Longitudinal Analysis of Changes in Facial Asymmetry and Quality of Life in Patients with Cleft Lip and/or Palate

Previous research has suggested that youth diagnosed with cleft lip and/or palate (CL/P) with more visible facial differences may report lower quality of life than those with less visible facial differences. Three-dimensional imaging has been identified as a reliable and accurate measurement of facial difference; however, use of objective measurement of facial differences in the literature on psychosocial outcomes in the CL/P population is lacking (Mosmuller et al., 2013). This study utilized three-dimensional imaging technology to explore the relationship between nasolabial asymmetry, appearance satisfaction, and patient-rated quality of life cross-sectionally and longitudinally. Data were collected for 120 pediatric patients (74 with follow up visit) with orofacial cleft diagnoses seen in a multidisciplinary craniofacial team clinic between March 2013 and March 2017. Path analyses were conducted to examine the model and results demonstrated that nasolabial asymmetry did not predict appearance satisfaction or quality of life at either time point after controlling for age, sex, and speech therapy status. However, appearance satisfaction was a significant predictor of improvement in quality of life from T1 to T2. Findings suggest that appearance satisfaction may play a major role and may be meaningful in predicting quality of life outcomes, independent of measured facial asymmetry.