Revision Procedures for Cleft Lip and Nose Yield Improved Appearance, Quality of Life for Patients

Alyssa KirkmanACPA News

  • Revision surgery of cleft lip and nose common procedure following CL/P correction
  • Patient benefits include more self-confidence, higher self-esteem after revision surgery

CHAPEL HILL, N.C. / August 5, 2020 – Patients who underwent revision procedures for cleft lip and nasal defects reported positive psychosocial benefits, in addition to improved appearance, according to a recent research study, “Patient-Centered Satisfaction After Secondary Correction of the Cleft Lip and Nasal Defect”. The results were published in the July 2020 issue of The Cleft Palate-Craniofacial Journal (CPCJ).

“Across all areas of cleft care, we are seeing a greater emphasis on the patient’s perspective to help define what ‘success’ really means and how it should be measured. Furthermore, we are finding that provider/clinician/surgeon perspective of gains/benefit do not always align perfectly with patients. This does not discredit the perspective of the professional but demonstrates the value of keeping a pulse on both as we evaluate our methods in cleft care. This paper provides valuable insights into the patients’ perspectives specifically to revisional surgery,” said Jamie L. Perry, PhD, CCC-SLP, editor of The Cleft Palate-Craniofacial Journal.

Patients who undergo a primary procedure to correct cleft lip/palate (CL/P) often have revision surgery to further repair cleft lips and nasal abnormalities. The secondary corrections address asymmetry or scar burden and help to further normalize the appearance of the lip and nose.

“There is evidence, much of it from the physician’s perspective, that these secondary procedures benefit the patient by improving their appearance and the functionality of the nose,” said Alexis Rothermel, M.D., lead researcher. “Our study focused on the patient’s point of view to quantify their satisfaction after undergoing secondary correction of the cleft lip and nasal defect.”

Forty-two patients who underwent secondary revision of the cleft defect participated in the study by completing an eight-question anonymous survey during a routine follow-up appointment. The patients’ age at the time of surgery ranged from six to 17 years, and age of survey participants ranged from eight to 18 years. Survey questions focused on specific issues related to patients undergoing revision cleft lip and nose procedures.

Patients reported a high satisfaction with their physical appearance following revision surgery. They said they felt more confident about their facial profile and less self-conscious about their appearance. Patients also said they were teased less by peers about their appearance and were more likely to engage in social activities like sports, clubs, and youth groups with other kids their age.

“This study confirmed, from the patient’s perspective, that secondary revisions of the cleft lip and nasal defect not only improve the patient’s physical appearance, but have a positive psychosocial impact on patients’ lives,” Rothermel noted. “With this better understanding of the impact of revision procedures, we can now advocate for the critical role these revisions play in this sensitive patient population, and tailor management strategies to the individual patient’s preferences.”

To learn more about the American Cleft Palate-Craniofacial Association and cleft and craniofacial conditions, please visit acpa-cpf.org.

About the American Cleft Palate-Craniofacial Association
The American Cleft Palate-Craniofacial Association (ACPA) is a nonprofit 501(c)(3) association of interested individuals and health care professionals who treat and/or perform research on oral cleft and craniofacial conditions. Since 1943, ACPA has worked to optimize outcomes for individuals with oral cleft and craniofacial conditions through education, support, research, advocacy and interdisciplinary team care. ACPA also provides information to affected individuals and families and seeks to educate the public about facial differences through its ACPA Family Services program. For more information, please visit acpa-cpf.org.