Predictive Capabilities of the Asher-McDade Esthetic Index for Nasolabial Revision Surgery: A Pilot Study
Issued Date
2026-01-01
Resource Type
ISSN
10556656
eISSN
15451569
Scopus ID
2-s2.0-105029503920
Journal Title
Cleft Palate Craniofacial Journal
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SCOPUS
Bibliographic Citation
Cleft Palate Craniofacial Journal (2026)
Suggested Citation
Tatiyanupanwong F., Boonpratham S., Srimaneekarn N., Chaweewannakorn C., Satravaha Y., Peanchitlertkajorn S. Predictive Capabilities of the Asher-McDade Esthetic Index for Nasolabial Revision Surgery: A Pilot Study. Cleft Palate Craniofacial Journal (2026). doi:10.1177/10556656251415230 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115028
Title
Predictive Capabilities of the Asher-McDade Esthetic Index for Nasolabial Revision Surgery: A Pilot Study
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Abstract
Objective: This pilot study explored the predictive capabilities of individual components and composite scores of the Asher-McDade Esthetic Index (AMEI) for determining the need for nasolabial revision surgery in patients with repaired complete unilateral cleft lip and palate (UCLP). Receiver operating characteristic (ROC) analysis and Youden's index were employed to assess predictive power and identify optimal thresholds, respectively. Design: Single-center retrospective cross-sectional pilot study Setting: Cleft and craniofacial center Participants: Thirty-two pre-adolescent patients with complete UCLP who underwent primary repair. Interventions: Standardized frontal and lateral facial photographs were rated by three calibrated plastic surgeons using the AMEI. Components assessed included nasal form, nasal symmetry, vermilion border, and nasolabial profile. A separate panel of three plastic surgeons determined the need for nose and/or lip surgical revision by majority vote, based on the same photographs. ROC analysis evaluated the predictive ability of individual AMEI components and composite scores, with cutoffs identified via Youden's Index. Main Outcome Measures: The predictive ability of AMEI for determining the need for nasolabial revision, using ROC analysis and Youden's Index. Results: Nasal symmetry demonstrated the highest predictive accuracy for nose revision, and vermilion border was the strongest predictor for lip revision. Although composite scores showed promising predictive potential, they did not surpass the predictive power of the strongest individual AMEI components. Conclusion: This pilot study provides preliminary evidence that the AMEI can serve as a useful objective tool to predict the need for revision surgery in patients with repaired UCLP.