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Quality of Life Varies with Gender and Age among Adults Treated for Unilateral Cleft Lip and Palate
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Linköpings universitet.
2010 (English)In: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 47, no 5, 491-498 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate health-related quality of life among adults treated for unilateral cleft lip and palate and to investigate whether patients were affected differently depending on gender and age.

Design: Cross-sectional population study with long-term follow-up.

Patients/Settings: All unilateral cleft lip and palate patients born 1960-1987 and treated at Uppsala University Hospital were invited (n = 109). Response rate was 79% (n = 86). Mean follow-up time was 35 years. Norm data matched for age and gender were used for comparison (n = 1385).

Main Outcome Measures: Health-related quality of life measured with the SF-36 questionnaire. High values indicate good level of health-related quality of life.

Results: The total patient group had lower values in the Mental Health subscale compared with norm data (p = .005). Values in all other subscales did not differ from norm data. Women had a higher positive difference than men in the subscale emotional role function compared with the matched norm population (p < .001). The younger age group (20 to 32 years old) consistently had a larger negative difference to matched norm data compared with the older age group (33 to 47 years old) in the subscales social function (p = .009), physical role function (p < .001), and emotional role function (p < .001).

Conclusions: Unilateral cleft lip and palate affected health-related quality of life differently depending on gender and age of the patient. Younger patients were affected more negatively than older patients on several subscales. However, except for the mental health subscale, health-related quality of life was similar among unilateral cleft lip and palate patients and norm data.

Place, publisher, year, edition, pages
2010. Vol. 47, no 5, 491-498 p.
Keyword [en]
adults, cleft lip and palate, gender, quality of life, SF-36
National Category
Medical and Health Sciences
Research subject
Plastic Surgery
Identifiers
URN: urn:nbn:se:uu:diva-122380DOI: 10.1597/08-281ISI: 000281619700007PubMedID: 20180705OAI: oai:DiVA.org:uu-122380DiVA: diva2:310598
Available from: 2010-04-14 Created: 2010-04-09 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Unilateral Cleft Lip and Palate: Quality of Life and Nasal Form and Function among Adults
Open this publication in new window or tab >>Unilateral Cleft Lip and Palate: Quality of Life and Nasal Form and Function among Adults
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Unilateral cleft lip and palate (UCLP) is a craniofacial malformation with functional and aesthetical impact on the face and the upper airways. The aims of the current thesis were to evaluate Quality of life (QoL) in adults treated for UCLP  (I), to objectively evaluate nasal form and function and to search for possible differences in residual nasal deformity and impairment of function between patients operated according to one-stage and two-stage palate closure (II) as well as to evaluate the relationship between professional and lay rating and patient satisfaction with nasolabial appearance (III) and to identify factors associated with lower levels of QoL and less satisfaction with nasal appearance among adults treated for UCLP (IV).

Analyses of data from a homogenous population of UCLP patients treated at Uppsala University Hospital form the basis of this thesis. The mean follow-up time after primary surgery was 35 years (20-47 years) and participation rate was 79% (n=86). An age and gender matched control group of 68 people without clefts were evaluated according to the same protocol. The evaluation protocol included the Short Form 36 questionnaire (SF-36), rhinomanometry, acoustic rhinometry, odor test, peak nasal inspiratory flow test and photographies of faces. For the SF-36 data, age- and gender-matched norm data of 1385 people from the Swedish population were used.

Unilateral cleft lip and palate affected QoL differently depending on gender and age of the patient. Younger patients were affected more negatively than older patients in several subscales. However, except for lower values in the Mental Health subscale, QoL was similar among UCLP patients and norm data. Objectively measured nasal function was extensively affected among adults treated for UCLP. No difference in impairment of nasal function was found between one-stage and two-stage palate closure protocols on the cleft side. Judgment of nasolabial appearance differed between professionals, lay people and patients. Large infant cleft width was associated with less satisfaction with nasal appearance and male gender was associated with lower levels of mental QoL. Correlation between high nasal breathing resistance and low levels of physical QoL was found. In conclusion, this thesis provides a platform for future research for optimal evaluation of cleft treatment outcome.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 73 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 558
Keyword
unilateral cleft lip and palate, quality of life, SF-36, nasal function, nasal breathing, nasolabial appearance, cleft width, long-term results
National Category
Surgery
Research subject
Plastic Surgery
Identifiers
urn:nbn:se:uu:diva-122574 (URN)978-91-554-7799-8 (ISBN)
Public defence
2010-06-11, Skoogsalen, Uppsala University Hospital, entrance 79, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-29 Created: 2010-04-14 Last updated: 2010-05-18

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