Cleft distraction versus orthognathic surgery - which one causes more distress?

Abstract

Objective: To compare the psychological impact of distraction osteogenesis and conventional orthognathic surgery in CLP patients. Methods: This is a prospective randomized controlled study in comparing the psychological changes of CLP patients undergoing maxillary Le Fort I advancement by either distraction osteogenesis or conventional orthognathic surgery. All patients were asked to complete a set of psychological questionnaires to enable their psychological profiles to be assessed. The series of questionnaires include: Social Avoidance and Distress Scale (SADS), Satisfaction with Life Scale (SWLS) and Culture Free Self-esteem Inventory (CFSEI). Results: 13 patients underwent conventional orthognathic surgery and 11 had distraction osteogenesis. The CLP patients treated with distraction osteogenesis were happier, but had a higher level of social anxiety and depression than the CLP patients receiving conventional orthognathic surgery during the 2nd−8th week post-operatively. Patients who received distraction osteogenesis also exhibited higher parental self-esteem during the same period when compared to those who received conventional orthognathic surgery. On the other hand, the CLP patients treated with conventional orthognathic surgery had lower social anxiety and depression. Conclusion: Distraction osteogenesis may induce more social anxiety and distress on a cleft patient when compared to conventional orthognathic surgery during the first three months postoperatively. CLP patients were generally happier, and had a higher level of parental support, than normal patients suffering from dentofacial deformities.