Early Surgical Outcomes in 5-Year-Old Patients with Repaired Unilateral Cleft Lip and Palate

Abstract

Objective: To assess the surgical outcome of 5-year-old subjects with repaired unilateral cleft lip and palate who had been operated on by a single surgeon. Design: Retrospective consecutive outcome study. Setting: The cleft lip and palate center at Frenchay Hospital, North Bristol NHS Trust, U.K. Participants: All patients born with unilateral cleft lip and palate between May 1992 and April 1998 were identified and their study models were located. Main Outcome Measures: The reasons for failing to obtain study models were recorded. The “test” study models were combined randomly with a “gold standard” set of study models to give a group of 53 for assessment purposes. These study models were assessed twice by two examiners independently using the 5-Year-Olds’ Index. The weighted kappa (κ) statistic and components of variance were used to establish the levels of agreement within and between examiners, as well as between the gold standard and the examiners. Results: Thirty sets of study models out of a possible 43 were located. The most common reason for not obtaining records was poor cooperation. More than 50% of study models were assessed as being good outcomes (Index groups 1 and 2), whereas fewer than 20% of the records were evaluated as being poor outcomes (Index groups 4 and 5). There was good inter- and intraexaminer agreement and agreement with the gold standard values. Conclusion: Study model collection in this age group can be difficult due to patient cooperation.