Primary Cleft Repair in Adult Patients with Untreated Cleft Lip and Palate Deformity | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 8, Volume 45, Issue 3, July 2021, Page 169-174 PDF (13.03 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2021.183870 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Karam A. Allam   ; Mostafa M. Haredy ; Ahmed G. AbdelMegeed
| ||||
| The Department of Plastic Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt | ||||
| Abstract | ||||
| Background: Referring cleft patients to a specialized medical center at the earliest possible time after birth provides the best outcome and minimizes possible complications. For diversity of economic and social factors, some patients may not receive the adequate care and surgical repair at the proper time and present late in adulthood with totally or partially unrepaired clefts. Patients and Methods: Patients with untreated primary cleft deformity older than 16 years, who were treated at The Department of Plastic Surgery, Sohag University, in the period between 2009 and 2019, were retrospectively reviewed. The assessment included evaluation of demographic data (age at first consultation and sex distribution), type and laterality of cleft, patients' social and educational status, and previous cleft surgeries. Patients' satisfaction following surgery was also assessed. Results: All adult patients with untreated primary cleft deformity in this study were males, unilateral cleft lip and palate was the commonest deformity. Majority of patients had no education. Marriage was the main motive for having surgery done. All patients were moderately to highly satisfied with surgical outcomes. Conclusions: Although uncommon nowadays, unrepaired primary cleft deformity in adults can still be seldom reported in some patients especially in lower socioeconomic classes. Surgical repair is more challenging and need more radical solutions, but it achieves good satisfaction in all patients. | ||||
| Keywords | ||||
| Cleft lip and palate – Adults; Late presentation – Unrepaired – Untreated cleft | ||||
| References | ||||
|
Strauss R.P. and Cassell C.H.: Critical issues in craniofacial care: Quality of life, costs of care, and implications of prenatal diagnosis. Acad. Pediatr., 9: 427-432, 2009. 2- Basseri B., Kianmahd B.D., Roostaeian J., et al.: Current national incidence, trends, and health care resource utilization of cleft lip-cleft palate. Plast. Reconstr. Surg., 127: 1255-1262, 2011. 3- Watkins S.E., Meyer R.E., Strauss R.P., et al.: Classification, epidemiology, and genetics of orofacial clefts. Clin. Plast. Surg., 41: 149-163, 2014. 4- Abbott M.M., Kokorowski P.J. and Meara J.G.: Timeliness of surgical care in children with special health care needs: Delayed palate repair for publicly insured and minority children with cleft palate. J. Pediatr. Surg., 46: 1319- 1324, 2011. 5- Zaluzec R.M., Rodby K.A., Bradford P.S., et al.: Delay in Cleft Lip and Palate Surgical Repair: An Institutional Review on Cleft Health Disparities in an Urban Population. J. Craniofac. Surg. Nov-Dec., 30 (8): 2328-2331, 2019. 6- Capelozza Júnior L., Taniguchi S.M. and da Silva Júnior O.G.: Craniofacial morphology of adult unoperated complete unilateral cleft lip and palate patients. Cleft Palate Craniofac. J. Jul;., 30 (4): 376-381, 1993. 7- Derijcke A., Kuijpers-Jagtman A.M., Lekkas C., et al.: Dental arch dimensions in unoperated adult cleft-palate patients: An analysis of 37 cases. J. Craniofac. Genet Dev. Biol. Jan-Mar., 14 (1): 69-74, 1994. 8- Will L.A.: Growth and development in patients with untreated clefts. Cleft Palate Craniofac. J. Nov., 37 (6): 523-526, 2000. 9- Shetye P.R.: Facial growth of adults with unoperated clefts. Clin. Plast. Surg. Apr., 31 (2): 361-71, 2004. 10- Mantinàos C.: Untreated cleft lip in an aged patient. Plast. Reconstr. Surg. May, 87 (5): 954-955, 1991. 11- Ward C.M. and James I.: Surgery of 346 patients with unoperated cleft lip and palate in Sri Lanka. Cleft Palate J. Jan., 27 (1): 11-15; discussion 15-17, 1990. 12- Morioka D., Yoshimoto S., Udagawa A., et al.: Primary repair in adult patients with untreated cleft lip-cleft palate. Plast. Reconstr. Surg. Dec., 120 (7): 1981-1988, 2007. 13- Likert R.: A technique for the measurements of attitudes. Archives of Psychology, 140 (22): 5-55, 1932. 14- Mohler L.R.: Unilateral cleft lip repair. Plast. Reconstr. Surg., 80: 511-517, 1987. 15- Mulliken J.B.: Principles and techniques of bilateral complete cleft lip repair. Plast. Reconstr. Surg. Apr., 75 (4): 477-487, 1985. 16- Sommerlad B.C.: A technique for cleft palate repair. Plast. Reconstr. Surg. Nov., 112 (6): 1542-1548, 2003. 17- Rohrich R.J., Love E.J., Byrd H.S. and Johns D.F.: Optimal timing of cleft palate closure. Plast. Reconstr. Surg. Aug., 106 (2): 413-21; quiz 422; discussion 423-425, 2000. 18- Kobus K. and Kobus-Zalesna K.: Timing of cleft lip and palate repair. Dev. Period Med., 18: 79-83, 2014. 19- Chow I., Purnell C.A., Hanwright P.J., et al.: Evaluating the rule of 10s in cleft lip repair: Do data support dogma? Plast. Reconstr. Surg., 138: 670-679, 2016. 20- Hammoudeh J.A., Imahiyerobo T.A., Liang F., et al.: Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol. Plast. Reconstr. Surg. Glob Open. Jun., 26; 5 (6): e1340, 2017. 21- Dorf D.S. and Curtin J.W.: Early cleft palate repair and speech outcome. Plast. Reconstr. Surg., 70: 74-81, 1982. 22- Bluher A.E., Cunningham T.D. and Reeves T.D.: Effect of Cleft Palate Repair Timing on Inpatient Complication Rate: Review of a National Database. J. Craniofac. Surg. Nov., 6, 2020. 23- Adeyemo W.L., Ogunlewe M.O., Desalu I., et al.: Cleft deformities in adults and children aged over six years in Nigeria: Reasons for late presentation and management challenges. Clin. Cosmet Investig Dent. Nov., 30 (1): 63- 69, 2009. 24- Pelchat D., Bisson J., Richard N., et al.: Longitudinal effects of an early family intervention programme on the adaption of parents of children with disability. Int. J. Nurs. Stud., 36: 465-477, 1999. 25- Boo-Chai K.: The unoperated adult bilateral cleft of the 174 Vol. 45, No. 3 / Primary Cleft Repair in Adults with Untreated Cleft Lip lip and palate. Br. J. Plast. Surg. Jul., 24 (3): 250-257, 1971. 26- Greer Walker D.: Clefts of the palate and timing of the operation. In Transactions of the International Society of Plastic Surgeons, 2nd Congr., I959, P.40 - Edinburgh: Livingstone, 1960. 27- Aziz S.R., Rhee S.T. and Redai I.: Cleft surgery in rural Bangladesh: Reflections and experiences. J. Oral Maxillofac. Surg., 67: 1581-1588, 2009. 28- Eipe N., Choudhrie A., Pillai A.D. and Choudhrie R.: Regional anesthesia for cleft lip repair: A preliminary study. Cleft Palate Craniofac. J. Mar., 43 (2): 138-141, 2006. 29- Fuller J., Drake D., Felstead A., et al.: Cleft Repair in Adults: A Report on a Case Series. Cleft Palate Craniofac. J. Aug., 55 (7): 1030-1034, 2018. 30- Fuller J., Felstead A., Brennan P., et al.: Technical challenges of adult cleft repair. Br. J. Oral Maxillofac. Surg., 54 (10): e171, 2016. 31- Alasseri N.A., Al Dhalaan N.A. and Almoraisi E.: Unusual presentation of unrepaired cleft lip in a fifty years old Saudi lady. Oral Maxillofac. Surg. Cases, 6 (4): 100204. https://doi.org/10.1016/j.omsc.2020.100204, 2020 | ||||
|
Statistics Article View: 232 PDF Download: 863 |
||||
