Life Beyond Surgery: Postoperative Quality of Life in Patients With Cleft Lip/Palate

Cleft lip/palate (CL/P) affects patients' appearance, function, and mental health. The CLEFT-Q is the first condition-specific tool to assess quality of life (QoL) in CL/P patients, yet limited data exist on postoperative outcomes, especially in nonwestern populations.

The purpose of this study was to measure the QoL of CL/P patients who had undergone secondary surgical correction for deformities following cheiloplasty.

A prospective cross-sectional study was conducted at the Plastic Surgery Hospital from July 2023 to June 2024, enrolling individuals aged 8-29 years, including CL/P subjects who had undergone secondary surgical correction after cheiloplasty and healthy controls.

The primary predictor variable was disease status (CL/P vs healthy controls). Within the CL/P group, cleft phenotypes served as the secondary predictor variable.

The outcome variable was QoL, quantified by the CLEFT-Q scale. Higher scores indicate better patient-reported outcomes.

Age, household income, and parental education were identified as significant confounders and included as covariates in the final multivariable models.

Independent samples t-tests, χ² tests, nonparametric methods, Spearman's correlation analyses, one-way analysis of variance, and multivariable linear regression were employed. Statistical significance was set at P < .05, with Benjamini-Hochberg and posthoc Bonferroni corrections applied to control for multiple comparisons.

A total of 133 participants were enrolled, including 100 (75.2%) CL/P subjects and 33 (24.8%) healthy controls. Bivariate screening identified age, household income, and parental education as statistically significant covariates, whereas sex and surgical characteristics demonstrated no statistically significant confounding effects. In multivariable models adjusting for these covariates, the CL/P group demonstrated a statistically significant reduction in appearance scores compared to control group (all P ≤ .005, unstandardized B < 0). Conversely, no statistically significant differences were observed in any health-related QoL subscales (all P > .2). Furthermore, subgroup analyses within the CL/P group revealed that cleft phenotype was not statistically significantly associated with QoL following Benjamini-Hochberg correction.

CL/P was independently associated with lower self-perceived appearance scores. Higher household income and parental education levels served as protective factors, whereas increasing age was inversely associated with QoL.