Cleft Lip and Palate Repair

Gatti, G; Freda, Nicola; Giacomina, Alessandro; Montemagni, Marina; Sisti, Andrea

doi:10.1097/scs.0000000000003820

Cited by 39 publications

(30 citation statements)

References 21 publications

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“…The chi-square value was 0.452 which is not signi icant. In the study done by Gatti et al (2017), the most common cleft type was incomplete cleft palate (152 patients) (Gatti et al, 2017). Medical neglect and medical non-adherence are the main reasons for the development of cleft palate (Konda et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

Incidence of Cleft Lip and Cleft Palate - An Institutional Based Retrospective Study

Inchara

Santhanam

Subhashree

2020

ijrps

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Cleft lip or the palate is the congenital birth defect with which is characterised by complete or partial cleft lip or palate. The congenital cleft involving the facial structures may vary from trace of notching of the lip to a complete non fusion of lip and the palate. This study was done to determine the incidence of cleft lip and palate. It is a single centered retrospective study. Data was collected from the patient record system used in a private dental institution and following parameters such as gender, type of cleft lip and palate, unilateral or bilateral was recorded. 86000 patient details were analysed between June 2019 to March 2020 out of which 74 patients who fulfilled the inclusion and exclusion criteria were included in the study. The data was statistically analysed using SPSS software. In this study, it was observed that cleft lip was most commonly seen in males and cleft palate in females. Unilateral cleft lip is common in both males and females. Incomplete cleft palate is more common followed by complete cleft palate. Orofacial defects are most commonly seen at the time of birth.

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Section: Resultsmentioning

confidence: 99%

Incidence of Cleft Lip and Cleft Palate - An Institutional Based Retrospective Study

Inchara

Santhanam

Subhashree

2020

ijrps

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“…The data from the current study add to the current literature and demonstrate that cleft palate repair was performed at a median age of 12 months (IQR: 10-29 months), which was somewhat older than a previous analysis of cleft palate repairs. 1 Farronato et al have noted that the optimal timing for surgical intervention varies between centers; however, at most Western centers it is undertaken between 6 and 12 months of age. 15 Another interesting finding in the current study was that more than one-third of patients were operated under the Smile Train initiative.…”

Section: Discussionmentioning

confidence: 99%

“…Orofacial clefts represent the most common congenital craniofacial deformity occurring in 1 per 700 live births. 1 Interestingly, the global incidence of orofacial clefts is noted to have considerable geographic, ethnic, and racial variation. 2 For example, Asians and Native Americans are known to have the highest incidence of 1 per 500 live births, followed by Caucasians with an incidence of 1 in 1000 births, whereas people of African descent have the lowest incidence at 1 per 2500 live births.…”

Section: Introductionmentioning

confidence: 99%

Aboard the Smile Train: Outcomes of Primary Cleft Palate Repair at a Tertiary Care Center: À bord du Smile Train : les résultats cliniques de réparations de fentes palatines dans un centre de soins tertiaires

et al. 2020

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Introduction: Cleft palate repair is considered to be a safe procedure, yet still carries a 5% to 30% risk of complications. This study sought to assess the outcomes of this procedure in a high-burden Asian country that partners with the Smile Train to perform cleft surgeries. Methods: The Aga Khan University medical records database was queried for pediatric patients undergoing cleft surgery between 2014 and 2017. Data were abstracted from the patient medical records, and details of the clinical, demographic factors, and postoperative outcomes were assessed. Results: Among 142 patients with orofacial clefts, 102 (72%) underwent primary cleft palate repair, one-third (n = 36, 35%) of whom were operated as part of the Smile Train. The median preoperative hemoglobin was 11.4 g/dL (interquartile range: 10.7-12.0 g/dL), whereas the median weight was 8.3 kg (7.7-11.4 kg). Nearly two-thirds (n = 64, 63%) of the cohort underwent preoperative cardiology screening, with only a minority undergoing orthodontic treatment (n = 6, 6%). Approximately 15% (n = 15) of patients experienced a postoperative complication, most often a fistula (n = 11, 73%). On multivariable analysis, with each unit increase in hemoglobin levels, there was a 50% reduction in the odds of experiencing a complication (odds ratio: 0.51, 95% CI: 0.28-0.87). There were no in-patient deaths among the cohort. Conclusion: The results of the current study provide useful information to key stakeholders including patients, plastic surgeons, and policy makers on the outcomes of cleft palate repair in a developing country.

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“…The Cleft Evaluation Profile is a seven-item questionnaire that addresses speech, hearing, and appearance, widely used among children with CLCP (Appendix) [23]. The CEP has been shown to have satisfactory levels of internal consistency among parents [18] and has been used previously to assess caregiver satisfaction [24–27]. Caregivers rated each item on a scale of 1 to 7, with 1 being “very satisfactory” and 7 being “very unsatisfactory.” The total scores were summed across both domains, as well as separate domain scores for speech/hearing and appearance.…”

Section: Methodsmentioning

confidence: 99%

Caregiver-Reported Outcomes and Barriers to Care among Patients with Cleft Lip and Palate

Bennett

Ranganathan

Patterson

et al. 2018

Plastic &Amp; Reconstructive Surgery

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Background For children with cleft lip and/or palate (CLCP), access to care is vital for optimizing speech, appearance, and psychosocial outcomes. The authors posited that that inadequate access to care negatively impacts outcomes in the CLCP population. Methods Sixty caregivers of children with CLCP were surveyed to assess perceived barriers using the validated Barriers to Care questionnaire (BCQ). The BCQ includes 39 items divided into five subscales, with higher scores indicating fewer barriers. Caregiver reported outcomes (CROs) were assessed using the Cleft Evaluation Profile (CEP), which captures CLCP specific appearance- and speech-related outcomes. Higher scores correspond to less satisfactory outcomes. Desire for revision surgery was assessed as a binary outcome amongst caregivers. Multivariable regression was used to evaluate the relationship between barriers to care, CROs, and desire for revision, adjusting for clinical and demographic covariates. Results 60% of caregivers perceived barriers to care, and caregivers who reported poorer access to care described poorer cleft-related outcomes (r2=0.19, p=0.024). Caregivers with poorer Skills (r2=0.17, p=0.037), Expectations (r2=0.17, p=0.045), and Pragmatics (r2=0.18, p=0.026) subscale scores were associated with lower CEP scores. Barriers were also negatively associated with aesthetic item scores (r2=0.11, p=0.025). Finally, caregivers reporting fewer barriers were 21.2% less likely to express interest in revision surgery. Conclusions Barriers to care were associated with poorer appearance-related outcomes and increased interest in revision among caregivers of patients with CLCP. Enhancing access to care is critical in order to effectively meet goals of care for these families.

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Cleft Lip and Palate Repair

Abstract: The multidisciplinary management of children with oral cleft determinated good results, in terms of satisfaction and aesthetic appearance. From our experience, periosteoplasty and lip-adhesion are key surgical techniques.

Cited by 39 publications

References 21 publications

Incidence of Cleft Lip and Cleft Palate - An Institutional Based Retrospective Study

Incidence of Cleft Lip and Cleft Palate - An Institutional Based Retrospective Study

Aboard the Smile Train: Outcomes of Primary Cleft Palate Repair at a Tertiary Care Center: À bord du Smile Train : les résultats cliniques de réparations de fentes palatines dans un centre de soins tertiaires

Caregiver-Reported Outcomes and Barriers to Care among Patients with Cleft Lip and Palate

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