Sustainability and Success of Cleft Surgery in Developing Countries: Satisfaction Outcome of 125 Patients Operated in Myanmar

Abstract

Non-syndromic orofacial clefts are significantly linked to socioeconomic status. Because of limited access to proper medical care in rural areas of developing countries charity missions are highly required to mitigate negative outcome, but there is still a lack of data on humanitarian missions' sustainability and success. A retrospective analysis of 125 patients who underwent cleft surgery during humanitarian missions in Myanmar was performed. Patients' satisfaction with facial features and function was evaluated pre-and post-surgery. Furthermore, postoperative complications and satisfaction with follow-up care have been analyzed. Between 2008 and 2020 125 patients underwent cleft surgery by the Interplast team. The median patient's age was 2,58 years (mean=7 years) with a range of 3 months to 54 years. Group 1 (patients with cleft lip only, n=58) was analyzed on satisfaction with facial aspects and significant improvement was found. All 125 patients were evaluated regarding function features like eating or drinking and their post-surgical satisfaction was significantly higher than before surgery. To analyze if hearing and nasal breathing difficulties in patients with cleft palate can be decreased by primary cleft surgery these parameters were analyzed in group 2 (n=67). Group 2 as well reported significant improvement. Even with limited medical infrastructure and later primary surgery than in developed countries, cleft surgeries can be performed successfully and sustainable by integrating local surgeons in charity missions. Patients benefit greatly by these missions and further investigation on humanitarian cleft missions should be conducted.

Modified Borggreve–Van Nes-Winkelmann rotationplasty for surgery in developing countries

“…Surgical interventions in lower-middle income or even low-income economies with the aim of conducting successful orthopedic surgeries (e.g. cleft palate surgery, pediatric surgery) have been previously described in the literature and carry certain difficulties regarding organization, costs, time and personnel next to many other variables [ 15 , 16 ]. The success of such incentives is based on adequate organization in advance together with the local team of surgeons, experience, adaptability and Non-profit organizations and their donors.…”