Change in Facial Appearance, Function, and Quality of Life after Cleft Surgery: A Nigerian Multicenter Longitudinal Pilot Study

Abstract

Background: We utilized the Cleft Questionnaire (CLEFT-Q) to determine the change in patient’s perception of facial appearance, facial function, and quality of life after surgery for cleft lip or cleft palate and factors associated with this change. Methods: A longitudinal pilot study of patients receiving surgery for cleft lip or cleft palate recruited from six participating tertiary hospitals in Nigeria between January 2022 and August 2023 was performed. The CLEFT-Q scores were obtained before surgery and 3, 6, and 12 months after surgery. Differences between the pre- and postsurgery scores were analyzed using Wilcoxon signed rank t test and a repeated measures analysis of variance to investigate factors associated with a difference in scores. Results: Thirty-four patients participated in the study. Most had primary procedures [24 (70.6)], and cleft palate repair was the predominant surgery done [28 (82.4%)]. There were statistically significant increases from preoperative to postoperative scores at 3, 6, and 12 months postsurgery for all facial function and quality-of-life subscale scores ( P < 0.001– P = 0.04). Female sex, ethnicity, and nature of surgery were associated with significant differences in CLEFT-Q scores. Conclusions: Patients’ perception of their facial appearance, function, and quality of life improved significantly after surgery. Female sex, Hausa ethnic group, and need for secondary surgery were associated with lower quality-of-life scores. This study shows the potential of using the CLEFT-Q as a standardized tool for large-scale patient-reported outcomes cleft research in Nigeria.