Multiple Surgeries for Cleft Lip, Palate Won't Cause Major Psychological Damage

FRIDAY, July 3, 2020 (HealthDay News) -- Having multiple surgeries for cleft lip and palate doesn't appear to have a major impact on children's mental health, a new study shows.

But there may be one three-year period that ups the odds for anxiety and depression, researchers say.

The study included 55 teens with cleft lip and palate (CLP), a birth defect where the lip or palate doesn't form properly and has an opening in it. The participants had multiple reconstructive surgeries to improve appearance, eating, hearing and speech. On average, they each had six procedures by age 14.

They, and a comparison group of teens without the birth defect, underwent standard assessments of anger, anxiety and depression.

There were no major differences between the two groups. Among those with CLP, there was no significant association between the overall number of surgeries and mental health outcomes, according to the study. The results are in the July issue of the journal Plastic and Reconstructive Surgery.

However, it did find that a higher number of surgeries between ages 8 and 10 was associated with higher scores for anxiety and depression. Also, higher scores for anger were associated with increased anxiety and depression.

In all other age groups of teens with CLP, the number of surgeries was unrelated to mental health outcomes.

"In conjunction with our previous work that identified the 8-to-10 age range as a critical at-risk time period for poor psychosocial functioning, we now find that teenagers who had more surgeries during that age range report worse long-term psychosocial functioning," study senior author Dr. Justine Lee said in a journal news release. She specializes in pediatric plastic surgery at the University of California, Los Angeles.

More than half of all the surgeries among teens with CLP were done between birth and age 7 years, and the most common procedures were to close the cleft lip and/or palate.

At older ages, the most common surgeries were bone grafts to augment the bone under the gums (alveolar bone grafts), which must be done before the permanent teeth start to come in, according to the study.

"While these conclusions may be considered positively in that patients with CLP have not been negatively impacted by more surgery, the negative aspect is that they have not demonstrated any benefit by having more surgery either," the researchers concluded.

More information

The March of Dimes has more on cleft lip and palate.

SOURCE: Plastic and Reconstructive Surgery, news release, June 26, 2020

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