Survey of management of children with cleft lip and palate in teaching and specialist hospitals in Nigeria

Type Journal Article - The Cleft Palate-Craniofacial Journal
Title Survey of management of children with cleft lip and palate in teaching and specialist hospitals in Nigeria
Volume 48
Issue 2
Publication (Day/Month/Year) 2011
Page numbers 150-155
Objective: A national survey was conducted to obtain an overall view of the current management of children with cleft lip and/or palate in Nigeria.
Method: Questionnaires were sent to 44 identified cleft surgeons in all teaching and specialist hospitals in Nigeria.
Results: A total of 38 respondents returned completed questionnaires. The findings are as follows: (1) a majority of the surgeons (68.4%) are “low-volume operators,” undertaking 10 or fewer new cleft repairs annually; (2) 86.8% of the surgeons repair cleft lip at 3 to 4 months of age, and the most common (71%) unilateral cleft lip repair method is the rotation-advancement technique; (3) 50% of the surgeons use straight line repair for bilateral cleft lip; (4) a majority (79%) of the respondents close the soft and hard palates as a single procedure; 47.3% of respondents use the von Langenbeck technique, 21.1% use the double-opposing Z-plasty and 21.1%, the palatal pushback; (5) in the management of protruding premaxilla, 52.6% of the respondents choose adhesive tape; (6) procedures such as alveolar bone grafting, rhinoplasty, and surgical treatment for velopharyngeal incompetence are rarely done as part of cleft management; and (7) the interdisciplinary team approach is practiced by 21% of respondents.
Conclusions: Issues are raised regarding the current organization of cleft services. We hope the findings of this study will provide preliminary information needed for the eventual establishment of standard cleft management for children with cleft lip and palate deformity in Nigeria.
Cleft lip and/or palate (CL/P) is the most common congenital craniofacial malformation and affects between 1 per 500 to 1 per 700 live births in Europe (World Health Organization, 1998). Genetic studies on human samples have demonstrated that CL/P has a heterogeneous genetic background, and environmental factors also contribute to this malformation (Marazita et al., 1986; Wyszynski et al., 1996). For a neonate with CL/P, appropriate corrective surgery in early childhood is necessary to improve function and appearance. Subsequent impairment of facial and dental development, speech, and hearing are common and may be accompanied by socio-psychological maladjustment (Strauss, 1998). A large number of specialist services are often necessary if the child's potential is to be maximized: neonatal nursing services, surgery, speech, hearing, dentistry, otolaryngology, psychology and genetic counseling

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