Long-Term Psychosocial Effects of Number of Childhood Surgeries in Teenagers with Cleft Lip and Palate
Fransia S. De Leon, BA1, Hi'ilani M. K. Potemra, BS1, Claire Liu, BS1, Miles J. Pfaff, MD1, James P. Bradley, MD2, Libby F. Wilson, MD3, Justine C. Lee, MD, PhD1.
1University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA, 2Division of Plastic and Reconstructive Surgery, Northwell Health Hofstra School of Medicine, New York, NY, USA, 3Cleft Palate Program, Orthopaedic Institute for Children, Los Angeles, CA, USA.
PURPOSE: Children with cleft lip and palate (CLP) face unique psychosocial stressors during childhood including coping with facial differences and being subjected to both surgical and non-surgical reconstructive therapies. In this study, we examined whether the quantity of cleft-related reconstructive surgeries during childhood impacted long-term psychosocial functioning in CLP patients.
METHODS: 120 CLP patients were prospectively recruited from two craniofacial centers and administered the Patient-Reported Outcomes Measurement System to assess psychosocial functioning. To assess long-term outcomes of childhood surgeries, teenagers 14-17 years old (n=46) were selected and the cumulative number of surgeries between ages 0-13 and age subgroups (0-7, 8-10, and 11-13 years) were evaluated using linear regression analyses. p<0.05 was considered significant
RESULTS: The cumulative number of cleft-related surgeries that occurred between 0-13 years, during subgroup 0-7 years, and during subgroup 11-13 years did not demonstrate a long-term effect on psychosocial functioning in teenagers with CLP. However, the number of cleft-related surgeries between 8-10 years predicted increased anxiety (R^2=0.29, Beta=0.54, p=0.001), anger (R^2=0.12, Beta=0.35, p=0.04), and depression (R^2=0.19, Beta=0.43, p=0.01) in teenagers.
CONCLUSION: Children with CLP are known to have age-related variations in psychosocial functioning. The age range of 8-10 years is a high-risk period for the worst functioning for CLP children. Our current work suggests that increased number of surgeries during the ages of 8-10 years in CLP children is associated with increased anxiety, anger, and depression during the teenage years.
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