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Parental Perceptions Following Cleft Lip Repair in Their Children
Michal A Brichacek1, Damir B Matic2
1Section of Plastic Surgery, University of Manitoba, Winnipeg.
Insights
Parental perceptions of cleft lip (CL) repair at 3 months show satisfaction, with most parents preferring the current timing. Some parents would consider delaying CL repair for better aesthetics, suggesting a need for individualized options.
Area of Science:
- Pediatric surgery
- Craniofacial anomalies
- Parental perception studies
Background:
- Cleft lip (CL) repair timing is traditionally set at 3 months, often without clear functional advantages.
- Delaying CL repair may offer improved cosmetic outcomes.
- Parental views on CL repair timing are crucial for guideline evaluation.
Purpose of the Study:
- To investigate parental perceptions regarding cleft lip repair timing.
- To assess if current 3-month repair guidelines align with parental expectations and priorities.
- To inform future recommendations on optimal cleft lip repair timing.
Main Methods:
- Retrospective cross-sectional survey of parents with children under 6 years who underwent CL repair.
- Qualitative analysis of open-ended survey responses.
- Fisher exact test for statistical significance.
Main Results:
- Most parents (36/37) deemed CL repair essential for feeding, speech, and appearance.
- A majority (28/37) believed surgery would resolve the issue.
- 15/37 parents would consider delaying repair for better aesthetics, while 20/37 would not.
Conclusions:
- Current 3-month CL repair recommendations are largely supported by positive parental perceptions of their child's well-being.
- While most parents are satisfied, offering delayed repair as an option warrants consideration.
- Further research into cultural factors and long-term aesthetic/developmental outcomes is needed to optimize repair timing.
Objective:
Cleft lip (CL) repair at 3 months is chosen mostly out of convention and offers minimal functional benefit. Potentially, a better cosmetic outcome is possible by delaying repair. This study examines parental perceptions around repair at 3 months to determine if current guidelines are appropriate.
Design:
Retrospective cross-sectional survey.
Setting:
Tertiary-care institution.
Participants:
Parents of children with CL ± P under age 6 years who underwent CL repair from 2004 to 2011 at our center were surveyed (n = 64). Response rate was 61% (n = 37).
Methods:
Open-ended survey asked about various aspects of parental perceptions before and after repair. Qualitative data analysis is used to interpret survey responses.
Statistics:
Fisher exact test using contingency tables to identify statistically significant results.
Results:
Nearly all (36/37) parents felt repair was important, citing reasons such as feeding, speech, and appearance. Most (28/37) felt surgery would fix the problem. A portion of parents (15/37) would delay repair if better aesthetics were possible later, but most would not (20/37). Most parents were satisfied with repair quality (33/37). On average, repair did not impact parent-child bonding, and eliminated negative interactions with strangers that parents found distressing.
Conclusions:
Arguably, positive parental perceptions of their child's condition reflect favorably on the child's well-being, and may outweigh any future aesthetic benefit. Therefore, current recommendations should be upheld. However, given that some parents would consider delaying repair, they could be offered this option. Future efforts should examine cultural factors, and aesthetic and developmental outcomes of repair at different ages to determine optimal repair timing.
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