The early psychological adjustment of cleft patients after maxillary distraction osteogenesis and conventional orthognathic surgery: a preliminary study.
OBJECTIVE
To compare the early psychological changes of cleft lip and palate (CLP) and noncleft patients after maxillofacial corrective surgery, including maxillary distraction osteogenesis and conventional orthognathic surgery.


METHODS
Nine CLP patients were compared with a group of 9 non-CLP patients having similar dentofacial deformities in a prospective longitudinal cohort study. Five of the CLP patients underwent maxillary distraction osteogenesis and 4 underwent conventional orthognathic surgery. A control group of 9 noncleft patients received conventional orthognathic surgery. All patients completed a set of questionnaires to enable their psychological profile to be assessed. The data were collected immediately before surgery (T1), and at 3 weeks (T2) and 12 weeks (T3) after surgery.


RESULTS
The CLP patients treated with distraction osteogenesis were happier, but had a higher level of social anxiety and distress than the CLP patients receiving conventional orthognathic surgery. On the other hand, the CLP patients overall were happier, with lower social anxiety and distress, than the noncleft control group. The CLP patients showed a higher level of parental self-esteem than the noncleft patients.


CONCLUSIONS
This preliminary study shows that CLP patients were generally happier, and had a higher level of parental support, than normal patients suffering from dentofacial deformities. Maxillary distraction osteogenesis seemed to induce a higher level of anxiety and distress in CLP patients than conventional orthognathic surgery in both cleft and noncleft patients.
Cheung
Lim Kwong
LK
Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China. lkcheung@hku.hk
Loh
John Ser Pheng
JS
Ho
Samuel M Y
SM
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002971:Cleft Lip / Q000523:psychology / Q000601:surgery; D002972:Cleft Palate / Q000523:psychology* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006240:Happiness; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000523:psychology*; D019340:Osteotomy, Le Fort / Q000523:psychology*; D010549:Personal Satisfaction; D011446:Prospective Studies; D012649:Self Concept; D012917:Social Adjustment; D011795:Surveys and Questionnaires