients have no anthropometric inte rest in their facial appearance.