Psychosocial outcome of craniofacial surgery in children

Thirty-four children between the ages of 7 and 15 years with congenital craniofacial anomalies underwent psychosocial evaluation before and 12 to 18 months after surgery. Also evaluated were healthy children matched to the craniofacial subjects by sex, age, intelligence, and economic background. Preoperative assessment revealed the craniofacial group to have multiple but not severe psychosocial limitations. At follow-up, only a measure of social functioning still differentiated the groups, with the craniofacial subjects experiencing more negative social encounters. Comparison of initial and follow-up scores for the craniofacial group revealed a significant reduction in trait anxiety and trends toward reduction in parent-reported inhibited and hyperactive behavior. Scores on measures of extraversion and social functioning tended to be positively correlated with age for the comparison subjects only. Results suggest a modest improvement in psychological adjustment following surgery with a residual, possibly increasing, deficit in social functioning.