The adult cleft lip and palate patient: beyond primary repair

Cleft lip and palate (CL/P) is the most common congenital craniofacial anomaly worldwide. While surgical techniques and multidisciplinary cleft care have advanced substantially, much of the literature focuses on pediatric outcomes. The long-term experiences of adults living with CL/P remain comparatively underexplored. This article aims to review the functional, psychological, and social experiences of adults with CL/P and consider how these factors influence long-term care.

Adults with CL/P face persistent functional challenges including speech difficulties, hearing loss related to chronic eustachian tube dysfunction (ETD), nasal airway obstruction, and dentofacial abnormalities that may require orthognathic correction. Psychological studies reveal higher rates of depression, anxiety, and social stigma among adults with CL/P, with protective factors including family support and engagement with the cleft community. Patient-reported outcome measures suggest that satisfaction with surgical outcomes varies by cleft phenotype, with bilateral clefts often associated with lower satisfaction and a higher likelihood of revision procedures such as secondary rhinoplasty.

Adults with CL/P face challenges of ongoing functional adaptation, psychosocial navigation, and decisions regarding additional interventions. Attention to patient-reported outcomes, psychosocial support, and lifelong engagement with cleft care may improve the long-term well being of adults living with CL/P.