Cleft lip and palate patients’ quality of life

Aim: The aim was to assess the differences in the quality of life of patients with cleft lip and palate and their healthy peers treated at the Department of Orthodontics and Cleft Defects, Clinic of Stomatology, 3rd Medical Faculty of Charles University and University Hospital Královské Vinohrady in Prague. We assess patients’ satisfaction with the treatment as well as speech therapy and psychological care. Using COHIP 19 questionnaire we assessed the quality of life of patients with cleft lip and palate, compared the differences between cleft and non-cleft patients and between genders in both groups. Material and method: The questionnaire study focused on adolescent patients treated at the Department of Orthodontics and Cleft Defects, Clinic of Stomatology in Prague. We examined the sample of 60 patients aged between 12 and 18, 30 with cleft lip and palate, 30 non-cleft subjects. In the cleft group 15 patients had visible cleft defect, and 15 the so-called invisible form of the cleft defect. Non-cleft patients suffered from some orthodontic abnormalityɸ– e.g. significant crowding, skeletal class II or III, agenesis of two and more teeth, open bite. All patients were treated with orthodontic appliance. We used questionnaire COHIP 19 (Child Oral Health Impact Profile) divided into three domains according to the type of questionsɸ– oral health, functional problems, socioemotional problems. We also used aɸsemi-structured questionnaire evaluating satisfaction with treatment. Results: Evaluation of the differences in the quality of life in cleft and non-cleft patients (control group) did not show significant differences in the overall score. The difference was found in the domain describing functional problemsɸ– cleft patients gave more often problems with articulation and pronunciation. Comparison between cleft patient with visible defect and invisible defect did not show significant difference in the overall score. The difference was found only in functional problemsɸ– patients with visible form of cleft defect had more problems during food chewing. There were found no differences between genders. Satisfaction questionnaire proved that our patients (cleft as well as non-cleft) are satisfied with the treatment, however, they object to the length of therapy and time spent in waiting rooms. 80% of cleft patients attended or still attend speech therapist; 37% of non-cleft patients attended speech therapist in the past. 16.6% of cleft patients attend psychological therapist, 13.4% of non-cleft searched psychotherapy. Interestingly, 10% of non-cleft patients would like to attend psychotherapy, but none from the cleft group. There was also aɸsignificant difference in commuting distance. 2/3 of cleft patients travel more than 80 kilometers, only 7% of non-cleft patients commute from such aɸdistant place. There are only 2 cleft defect centers in the Czech Republic with specialists in cleft lip and palate providing the most up-to-date and complex care. We have to explain the situation to our patients. Conclusion: No significant difference in the overall score of quality of life was found between cleft patients and their non-cleft peers. We expected differences between the two groups in socioemotional part of the questionnaire. However, they were not proved. On the contrary, both cleft and non-cleft patients reported unsatisfactory appearance as their main problem. We did not find any difference between cleft patients with visible and invisible form of the defect. However, we found the difference in the functional problems. Patients with visible cleft defect had more problems with chewing. Comparison between genders agrees with the results quoted by foreign studies. There was found no difference in the quality of life assessment between girls and boys. Speech therapy (almost twice as many cleft patients attend the therapy) contributes to the length of treatment in cleft patients. The result dealing with psychotherapy (10% of non-cleft patients stated they need to attend psychotherapy) was also interesting. More detailed analysis of this aspect will be the subject of another study.