Our Summary

This research paper discusses the lack of care for cleft lip and/or palate (CL/P) in low- and middle-income countries (LMICs). Using data from Operation Smile surgical programs and statistics from the World Health Organization and World Bank, the researchers created a model to estimate the number of individuals with unrepaired CL/Ps who are older than the recommended ages for surgery.

They found that there are over 600,000 cases of unrepaired CL/Ps in the LMICs studied. The rates of unrepaired CL/Ps varied greatly - from 2.5 per 100,000 people in Romania to 28.5 per 100,000 people in Cambodia.

The paper highlights that while countries with larger populations have more cases of unrepaired CL/Ps, poorer countries with less healthcare infrastructure have higher rates. These findings can help healthcare organizations strategize and prioritize resources to better support cleft care.

FAQs

  1. What is the estimated number of individuals with unrepaired cleft lip and/or palate (CL/P) in low- and middle-income countries (LMICs)?
  2. How does the rate of unrepaired CL/P cases vary between countries in LMICs?
  3. How can these findings about unrepaired CL/P cases be useful for healthcare organizations?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cleft palate surgery is to follow all pre-operative and post-operative instructions provided by the medical team. This can include guidelines on medication, wound care, diet, and activity restrictions to ensure a successful recovery and optimal outcome. It is also important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. By following these recommendations, patients can help minimize complications and achieve the best results from their cleft palate surgery.

Suitable For

Patients who are typically recommended cleft palate surgery are those with cleft lip and/or palate (CL/P) that is causing functional and/or cosmetic issues. This can include difficulties with feeding, speech development, dental health, and social interactions. In the study mentioned above, the researchers found that there are over 600,000 cases of unrepaired CL/Ps in low- and middle-income countries, highlighting the significant need for surgical intervention in these populations. Additionally, patients who have not undergone surgery at a young age may be recommended for surgery later in life to address any ongoing issues related to their cleft palate.

Timeline

Before cleft palate surgery:

  1. Prenatal diagnosis: The cleft palate may be detected during prenatal ultrasounds or after birth.

  2. Consultation with healthcare professionals: Parents will meet with a team of specialists, including surgeons, speech therapists, and pediatricians, to discuss treatment options.

  3. Feeding challenges: Babies with cleft palate may have difficulty feeding due to difficulty creating suction.

  4. Speech therapy: Children may receive speech therapy to help with communication skills before surgery.

  5. Psychological support: Families may receive counseling to help cope with the emotional challenges of having a child with cleft palate.

After cleft palate surgery:

  1. Surgery: The cleft palate repair surgery is typically performed when the child is between 6-18 months old.

  2. Post-operative care: The child will be monitored closely after surgery to ensure proper healing and to manage any potential complications.

  3. Speech therapy: Children may continue to receive speech therapy after surgery to improve speech and language development.

  4. Follow-up appointments: Regular check-ups with the healthcare team will be necessary to monitor the child’s progress and address any issues that may arise.

  5. Long-term care: Some children may require additional surgeries or treatments as they grow to address any residual issues related to the cleft palate.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cleft palate surgery include:

  1. What are the benefits of cleft palate surgery for me or my child?
  2. What are the risks and potential complications of the surgery?
  3. What is the success rate of cleft palate surgery?
  4. How long is the recovery period after cleft palate surgery?
  5. Will additional surgeries or treatments be needed in the future?
  6. What type of anesthesia will be used during the surgery?
  7. What is the experience of the surgical team in performing cleft palate surgeries?
  8. Are there any specific pre-operative or post-operative instructions that need to be followed?
  9. Will there be any scarring or changes in appearance after the surgery?
  10. How long will the results of the cleft palate surgery last?

Reference

Authors: Carlson LC, Stewart BT, Hatcher KW, Kabetu C, VanderBurg R, Magee WP Jr. Journal: World J Surg. 2016 Dec;40(12):2857-2867. doi: 10.1007/s00268-016-3637-4. PMID: 27417108