Epidemiology, outcomes and challenges of cleft palate surgeries in Port Harcourt: a 10-year retrospective study
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Abstract
Background: Cleft palate is a significant congenital condition affecting feeding, speech, hearing, and psychosocial development. In low-resource settings like Nigeria, limited access to specialized care often results in delayed treatment and poor outcomes.
Aim: To investigate the epidemiology, outcomes and challenges of cleft palate surgeries in Port Harcourt, Nigeria.
Methods: A retrospective study of patients who underwent cleft palate repair from January 2015 to December 2024 at the University of Port Harcourt Teaching Hospital, Port Harcourt. Data were obtained from the Smile Train Express database and included demographics, age at presentation, cleft type, associated anomalies, surgical techniques, and complications. Analysis was conducted using Microsoft Excel and SPSS version 20.
Results: The mean age at surgery was 2.5 years (range: 6 months–25 years) with slight male preponderance. Majority underwent surgery between the ages of 9 months and 3 years. Unilateral cleft palate was present in 70% of cases; bilateral in 30%. Associated anomalies, primarily cardiac and auditory, were noted in 20%. Primary repair was performed in 80%, predominantly using the von Langenbeck technique. The overall complication rate was 15%, with wound infections (8%) being most common, followed by fistula formation (4%) and respiratory complications (3%).
Conclusion: There is a slight male preponderance among those who had surgery for cleft palate. There were more unilateral cleft palates than bilateral cleft palates. Associated anomalies were identified in one-fifth of the patients. Primary cleft palate repair was the most frequently performed procedure using the von Langenbeck technique. The most common complication was wound dehiscence.
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References
Panamonta V, Pradubwong S, Panamonta M, Chowcheun B. Global birth prevalence of orofacial clefts: a systematic review. J Med Assoc Thai 2015;98 Suppl 7:S11-21.
Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM, et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg 2016;154(1 Suppl):S1-S41.
Skinner ML, Tunkel DE. Primary care of infants and children with cleft palate. In: Bluestone CD, Simons JP, Healy GB, editors. Bluestone and Stool's pediatric otolaryngology, 5th ed. Shelton, CT: People’s Medical Publishing House-USA, 2014;1879-1884.
Mossey PA, Little J. Epidemiology of oral clefts: an international perspective. In: Wyszynski DF (ed.). Cleft lip and palate: from origin to treatment. Oxford: Oxford University Press, 2002; 127-144.
Wehby GL, Cassell CH. The impact of orofacial clefts on quality of life and healthcare use and costs. Oral Dis 2010;16(1):3-10.
Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet 2011;12(3):167-178.
Department of Paediatrics, University of Virginia School of Medicine. Causes of cleft lip & palate. Available from: https://med.virginia.edu/pediatrics/clinical-and-patient-services/patient-tutorials/cleft-lip-palate/causes-of-cleft-lip-palate/. Accessed 12th April 2024.
Stock NM, Feragen KB. Psychological adjustment to cleft lip and/or palate: a narrative review of the literature. Psychol Health 2016 ;31(7):777-813.
Kuehn DP, Moller KT. Speech and language issues in the cleft palate population: the state of the art. Cleft Palate Craniofac J 2000;37(4):1-35.
Flynn T, Möller C, Jonsson R, Lohmander A. The high prevalence of otitis media with effusion in children with cleft lip and palate. Int J Pediatr Otorhinolaryngol 2009;73(10):1441-1446.
Wilson J, Hodges A. Cleft lip and palate surgery carried out by one team in Uganda: where have all the palates gone? Cleft Palate Craniofac J 2012;49(3):299-304.
Hunt O, Burden D, Hepper P, Stevenson M, Johnston C. Self-reports of psychosocial functioning among children and young adults with cleft lip and palate. Cleft Palate Craniofac J 2006;43(5):598-605.
Strauss RP. Cleft palate and craniofacial teams in the United States and Canada: a national survey of team organization and standards of care. The American Cleft Palate-Craniofacial Association (ACPA) Team Standards Committee. Cleft Palate Craniofac J 1998;35(6):473-480.
Nelson P, Glenny AM, Kirk S, Caress AL. Parents' experiences of caring for a child with a cleft lip and/or palate: a review of the literature. Child Care Health Dev 2012;38(1):6-20.
Liu RH, Manana W, Tollefson TT, Ntirenganya F, Shaye DA. Perspectives on the state of cleft lip and cleft palate patient care in Africa. Curr Opin Otolaryngol Head Neck Surg 2024;32(4):202-208.
Setabutr D, Sathavornmanee T, Jitpakdee P, Nudchawong S, Krergmatukorn P. The trend of cleft care at a children's referral center in Thailand. Cleft Palate Craniofac J 2020;57(9):1100-1104.
Sitzman TJ, Girotto JA, Marcus JR. Current surgical practices in cleft care: unilateral cleft lip repair. Plast Reconstr Surg 2008;121(5):261e-270e.
Hodgkinson PD, Brown S, Duncan D, Grant C, McNaughton A, Thomas P, et al. Management of children with cleft lip and palate: a review describing the application of multidisciplinary team working in this condition based upon the experiences of a regional cleft lip and palate centre in the United Kingdom. Fetal Matern Med Rev2005;16(1), 1-27.
Chung KY, Ho G, Erman A, Bielecki JM, Forrest CR, Sander B. A systematic review of the cost-effectiveness of cleft care in low- and middle-income countries: what is needed? Cleft Palate Craniofac J 2023;60(12):1600-1608.
Roberts RM, Mathias JL, Wheaton P. Cognitive functioning in children and adults with nonsyndromal cleft lip and/or palate: a meta-analysis. J Pediatr Psychol 2012;37(7):786-797.
Berg E, Haaland ØA, Feragen KB, Filip C, Vindenes HA, Moster D, et al. Health status among adults born with an oral cleft in Norway. JAMA Pediatr 2016;170(11):1063-1070.