Assessment of the primary surgery treatment outcomes of patients born with a unilateral cleft lip and palate using the GOSLON yardstick index

Objectives: Evaluation of dental arch development using GOSLON yardstick for dental arch, following primary surgery in patients with complete unilateral cleft lip and palate treated at Facial Cleft Deformity (FCD) clinic of the University of Pretoria Oral Health Center and compare the outcome with cleft care UK (CCUK) and clinical standard advisory group (CSAG) United Kingdom studies outcome.
Methods: Study models of patients (aged between 7 and 12 years old) with a complete unilateral cleft lip and palate, who had been surgically treated at the Facial Cleft Deformity (FCD) clinic of the University of Pretoria Oral Health Centre, were assessed using the GOSLON yardstick by a collaborative team consisting of Dr G McIntyre and Prof A Mossey at the University of Dundee. Both observers have previously been calibrated in the use of the GOSLON yardstick. The models were numbered randomly and marked in pencil before scoring. In addition, matching clinical records were sourced from the archives, and details such as diagnosis, treatment planning, surgical intervention and treatment outcomes (including complications) were recorded. The mean outcome scores were calculated from the first scoring of the 29 sets of plaster models. The other rounds of scoring were used to calculate intra- and inter-observer agreement using Cohen’s weighted kappa and Fleiss’s multi-rater kappa.
Results: There was strong intra- and inter-observer agreement, with a weighted kappa of 0,87. The FCD clinic showed a good treatment outcome with a mean GOSLON score of 2,86 in comparison with a score of 3,2 for the CSAG and 2,62 for the CCUK cohort studies.
Conclusions: The FCD clinic of the University of Pretoria Oral Health Centre displayed a good treatment outcome, similar to the Cleft Care UK cohort results and better than the CSAG results.
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