New Nasal Deformity Classification System May Enhance Standardization in Cleft Lip and Palate Assessment: Research Shows - Video

A new classification tool for assessing nasal deformities in infants with cleft lip and/or palate (CLP) demonstrates high accuracy and reliability, according to a study published in The Journal of Craniofacial Surgery. The system is designed to improve diagnosis, treatment planning, and outcomes for infants with cleft lip and/or palate -related nasal abnormalities.

Cleft lip and/or palate is one of the most common birth defects, and many infants with cleft lip and/or palate also present with nasal deformities. However, these nasal issues are often overlooked in standard classification systems.

The study involved the development and evaluation of a standardized classification system based on visible nasal features such as nostril shape, nasal tip projection, and septum symmetry. The tool uses patient photographs and separates cases into unilateral and bilateral cleft categories. Clinicians rate each feature on a scale from mild to severe.

To test its effectiveness, the classification guide was sent to an international panel of plastic surgeons and orthodontists with various levels of experience in treating cleft lip and/or palate. Participants reviewed a randomized set of infant photographs and assessed the severity of nasal deformities using the proposed criteria. The consistency of their ratings was measured using the intraclass correlation coefficient (ICC).

Results showed "excellent" agreement among panelists, with ICC values of 0.816 for unilateral and 0.743 for bilateral clefts. These results affirm the tool's strong reliability and clinical usefulness.

The authors conclude that the system could play a key role in future treatment planning and outcome tracking.

Reference: Mejia, Martha DDS; Bernal, Isabel DO; Cordero, Juan P. BS; Bercu, Caleb BS; Policherla, Rohan MD; Steinberg, Jordan P. MD, PhD. A Proposed Nasal Deformity Classification System for Infants With Cleft Lip and Palate. The Journal of Craniofacial Surgery ():10.1097/SCS.0000000000011151, May 27, 2025. | DOI: 10.1097/SCS.0000000000011151