Cleft Lip and Palate

Abstract

Cleft lip and/or palate is a debilitating condition if left unrepaired, resulting in significant speech, hearing, swallowing, feeding, and psychosocial impairments. The authors' objective was to determine the potential impact of being born with cleft lip and/or palate by using previously validated health state utility assessment measures. A utility assessment using the visual analogue scale, time trade-off, and standard gamble was used to obtain utilities for cleft lip and/or palate, monocular blindness, and binocular blindness from a prospective sample of the general population and medical students. Average utility scores were compared using paired t test. Linear regression was performed using age, race, and education as independent predictors of each of the utility scores. Over a 1-year prospective enrollment period, 110 participants were included in our utility analysis. The utility outcome scores for cleft lip and/or palate (visual analogue scale, time trade-off, and standard gamble, 0.69±0.18, 0.85±016, and 0.84±0.18, respectively) were statistically different from those of binocular blindness (visual analogue scale, time trade-off, and standard gamble: 0.38±0.17, 0.70±0.24, and 0.66±0.25, respectively; p<0.001) but not statistically different from those of monocular blindness (visual analogue scale, time trade-off, and standard gamble, 0.67±0.15, 0.86±0.15, and 0.84±0.18, respectively). There was no statistically significant difference in utility scores between male and female participants. The results of the study demonstrate objectively via health state utility scores that the perceived burden of being born with cleft lip and/or palate is comparable to living with monocular blindness.