Variation in the Desire for Cleft Revision Surgery among Children, Caregivers, and Surgeons

Kavitha Ranganathan, Jeanne M. Kochkodan, Michaella K. Baker, Niki Matusko, Katelyn G. Bennett, Danielle N. Shapiro, Seth A. Warschausky, Christian J. Vercler, Steven J. Kasten, Steven R. Buchman, Jennifer F. Waljee

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Although revision surgery is part of the reconstructive process for children with cleft lip and/or cleft palate, the indications for revision vary, and the extent to which surgeons and families agree on appearance is unclear. The authors sought to understand the extent to which children with cleft lip and/or cleft palate, surgeons, caregivers, and control observers agree on satisfaction with appearance and the desire for revision. METHODS: Children with cleft lip and/or cleft palate (n = 100) and their caregivers (n = 100) were surveyed regarding satisfaction with appearance using the Cleft Evaluation Profile. Surgeons (n = 10) and control observers (n = 10) rated photographs of these children using questions analogous to the Cleft Evaluation Profile. General linear model repeated measures analysis of variance were used to detect significant differences between raters, with an alpha of 0.05. RESULTS: The children reported greater satisfaction with appearance across all domains compared with surgeons (nose, 7.77 versus 5.51, p < 0.001; lip, 7.94 versus 5.90, p < 0.001; maxilla, 8.16 versus 6.56, p < 0.001) and general observers (nose, 7.78 versus 6.00, p < 0.001; lip, 7.80 versus 6.12, p < 0.001; maxilla, 8.16 versus 7.40, p < 0.001). Children and caregivers expressed similar degrees of satisfaction with appearance of the lip (5.48 ± 1.69 versus 5.6 ± 1.49, p > 0.5) and maxilla (6.08 ± 1.1 versus 5.8 ± 1.2, p = 0.07). There was no significant relationship between children and surgeons in terms of the desire for revision surgery (p = 0.44). CONCLUSIONS: All groups expressed differing levels of satisfaction with cleft-specific aspects of appearance. Importantly, children were more satisfied than all other groups. Care must be taken to evaluate perceptions of all stakeholders before moving forward with cleft revision surgery.

Original languageEnglish (US)
Pages (from-to)171-178
Number of pages8
JournalPlastic and reconstructive surgery
Volume144
Issue number1
DOIs
StatePublished - Jul 1 2019
Externally publishedYes

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Reoperation
Caregivers
Cleft Lip
Cleft Palate
Maxilla
Surgeons
Nose
Linear Models
Analysis of Variance

ASJC Scopus subject areas

  • Surgery

Cite this

Ranganathan, K., Kochkodan, J. M., Baker, M. K., Matusko, N., Bennett, K. G., Shapiro, D. N., ... Waljee, J. F. (2019). Variation in the Desire for Cleft Revision Surgery among Children, Caregivers, and Surgeons. Plastic and reconstructive surgery, 144(1), 171-178. https://doi.org/10.1097/PRS.0000000000005722

Variation in the Desire for Cleft Revision Surgery among Children, Caregivers, and Surgeons. / Ranganathan, Kavitha; Kochkodan, Jeanne M.; Baker, Michaella K.; Matusko, Niki; Bennett, Katelyn G.; Shapiro, Danielle N.; Warschausky, Seth A.; Vercler, Christian J.; Kasten, Steven J.; Buchman, Steven R.; Waljee, Jennifer F.

In: Plastic and reconstructive surgery, Vol. 144, No. 1, 01.07.2019, p. 171-178.

Research output: Contribution to journalArticle

Ranganathan, K, Kochkodan, JM, Baker, MK, Matusko, N, Bennett, KG, Shapiro, DN, Warschausky, SA, Vercler, CJ, Kasten, SJ, Buchman, SR & Waljee, JF 2019, 'Variation in the Desire for Cleft Revision Surgery among Children, Caregivers, and Surgeons', Plastic and reconstructive surgery, vol. 144, no. 1, pp. 171-178. https://doi.org/10.1097/PRS.0000000000005722
Ranganathan, Kavitha ; Kochkodan, Jeanne M. ; Baker, Michaella K. ; Matusko, Niki ; Bennett, Katelyn G. ; Shapiro, Danielle N. ; Warschausky, Seth A. ; Vercler, Christian J. ; Kasten, Steven J. ; Buchman, Steven R. ; Waljee, Jennifer F. / Variation in the Desire for Cleft Revision Surgery among Children, Caregivers, and Surgeons. In: Plastic and reconstructive surgery. 2019 ; Vol. 144, No. 1. pp. 171-178.
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abstract = "BACKGROUND: Although revision surgery is part of the reconstructive process for children with cleft lip and/or cleft palate, the indications for revision vary, and the extent to which surgeons and families agree on appearance is unclear. The authors sought to understand the extent to which children with cleft lip and/or cleft palate, surgeons, caregivers, and control observers agree on satisfaction with appearance and the desire for revision. METHODS: Children with cleft lip and/or cleft palate (n = 100) and their caregivers (n = 100) were surveyed regarding satisfaction with appearance using the Cleft Evaluation Profile. Surgeons (n = 10) and control observers (n = 10) rated photographs of these children using questions analogous to the Cleft Evaluation Profile. General linear model repeated measures analysis of variance were used to detect significant differences between raters, with an alpha of 0.05. RESULTS: The children reported greater satisfaction with appearance across all domains compared with surgeons (nose, 7.77 versus 5.51, p < 0.001; lip, 7.94 versus 5.90, p < 0.001; maxilla, 8.16 versus 6.56, p < 0.001) and general observers (nose, 7.78 versus 6.00, p < 0.001; lip, 7.80 versus 6.12, p < 0.001; maxilla, 8.16 versus 7.40, p < 0.001). Children and caregivers expressed similar degrees of satisfaction with appearance of the lip (5.48 ± 1.69 versus 5.6 ± 1.49, p > 0.5) and maxilla (6.08 ± 1.1 versus 5.8 ± 1.2, p = 0.07). There was no significant relationship between children and surgeons in terms of the desire for revision surgery (p = 0.44). CONCLUSIONS: All groups expressed differing levels of satisfaction with cleft-specific aspects of appearance. Importantly, children were more satisfied than all other groups. Care must be taken to evaluate perceptions of all stakeholders before moving forward with cleft revision surgery.",
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AU - Ranganathan, Kavitha

AU - Kochkodan, Jeanne M.

AU - Baker, Michaella K.

AU - Matusko, Niki

AU - Bennett, Katelyn G.

AU - Shapiro, Danielle N.

AU - Warschausky, Seth A.

AU - Vercler, Christian J.

AU - Kasten, Steven J.

AU - Buchman, Steven R.

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N2 - BACKGROUND: Although revision surgery is part of the reconstructive process for children with cleft lip and/or cleft palate, the indications for revision vary, and the extent to which surgeons and families agree on appearance is unclear. The authors sought to understand the extent to which children with cleft lip and/or cleft palate, surgeons, caregivers, and control observers agree on satisfaction with appearance and the desire for revision. METHODS: Children with cleft lip and/or cleft palate (n = 100) and their caregivers (n = 100) were surveyed regarding satisfaction with appearance using the Cleft Evaluation Profile. Surgeons (n = 10) and control observers (n = 10) rated photographs of these children using questions analogous to the Cleft Evaluation Profile. General linear model repeated measures analysis of variance were used to detect significant differences between raters, with an alpha of 0.05. RESULTS: The children reported greater satisfaction with appearance across all domains compared with surgeons (nose, 7.77 versus 5.51, p < 0.001; lip, 7.94 versus 5.90, p < 0.001; maxilla, 8.16 versus 6.56, p < 0.001) and general observers (nose, 7.78 versus 6.00, p < 0.001; lip, 7.80 versus 6.12, p < 0.001; maxilla, 8.16 versus 7.40, p < 0.001). Children and caregivers expressed similar degrees of satisfaction with appearance of the lip (5.48 ± 1.69 versus 5.6 ± 1.49, p > 0.5) and maxilla (6.08 ± 1.1 versus 5.8 ± 1.2, p = 0.07). There was no significant relationship between children and surgeons in terms of the desire for revision surgery (p = 0.44). CONCLUSIONS: All groups expressed differing levels of satisfaction with cleft-specific aspects of appearance. Importantly, children were more satisfied than all other groups. Care must be taken to evaluate perceptions of all stakeholders before moving forward with cleft revision surgery.

AB - BACKGROUND: Although revision surgery is part of the reconstructive process for children with cleft lip and/or cleft palate, the indications for revision vary, and the extent to which surgeons and families agree on appearance is unclear. The authors sought to understand the extent to which children with cleft lip and/or cleft palate, surgeons, caregivers, and control observers agree on satisfaction with appearance and the desire for revision. METHODS: Children with cleft lip and/or cleft palate (n = 100) and their caregivers (n = 100) were surveyed regarding satisfaction with appearance using the Cleft Evaluation Profile. Surgeons (n = 10) and control observers (n = 10) rated photographs of these children using questions analogous to the Cleft Evaluation Profile. General linear model repeated measures analysis of variance were used to detect significant differences between raters, with an alpha of 0.05. RESULTS: The children reported greater satisfaction with appearance across all domains compared with surgeons (nose, 7.77 versus 5.51, p < 0.001; lip, 7.94 versus 5.90, p < 0.001; maxilla, 8.16 versus 6.56, p < 0.001) and general observers (nose, 7.78 versus 6.00, p < 0.001; lip, 7.80 versus 6.12, p < 0.001; maxilla, 8.16 versus 7.40, p < 0.001). Children and caregivers expressed similar degrees of satisfaction with appearance of the lip (5.48 ± 1.69 versus 5.6 ± 1.49, p > 0.5) and maxilla (6.08 ± 1.1 versus 5.8 ± 1.2, p = 0.07). There was no significant relationship between children and surgeons in terms of the desire for revision surgery (p = 0.44). CONCLUSIONS: All groups expressed differing levels of satisfaction with cleft-specific aspects of appearance. Importantly, children were more satisfied than all other groups. Care must be taken to evaluate perceptions of all stakeholders before moving forward with cleft revision surgery.

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