Work

Early Alveolar Bone Grafting Decreases Regraft Rates and Improves Long-Term Psychosocial Outcomes

Year: 2020

Type: article

Abstract: BACKGROUND: Late childhood (8–10 years of age) has emerged as a vulnerable period in children with cleft and craniofacial anomalies such that increased interventions during this period is associated with worse long-term patient-reported anxiety and depressive symptoms. These findings suggest that one possible practice change may be to consider changes in timing for surgical treatment algorithms. In this work, we investigated outcomes in altering the timing of the most common surgery in late childhood for cleft lip and palate (CLP) patients, alveolar bone grafting (ABG). METHODS: A 2-part, multi-institutional cohort study was conducted. To understand the feasibility of changing ABG timing with respect to the surgical success, reoperation rates were retrospectively compared among patients grafted at different age groups (4–7, 8–10, and 11–13 years of age). To understand the long-term effect of changing ABG timing on psychosocial outcomes, the psychosocial suite of the Patient-Reported Outcomes Measurement Information System was prospectively administered to CLP teenagers and adults. RESULTS: Among the three age groups, early grafting (4–7 years of age) demonstrated the lowest regraft rates compared with the other groups. As these results suggested that early grafting is a viable alternative to standard timing, we next compared the differences in long-term psychosocial outcomes. Patients who were grafted early reported lower levels of anxiety and depressive symptoms as teenagers and adults. CONCLUSIONS: Altering timing of 1 stage in CLP reconstruction to an earlier age decreases regraft rates and improves long-term patient-reported anxiety and depressive symptoms.

Source: Plastic & Reconstructive Surgery Global Open

DOI: 10.1097/01.gox.0000720604.06429.16