Quality of life improvement, psychosocial benefits, and treatment satisfaction following cleft lip and/or palate surgery: an overview of systematic reviews

Abstract

Objective: To evaluate the impact of cleft surgery on quality of life (QoL), psychosocial well-being and patient satisfaction. Design: Overview of systematic reviews. Searches were conducted in MEDLINE via OVID, Scopus, EMBASE, Web of Science, Cochrane Database of Systematic reviews, PsycInfo, AMED (Allied and Complementary Medicine Database), and PubMed up to 31 January 2025. Participants: Patients with cleft lip and/or palate Intervention: Cleft surgery undertaken at any stage of the cleft pathway, including orthognathic surgery, distraction osteogenesis, rhinoplasty, lip revision and speech surgery. Main Outcome Measures: Patient-related outcomes measured through appropriate assessment tools assessing effect of surgery on factors such as QoL, psychosocial well-being and patient satisfaction. Results: A total of 33 studies were identified by the search, with 10 selected for full-text evaluation, resulting in 4 eligible systematic reviews. None of the studies conducted a meta-analysis, which limited this study to a qualitative one. Categorisation of the data were presented among the following themes: 1. Assessment tools used to assess patient outcomes; 2. Gender and age; 3. Psychosocial well-being; 4. QoL; 5. Patient satisfaction. Conclusions: Evidence suggests cleft lip and/or palate surgery is associated with improvements in selected appearance-related and functional domains of quality of life; however, substantial heterogeneity and low methodological quality limit the strength of the conclusions that can be drawn. The evidence derives predominantly from low- to critically low-quality systematic reviews of observational studies, and causal inference is not possible. Registration: PROSPERO CRD42022369051