The Early Psychological Adjustment of Cleft Patients After Maxillary Distraction Osteogenesis and Conventional Orthognathic Surgery: A Preliminary Study
Purpose
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.
Materials and 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.
Conclusion
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.
⁎Chair Professor, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
†Master’s Degree Graduate, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
‡Associate Professor, Department of Psychology, Faculty of Social Sciences, University of Hong Kong, Hong Kong, China.
Address correspondence and reprint requests to Dr Cheung: Oral and Maxillofacial Surgery, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
This clinical study was supported by the Competitive Earnmarked Research Grant from the Hong Kong Research Grant Council (HKU 7577/05M).
ABSTRACT