The Lip-Philtrum Guides (2014) are 5-point pictorial guides (see images below) that are used by the FASD 4-Digit Code to accurately measure philtrum smoothness and upper lip thinness. The performance of 4-Digit Code Lip-Philtrum Guides have been extensively assessed and validated. Only Lip-Philtrum Guides distributed by the University of Washington should be used with the University of Washington FASD 4-Digit Diagnostic Code.
The Rank 5 picture portrays a philtrum that is completely smooth and an upper lip that is very thin (characteristic of FAS). The philtrum is the vertical groove between the nose and upper lip. The Rank 1 picture portrays a deeply grooved philtrum and very thick upper lip. As you advance up the Guide from Rank #1 to #5, the upper lip becomes thinner and the philtrum becomes smoother.
The Lip-Philtrum Guide reflects the full range (or normal distribution) of lip thickness and philtrum depth one would see in a general population. The Rank 3 picture reflects the population mean (or 50th percentile). Ranks 1 and 5 reflect the extreme ends of the normal curve
(< 2.5th percentile and > 97.5th percentile).
The Lip-Philtrum Guides are intended for use by medical professionals.
- Lip-Philtrum Guide 1 is used for Caucasians and all races (or combinations of races) with thinner lips like Caucasians.
- Lip-Philtrum Guide 2 is used for African Americans and all races (or combinations of races) with thicker lips like African Americans.
- The medical doctor should select the Guide that best matches the phenotype of the patient's race(s).
The Lip-Philtrum Guides are distributed as digital images free of charge.
The digital image format is to be used on a mobile phone or computer tablet. These images are available free of charge and can be obtained by emailing Susan (Astley) Hemingway, PhD astley@uw.edu or completing and submitting our Order Form.
The Digital Image Format of Lip-Philtrum Guides 1 and 2.
The digital image format of Lip-Philtrum Guides 1 and 2 are displayed below. They come with a frontal and 3/4 view of the lips and philtrums. The 3/4 view images help to further portray the distinctions beween the 5 philtrum ranks. The frontal photos are used to rank lip thinness. The frontal and 3/4 view photos are used to rank philtrum smoothness. These digital images are intended to be loaded on a smartphone or computer tablet; devices that are small enough to hold next to the patient's face when you measure their features.
Please do not print these digital images. Printing will invalidate the digital Lip-Philtrum Guides. If you print the digital guides, we cannot ensure your printer will provide the required image quality to ensure the tool's validity. For example, there are very subtle differences between the Rank 4 and Rank 5 philtrums. Not all printers will capture this subtle difference. The images are also invalidated if the height-to-width ratio of the Guide is altered. The square printed on the digital guide helps ensure the height-to-width ratio of the Guide is correct. If the square looks retangular in shape, the aspect ratio of the Guide has been altered rendering the guide invalid.
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