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Long-term Quality of Life in Adult Patients with Hemifacial Microsomia: Our Institution's 30-Year Experience
Dominic Romeo
*, Leigh Friedman, Manisha Banala, Carlos E. Barrero, Benjamin Massenburg, Jinggang Ng, Meagan Wu, Carrie Morales, Jordan W. Swanson, Jesse A. Taylor, Scott Bartlett
Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Phiadelphia, Philadelphia, PA
Background: While studies have analyzed the quality of life (QOL) in children with hemifacial microsomia (HFM), little is known about long-term QOL in adults with HFM. This study compares long-term QOL in adults with HFM to a cohort of unaffected controls using a validated questionnaire.
Methods: Adults aged 18 years or older with HFM were prospectively contacted and administered the World Health Organization (WHO) Quality of Life Biomedical Research and Educating Foundation questionnaire (QOL-BREF). Responses were compared to an age-matched normative database. Relationships among OMENS severity classification, Kaban-Pruzansky grade, demographics, surgical history, and QOL were compared using t-tests, multivariate linear regression models, and correlation analysis.
Results: One hundred and fifteen patients met inclusion criteria, 41 (35.7%) were successfully contacted, and 29 (25.2%) completed the questionnaire in an average of 9.7±3.3 minutes. Respondents were 24.0±4.5 years old (minimum 18.4, maximum 32.8 years) with 16 (55.2%) females and 13 (44.8%) males. This cohort of adults with HFM scored worse in the physical domain (13.9±1.5 vs. 15.5±3.2, p<0.01) than controls and there was a negative correlation between craniofacial surgical burden and physical domain scores (r=-0.401, p=0.034). Severity of nerve involvement on OMENS classification (r=-0.451, p=0.018) as well as composite OMENS severity score (r=-0.413, p=0.032) were negatively correlated with self-reported social relationship scores. Adults with HFM scored better in the social (16.0±3.1 vs. 13.2±3.2, p<0.01) and environmental domains (16.8±1.7 vs. 11.7±2.7, p<0.01) than age-matched controls, but similar in the psychological domain (14.7±1.9 vs. 13.8±3.2, p>0.05).
Conclusions: Severity of nerve involvement, composite OMENS severity score, and increased surgical burden are associated with lower reported quality of life in adults treated for hemifacial microsomia. Still, quality of life in these patients remains high relative to the general population.
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