Reconstruction of residual cleft nasal deformities in adolescents: Effects on social perceptions

Purpose: The investigators hypothesized that a layperson\u27s social perceptions of a primarily repaired adolescent cleft lip and palate (CL/P) patient is more favorable after definitive nasal reconstruction with regard to perceived social traits. Methods: The investigators implemented a survey comparing layperson\u27s social perceptions of 6 personality traits, 6 emotional expression traits, and 7 perceptions of interpersonal experiences before and \u3e6 months after definitive nasal reconstruction in CL/P adolescent subjects by viewing standardized facial photographs. The sample was composed of consecutive CL/P subjects treated by one surgeon using a consistent technique involving a rib cartilage caudal strut graft through an open approach. Five non-cleft adolescent subjects who underwent cosmetic rhinoplasty involving a septal cartilage caudal strut graft through an open approach were used as a comparison group. The outcome variable was change in 6 perceived personality, 6 emotional expression traits studied, and 7 perceptions of interpersonal experiences. Descriptive and bivariate statistics were computed (p-value \u3c0.05). Results: The sample was composed of 10 consecutive CL/P subjects and 5 non-cleft adolescent comparison subjects. 500 respondents (raters) completed the survey. The respondents were 54% male with 56% age 25 to 34. After definitive cleft nasal reconstruction, study subjects were perceived to be significantly more attractive (p = 0.04) and less threatening (p = 0.04). They were also perceived as less angry (p \u3c 0.01), sad (p \u3c 0.01), or disgusted (p \u3c 0.01) than prior to surgery. The subjects were also perceived to be less likely to have negative interpersonal experiences (p \u3c 0.01). Conclusion: We confirmed that laypeople consistently report positive changes in adolescent CL/P subject\u27s perceived social traits after definitive cleft nasal reconstruction. Overall, the positive changes were largely comparable between the cleft and non-cleft groups