Impact of cleft lip and palate before and after treatment in a low-income population

Background: Individuals with cleft lip and palate (CLP) and other craniofacial deformities are often perceived negatively in various social circumstances, resulting in failure to achieve full socio economic potential. Aim of the study: This study aimed to identify social stigmata and their causes associated with CLP and other deformities in an Indian population from a low socio-economic background, ways to reduce such effects and the potential reduction of disability following surgery. Methods: To assess the general awareness of the patients and their families regarding clefts, A GSR Institute: Cleft-Awareness Questionnaire (Reddy SG et al 2018) was used for data collection. 100 consecutive patients treated in GSR Institute for Craniofacial and Facial Plastic Surgery in Hyderabad, Telangana, were invited to join the study Statistical analysis regarding consanguineous marriage, understanding of clefts by parents and members of their community and of their societal conditions and the impact before and after surgery was carried out. Results: Statistical analysis using chi-squared test regarding the frequency of consanguineous marriage revealed no significant difference between the expected and observed frequencies in Telangana whereas there was a significant difference (p<0.001) between the values in India and also for understanding of clefts by parents (p<0.001) and friends/neighbours (p<0.001). On Kruskall-Wallis test and Pearson Chi-Squared Goodness of Fit test, no significance was observed on social conditions and associated problems faced by child before and after surgery respectively. Conclusion: These results confirm the impact of social stigmata in an Indian population with CLP and other craniofacial deformities predominantly related to the lack of education due to low socio-economic background and a heightened sense of superstitions of family, friends/neighbours of the affected individual thereby, causing embarrassment and depression. However, these were alleviated by surgical intervention and adequate speech therapy, thereby, improving social acceptance.