Patient Reported Outcomes Pre- and Post-Surgery in Patients With Cleft Lip/Palate: An Assessment of Post-Operative Change Utilizing CLEFT-Q

Abstract

Objective

To evaluate how patient-reported outcomes change from pre- to post-operation after common procedures in patients with cleft lip and/or palate (CL/P), as well as compared to patients who did not undergo surgery.

Design

Retrospective chart review.

Setting

Tertiary care hospital in the United States.

Patients

All patients with CL/P who had multiple CLEFT-Q completions from 2021 to 2025.

Main Outcome Measure

CLEFT-Q scores.

Results

Totally, 256 patients with 594 CLEFT-Q responses were included. Sixty (23.4%) patients received 66 craniofacial operations between CLEFT-Q completions. Of these operations, 16 (24.2%) were dental extractions/exposures, 15 (22.7%) rhinoplasties, 10 (15.2%) velopharyngeal insufficiency repairs, 6 (9.1%) alveolar bone grafts, 6 (9.1%) orthognathic surgeries, and 4 (6.1%) oronasal fistula repairs. Surgical patients had lower first CLEFT-Q scores across nearly all domains compared to those in the non-surgical cohort (P < .05). Patients who underwent rhinoplasty (n = 15) demonstrated increased face (64.1 vs 49.6, P = .006), nose (64.8 vs 43.3, P = .003), nostrils (62.0 vs 34.2, P = .001), teeth (59.5 vs 41.3, P = .008), and lips (63.5 vs 48.4, P = .007) scores post-operatively. Jaw scores increased following orthognathic surgery, though this did not reach significance (71.2 vs 55.8, P = .100). No other operation had a statistically significant impact on CLEFT-Q scores (P > .05).

Conclusions

Patients who underwent surgery demonstrated improvements in post-operative CLEFT-Q scores compared to patients who did not undergo surgery during this surveyed period. Of those who underwent surgery, rhinoplasty was associated with the most significant improvements in patient facial perception post-operatively.