Surgical repair of cleft lip and cleft palate

2009 ◽  
Vol 20 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Robert J. Tibesar ◽  
Angela Black ◽  
James D. Sidman
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Surgical Repair

Surgical Repair of Orofacial Clefts in North Kivu Province of Eastern Democratic Republic of Congo (DRC)

2020 ◽  
Vol 57 (11) ◽  
pp. 1314-1319
Author(s):  
Luc Malemo Kalisya ◽  
Jacques Fadhili Bake ◽  
Bake Elisee ◽  
Kavira Nyavandu ◽  
Robert Perry ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Democratic Republic ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Democratic Republic Of Congo ◽  
Orofacial Clefts ◽  
Republic Of Congo ◽  
General Surgeons ◽  
North Kivu

Background: There is a high prevalence of orofacial clefts in low- and middle-income countries with significant unmet need, despite having 50% of the population younger than 18 years in countries such as the Democratic Republic of Congo (DRC). The purpose of this article is to report on the experience of general surgeons with orofacial clefts at a single institution. Methods: This is a retrospective study of patients treated for cleft lip/palate in the province of North Kivu, DRC between 2008 and 2017. Results: A total of 1112 procedures (122/year) were performed. All procedures were performed by general surgeons following training by an international nongovernmental aid organization. A total of 59.2% of patients were male and the median age was 3.4 years (interquartile range: 0.7-13 years). Average distance from surgical center to patient location was 242.6 km (range: 2-1375 km) with outreach performed for distances >200 kms. A majority (82.1%) of patients received general anesthesia (GA) with significant differences in use of GA, age, weight, and length of stay by major orofacial cleft category. Of the 1112 patients, 86.1% were reported to have cleft lip alone, 10.5% had cleft lip and palate, and 3.4% cleft palate alone. Despite this, only 5.3% of patients underwent surgical repair of cleft palate. Conclusions: Multiple factors including malnutrition, risk of bleeding, procedural complexity, and cosmetic results may contribute to the distribution of procedures performed where most cleft palates are not treated. Based on previously published estimates, unmet needs and social burden of cleft lip and palate are high in the DRC.

scholarly journals Speech Outcome Evaluation After Two-Flap Palatoplasty In Plastic Surgery Division Cipto Mangunkusumo Hospital: A Retrospective study

1970 ◽  
Vol 1 (2) ◽  
Author(s):  
Kristaninta Bangun ◽  
Siti Handayani ◽  
Intania Djoenaedi ◽  
Luh Karunia Wahyuni
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Surgical Repair ◽  
Outcome Evaluation ◽  
Analysis Study ◽  
Speech Pathologist ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Larger Sample ◽  
Normal Speech

One of the primary goal of cleft palate repair is to provide an intact mechanism for normal speech production. The purpose of this study is to evaluate the two-flap mucoperiosteal palatoplasty procedure on speech outcomes in patients undergoing surgical repair before the age of 2 years. A retrospective analysis study was done on 22 children with complete unilateral cleft palate (with or without cleft lip) who underwent two-flap palatoplasty between year 2002 to 2006 at Cipto Mangunkusumo Hospital. Evaluation was performed by a speech pathologist for pattern of articulation, hypernasality, intelligibility, and velopharyngeal competence. Palatoplasty were performed after 2 year-old in 11 patients and before 2 year-old in 11 patients. Speech of the 22 children postpalatoplasty was evaluated perceptually from standardised tape recordings. Velopharyngeal competence in patients who underwent palatoplasty before 2 year-old compared to after 2 year-old were 72.7% good, 18.2% fair and 9.1% poor versus 54,5% good, 9,1% fair and 36,4% poor respectively. Two-flaps mucoperiosteal palatoplasty performed before the age of 2 years old shows better spepolech outcome in all parameters, although the numbers are not statistically significant. Further prospective study with larger sample is needed.

Dentoalveolar Arch Dimensions in UCLP Boys After Neonatal Cheiloplasty or After Lip Surgery at the Age of 3 or 6 Months

2019 ◽  
Vol 56 (8) ◽  
pp. 1020-1025 ◽  
Author(s):  
Magdalena Kotova ◽  
Wanda Urbanova ◽  
Andrej Sukop ◽  
Renata Peterkova ◽  
Miroslav Peterka ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Control Group ◽  
Arch Width ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Deciduous Molars ◽  
Plaster Casts

Objective: To compare the influence of 3 different time protocols of cleft lip and palate operations on the growth of the dentoalveolar arch in patients with unilateral cleft lip and palate (UCLP). Materials and Methods: We evaluated 64 plaster casts of 8-year-old boys with UCLP operated on according to 3 different time protocols: lip repair at the age of 6 months and palate repair at 4 years, lip repair at 3 months and palate repair at 9 months, and neonatal lip repair and palate repair at 9 months. The control group contained 13 plaster casts of 8-year-old boys. The dentoalveolar arch width was measured between deciduous canines and between the second deciduous molars; the length was measured between incisive papilla and the line connecting both tuber maxillae. Results: All measured distances were statistically significantly smaller in boys with UCLP than in the control group. Intercanine width was not statistically significantly different between the patients operated on according to the different time protocols. In comparison to the lip repair at 6 months and palate repair at 4 years, the intermolar width was statistically significantly smaller in the group with neonatal lip repair; the alveolar arch length was statistically significantly shorter in both groups with lip repair performed neonatally or at 3 months. Conclusions: The length of the dentoalveolar arch is shorter after surgical repair of cleft lip neonatally or at the age of 3 months. Cleft palate repair at 9 months can contribute to a reduction in the width of the dentoalveolar arch.

Pre-Speech in Children with Cleft Lip and Palate or Cleft Palate Only: Phonetic Analysis Related to Morphologic and Functional Factors

1994 ◽  
Vol 31 (4) ◽  
pp. 271-279 ◽  
Author(s):  
Anette Lohmander-Agerskov ◽  
Ewa Söderpalm ◽  
Hans Friede ◽  
Eva-Carin Persson ◽  
Jan Lilja
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Place Of Articulation ◽  
Functional Factors ◽  
Phonetic Features ◽  
Delayed Closure ◽  
Manner Of Articulation ◽  
Positive Effect

Pre-speech in 35 children with clefts of the lip and palate or palate only were analyzed for place and manner of articulation. Transcriptions were made from tape recorded babbling sequences. Two children without clefts were used as reference. All of the children with clefts were treated according to a regimen of early surgical repair of the velum cleft and delayed closure of the cleft in the hard palate. The frequency of selected phonetic features was calculated. Correlations between phonetic/perceptual and functional and morphological factors were tested. Supraglottal articulation dominated among all the children Indicating a sufficient velopharyngeal mechanism. The results also showed correlations between cleft type and place of articulation. Anteriorly placed sounds (I.e., bilabial, dental, and alveolar sounds) occurred frequently among the children with cleft palate only and in the noncleft children. In children with cleft lip and palate, posteriorly placed articulations predominated. It was postulated that early intervention may have a positive effect on articulatory development.

Cleft Lip and Cleft Palate Surgery: Malpractice Litigation Outcomes

2017 ◽  
Vol 54 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Grant A. Justin ◽  
Scott E. Brietzke
Keyword(s):  
Brain Injury ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Inclusion Criteria ◽  
Financial Outcomes ◽  
Malpractice Litigation ◽  
Included Patient ◽  
Malpractice Claims

Objective This study examined malpractice claims related to cleft lip and cleft palate surgery to identify common allegations and injuries and reviewed financial outcomes. Design The WestlawNext legal database was analyzed for all malpractice lawsuits and settlements related to the surgical repair of cleft lip and palate. Main Outcomes Measures Inclusion criteria included patients undergoing surgical repair of a primary cleft lip or palate or revision for complications of previous surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes. Results A total of 36 cases were identified, with 12 unique cases from 1981 to 2006 meeting the inclusion criteria. Six cases (50%) were decided by a jury and six by settlement. Five cases involved complications related to the specific surgery, and the other seven were associated with any surgery and perioperative care of children and adults. Cleft palate repair (50%) was the most frequently litigated surgery. Postoperative negligent supervision was the most common allegation (42%) and resulted in a payout in each case (mean = $3,126,032). Death (42%) and brain injury (25%) were the most frequent injuries reported. Financial awards were made in nine cases (after adjusting for inflation, mean - $2,470,552, range - $0 to $7,704,585). The awards were significantly larger for brain injury than other outcomes ($4,675,395 versus $1,368,131 after adjusting for inflation, P - .0101). Conclusion Malpractice litigation regarding cleft lip and palate surgery is uncommon. However, significant financial awards involving perioperative brain injury have been reported.

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