<< Back to the abstract archive
Treatment of the Nasolabial Complex: Systematic Review of Available Classification Systems
Cagri Cakmakoglu M.D, Ahmed M. Hashem M.D, Russell Shane Frautschi B.S, Brianna Halasa, James E. Zins M.D
Cleveland Clinic Plastic Surgery Department
2016-02-01
Presenter: Cagri Cakmakoglu M.D
Affidavit:
%80 of the work on this project represents the original work of the resident.
Director Name: James Zins M.D
Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: Aesthetics
The aim of this study is to examine the different classification systems that have been described for assessment of the NLC (nasolabial complex: the "crease" and the "fold") and investigate their impact on decision making. The objective is to identify a NLC assessment tool that can guide treatment strategies.
A PubMed search, we identified 20 articles discussing NLC scoring system. We specifically tried to determine if each classification is: Simple (defined as easy to perform in the office setting, does not require sophisticated equipment, and uses a clear itemized approach), NLC focused (defined as specifically focusing on the NLC rather than a generalized facial wrinkle score), Comprehensive (taking into account the "crease" in addition to the "fold" which reflects associated changes in the midface), Uses objective measures and consistent reproducible anatomic landmarks.
We have identified 11 nasolabial grading tools in the literature. Most were simple (9/11), and the majority focused primarily on the nasolabial area (7/11). Three (3/11) were validated scales. Only two (2/11)classifications used fixed anatomic landmarks and objective measures. Only one (1/11) took into account the
associated fullness of the "fold "in addition to the depth of the "crease". Treatment options based on the
scoring system where proposed in only 2 studies (2/11).
The majority of NLC grading systems (9/11) rely on subjective parameters for "crease" evaluation. Changes in the nasolabial "fold" reflective of midface aging are seldom assessed (1/11). There is a need for a more detailed NLC assessment tool that takes into account temporal changes in the midface.
