• Users Online: 295
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Partners Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 2  |  Page : 99-103

Early cleft lip and palate repair: Experience of the National Orthopedic Hospital Enugu, Southeast Nigeria


Department of Burns and Plastic, National Orthopaedic Hospital, Enugu, Nigeria

Correspondence Address:
Dr. Chuwuemeka Patrick Okoye
Department of Burns and Plastic, National Orthopaedic Hospital, PMB 01294, Enugu
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jclpca.jclpca_26_18

Rights and Permissions

Background: Surgical treatment of clefts during infancy poses a challenge for the plastic surgeon and anesthetists. The timing of the procedures has been fraught with controversies with no consensus. Due to the many different treatment philosophies, the timing of treatment varies among cleft centers. Historically, anesthetic risk-related data suggest that the safe time period for surgery in this population of infants could be outlined by the rule of 10's. However, more sophisticated pediatric techniques and advances in intraoperative monitoring and pediatric anesthesia have resulted in the provision of safe general anesthesia for younger infants. This article attempts to provide an audit of the outcome and complications of cleft lip/palate repair performed earlier than the hitherto defined period. Aims/Objectives: The aims of the study were to evaluate the perioperative safety profile of early cleft lip and palate repairs and to evaluate early postoperative surgical complications. Materials and Methods: A retrospective audit of all patients that had early cleft lip and palate repair at the National Orthopedic Hospital Enugu, Nigeria, between May 2006 and May 2014. Early cleft lip and palate repairs were defined as repair done before 10 weeks and 9 months, respectively. Information was obtained from the folders of the patients and the smile train express database. The anesthetic technique was general anesthesia with endotracheal intubation and halothane as the inhalational agent. Armored tubes were used for palatal repairs. The Mohler's technique and Mulliken's technique were used for unilateral and bilateral lip repair, respectively. Intravelar veloplasty ± relaxing incisions/Bardach two-flap palatoplasty were used for palate repairs. All the procedures were carried out by one consultant plastic surgeon. Results: Four hundred and ninety-three cleft-related surgeries were performed in the period. Forty-one were early cleft lip/palate repairs. Thirty-one of these early procedures were done on the lip, whereas ten procedures were on the palate. There were no mortalities. One patient (2.4%) developed anesthetic complication (prolonged recovery time). There was neither need for intra- nor postoperative transfusion. One patient had a need for supplemental oxygen therapy beyond 1 h. There was no need to take any patient back to theater. The most common early complications following lip and palate repairs were wound dehiscence and palatal fistulae, respectively. Conclusion/Recommendation: These procedures can be safely carried out when performed early. The surgical complication rates appear to be few following early procedures. Further study on long-term cleft repair on facial growth and speech needed.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed744    
    Printed65    
    Emailed0    
    PDF Downloaded30    
    Comments [Add]    

Recommend this journal