Refining Measures of Lip Function

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DESCRIPTION (provided by applicant): The goal of this R03 is to conduct secondary analyses on an existing database of facial/lip functional measures. The data was collected during an on-going, NIDCR-funded, prospective non-randomized controlled clinical trial to assess outcomes of lip revision surgery in children with a cleft lip; and consists of measures of dynamic facial movement, lip force, lip sensation, and sensory-integrative function. The individual measures provide an objective assessment of facial/lip impairment that can be used by surgeons in the decision-making process for or against lip revision in cleft patients, and in the determination of which patients would benefit from revision surgery. In this R03, statistical approaches will be applied to these measures to address the following specific aims. Specific Aim 1-Generate composite statistical measures of lip impairment from the individual functional measures. Different combinations of measures will be explored in order to produce a set of measures that more completely characterizes facial functional problems or impairment. Specific Aim 2-To adapt current, and develop new, statistical approaches to the novel application of modeling dynamic facial movement and to analyze variation in movement in terms of predictor variables, movement velocity, and compensatory movements. The hypotheses to be tested are as follows: (1) Composite measures provide a greater sensitivity of analysis of facial impairment and (a) more accurately discriminate between patients with cleft lip and non-cleft subjects, and (b) more accurately quantify the change in facial impairment in patients with cleft lip who have lip revision surgery; and (2) Adaptations of current, and the development of new, statistical techniques can characterize facial movement in terms of subject predictor variables (e.g., cleft lip versus no cleft; unilateral versus bilateral cleft lip, etc), velocity of movement, and compensatory movements appropriate for the particular subject of study. The impact of this research will be the refinement of the current impairment measures and the development of a composite measure of facial/lip impairment that encompasses the interrelationships and information among the individual measures. The developed measure(s) will provide a tremendous advantage in terms of characterizing existing and future outcomes for surgical treatment.