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Cleft Lip and Palate: An Objective Measure Outcome Study

Sinno, Hani M.D.; Tahiri, Youssef M.D.; Thibaudeau, Stephanie M.D.; Izadpanah, Ali M.D.; Christodoulou, George B.Sc.; Lin, Samuel J. M.D.; Gilardino, Mirko M.D.

Plastic and Reconstructive Surgery: August 2012 - Volume 130 - Issue 2 - p 408–414
doi: 10.1097/PRS.0b013e3182589d4b
Pediatric/Craniofacial: Outcomes Article

Background: Cleft lip and/or palate is a debilitating condition if left unrepaired, resulting in significant speech, hearing, swallowing, feeding, and psychosocial impairments. The authors' objective was to determine the potential impact of being born with cleft lip and/or palate by using previously validated health state utility assessment measures.

Methods: A utility assessment using the visual analogue scale, time trade-off, and standard gamble was used to obtain utilities for cleft lip and/or palate, monocular blindness, and binocular blindness from a prospective sample of the general population and medical students. Average utility scores were compared using paired t test. Linear regression was performed using age, race, and education as independent predictors of each of the utility scores.

Results: Over a 1-year prospective enrollment period, 110 participants were included in our utility analysis. The utility outcome scores for cleft lip and/or palate (visual analogue scale, time trade-off, and standard gamble, 0.69 ± 0.18, 0.85 ± 016, and 0.84 ± 0.18, respectively) were statistically different from those of binocular blindness (visual analogue scale, time trade-off, and standard gamble: 0.38 ± 0.17, 0.70 ± 0.24, and 0.66 ± 0.25, respectively; p < 0.001) but not statistically different from those of monocular blindness (visual analogue scale, time trade-off, and standard gamble, 0.67 ± 0.15, 0.86 ± 0.15, and 0.84 ± 0.18, respectively). There was no statistically significant difference in utility scores between male and female participants.

Conclusion: The results of the study demonstrate objectively via health state utility scores that the perceived burden of being born with cleft lip and/or palate is comparable to living with monocular blindness.

Montreal, Quebec, Canada; and Boston, Mass.

From the Division of Plastic and Reconstructive Surgery, Montreal Children's Hospital, McGill University; the Faculty of Medicine, McGill University; and the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.

Received for publication September 5, 2011; accepted February 14, 2012.

The first two authors contributed equally to the article.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Mirko S. Gilardino, M.D.; H. Bruce Williams Craniofacial and Cleft Surgery Unit, Montreal Children's Hospital, 2300 Tupper Street, C11.35, Montreal, QC H3H 1P3 Canada, mirko.gilardino@muhc.mcgill.ca

©2012American Society of Plastic Surgeons