Management of Cleft Lip and Palate: A Five Year Review

Emmanuel JK Adu* and Peter Donkor

Introduction: Clefts of the lip may cause cosmetic and social problems. Clefts of the palate may affect feeding, speech and hearing. 

Objective: To document the clinical and epidemiological features, surgical techniques (Millard’s repair for cleft lip, and the Oxford palatoplasty for cleft palate) and the outcome of treatment of patients with cleft lip and palate at Komfo Anokye Teaching Hospital (KATH), Kumasi, between January 2010 and December 2014.

Patients and Methods: Data on cleft patients were retrieved from the records of the cleft clinic and theatre records at KATH and analysed. 

Results: From January 2010 to December 2014, 150 patients were treated for clefts. Their ages ranged from 0.25 to 25 years, mean age of 12 months with standard deviation of 14.5 

The commonest deformity (85, N=150) was combined cleft lip and palate. Isolated cleft palate was the least common (23, N=150). There was predominance (83%) of unilateral cleft lip, 46% were left sided, 71% were complete. Unilateral cleft lip was repaired by Millard’s rotation-advancement technique; bilateral cleft lip with Millard’s one stage repair (Mulliken’s modifi cation). Both included closed primary rhinoplasty. Cleft palate was repaired with single stage palatoplasty with intravelar veloplasty - the Oxford palatoplasty. 

Complications include failed endotraheal intubation (5 patients), partial gaping of lip repair (5), complete disruption of cleft palate repair (4).

Conclusion: Combined cleft lip and palate was the commonest cleft deformity. Most patients were one year or younger. Millard’s techniques with primary rhinoplasty provided acceptable aesthetic and functional result. Adequate pre-surgical preparation is a requirement for successful cleft palate repair.

Keywords:

Published on: Feb 24, 2017 Pages: 23-26

Full Text PDF Full Text HTML DOI: 10.17352/2455-1759.000038
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