Objectives: To assess the opinions of patients treated with midface distraction osteogenesis (DO) at University Hospital Birmingham, and to develop an evidence-based care pathway for these patients.
Methods: Thirty patients who had undergone DO from 2003 to 2007 at University Hospital Birmingham were retrospectively surveyed using a postal questionnaire based on the validated Bristol orthognathic questionnaire. This explored key themes including reasons for undertaking surgery, the level of perceived post-operative pain, quality of the information provided and the perceived benefits of treatment.
Results: Twenty two patients successfully completed the questionnaire of which twenty were cleft lip and palate patients. Seventeen patients had external distractors and five had internal devices. Patients reported the benefits of treatment included improved appearance (95%), increased confidence (77%) and improved smile (86%). Despite these benefits, 55% of patients said they would not have the same surgery again. Thirty two percent of patients reported experiencing pain worse than expected and 82% of patients had difficulty eating post-operatively. The majority of patients felt that they had been well-informed about the surgical procedure (68%), the outcome of treatment (59%) and the orthodontic treatment (55%).
Conclusion: Patients feel the benefits of DO are significantly rewarding. Some patients have negative opinions regarding post-operative pain control and the level of information provided pre-operatively. Our care pathway has been modified to include more dietary advice and counselling and we have produced information leaflets and an analgesia protocol. The unit has adopted the survey as part of its routine six-month post-surgery review.