Predictors of Positive Outcomes in Children with Facial Skeletal Discrepancies

Principal Investigator: Pravin Patel, M. D.
Co-Investigators: Kathleen A. Kapp-Simon, Ph.D.; Linping Zhao, Ph.D.; Mary O’Gara, M.A.; and Stephen Grud, DDS, M.S.

This grant-supported project seeks to identify those factors that influence surgical decision making in youth with facial skeletal dysostosis (FSD). The specific aims of this project are to:

1. Compare physiological characteristics including morphological appearance, oral-motor functioning, nasal airflow quality for speech and breathing; psychological adjustment; and quality of life between adolescents with and without FSD at initial assessment and one year later;

2. Identify which factors provide the primary motivation for reconstructive surgery for adolescents with FSD or orthodontic treatment for adolescents without FSD; and

3. Develop predictive models of psychological functioning and quality of life for adolescents following reconstructive surgery or orthodontic treatment.

Physiological characteristics (morphological appearance, oral-motor functioning, nasal airflow quality for speech and breathing), psychological adjustment, and quality of life between adolescents with and without FSD are compared at initial assessment and one year later. Differences between group means for degree of dysmorphology; speech airflow quality, and psychological adjustment are examined. Factors that provide primary motivation for treatment for adolescents with and without skeletal facial dysostosis are will be examined. Lastly, analysis of the data will be used to develop predictive models of treatment outcomes in adolescents following reconstructive surgery.

Two hundred male and female adolescents between the ages of 14 and 20 are being recruited with 100 adolescents having FSD; of these 50 adolescents are immediate candidates for surgery (surgery group, SG) and 50 will be at least one year prior to surgery (surgery wait group, SWG); 100 adolescents will not have FSD: 50 will be in active orthodontic treatment (orthodontic group, OG), and 50 adolescents will not be in active orthodontic treatment (nontreatment group, NTG). Subjects without FSD will be group-matched to subjects with FSD by age, gender, and racial background. There will be two measurement times. The SG will be assessed approximately at time of surgery (T1) and approximately one year post-surgery (T2). The SWG group will be assessed approximately one year before surgery (T1) and at time of surgery (T2). The other two groups will be assessed at comparable time points one year apart.