CC BY-NC-ND 4.0 · Indian J Plast Surg 2010; 43(01): 066-075
DOI: 10.1055/s-0039-1699407
Review Article
Association of Plastic Surgeons of India

A status report on management of cleft lip and palate in India

A. Gopalakrishna
Department of Plastic Surgery, Deccan College of Medical Sciences and Allied Hospitals, Hyderabad, Andhra Pradesh, India
,
Karoon Agrawal
Department of Plastic Surgery, Deccan College of Medical Sciences and Allied Hospitals, Hyderabad, Andhra Pradesh, India
› Author Affiliations
Further Information

Publication History

Publication Date:
08 January 2020 (online)

ABSTRACT

Introduction: This national survey on the management of cleft lip and palate (CLP) in India is the first of its kind. Objective: To collect basic data on the management of patients with CLP in India for further evaluation. Materials and Methods: A proforma was designed and sent to all the surgeons treating CLP in India. It was publicized through internet, emails, post and through personal communication. Subjects: 293 cleft surgeons representing 112 centers responded to the questionnaire. Most of the forms were filled up by personal interview. Results: The cleft workload of the participating centers is between 10 and 2000 surgeries annually. These centers collectively perform 32,500–34,700 primary and secondary cleft surgeries every year. The responses were analyzed using Microsoft excel and 112 as the sample size. Most surgeons are repairing cleft lip between 3-6 months and cleft palate between 6 months to 1 year. Millard and Tennison repairs form the mainstay of lip repair. Multiple techniques are used for palate repair. Presurgical orthopedics, lip adhesion, nasendoscopy, speech therapy, video-fluoroscopy and orthognathic surgery were not always available and in some cases not availed of even when available. Conclusion: Management of CLP differs in India. Primary surgical practices are almost similar to other studies. There is a lack of interdisciplinary approach in majority of the centers, and hence, there is a need for better interaction amongst the specialists. A more comprehensive study with an improved questionnaire would be desirable.

 
  • REFERENCES

  • 1 Maneksha R. Plastic surgery in the tropics. Mod Trends Plast Surg 1966;2:16-37.
  • 2 Takkar KL, Gupta JL. Cleft lip and palate. Indian Pediatr 1982;19:937-42.
  • 3 Antia NH. Plastic surgery in India. Keio J Med 1985;34:179-83.
  • 4 Brogan WF. Team approach to the treatment of cleft lip and palate. Ann Acad Med Singapore 1988;17:335-8.
  • 5 Pigott RW. Organisation of cleft lip and palate services--results of a questionnaire. Br J Plast Surg 1992;45:385-7.
  • 6 Williams AC, Shaw WC, Sandy JR, Devlin HB. The surgical care of cleft lip and palate patients in England and Wales. Br J Plast Surg 1996;49:150-5.
  • 7 Boorman JG. Treatment of cleft lip and/or palate in the UK. Br J Plast Surg 1998;51:167-8.
  • 8 Williams A, Sandy J.. Report on cleft lip and palate surgery. Disagreement between specialties was not impetus for study. BMJ 1998;316:1462.
  • 9 Di Biase D, Markus A. Cleft lip and palate care in the UK: the CSAG report. Br Dent J 1998;185:320-1.
  • 10 Brennan PA, Macey-Dare LV, Flood TR, Markus AF, Uppal R. Cleft lip and palate management by U.K. consultant oral and maxillofacial surgeons: a national survey. Cleft Palate Craniofac J 2001;38:44-8.
  • 11 D'Antonio LL, Achauer BM, Vander Kam VM. Results of a survey of cleft palate teams concerning the use of nasendoscopy. Cleft Palate Craniofac J 1993;30:35-9.
  • 12 Poole AE. Multidisciplinary cleft management. Atlas Oral Maxillofac Surg Clin North Am 1995;3:1-4.
  • 13 Sitzman TJ, Girotto JA, Marcus JR. Current surgical practices in cleft care: unilateral cleft lip repair. Plast Reconstr Surg 2008;121:261-70.
  • 14 Lee TJ, Kim ST. A survey of cleft lip and palate management taught in training programs in Korea. Cleft Palate Craniofac J 2003;40:80-3.
  • 15 Franco D, Gonçalves LF, Franco T. Management of cleft lip and palate in Brazil. Scand J Plast Reconstr Surg Hand Surg 2003;37:272-6.
  • 16 Prathanee B, Dechongkit S, Manochiopinig S. Development of community-based speech therapy model: for children with cleft lip/palate in northeast Thailand. J Med Assoc Thai 2006;89:500-8.
  • 17 Weinfeld AB, Hollier LH, Spira M, Stal S. International trends in the treatment of cleft lip and palate. Clin Plast Surg 2005;32:19-9.
  • 18 Semb G, Brattström V, Mølsted K, Prahl-Andersen B, Shaw WC. The Eurocleft study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 1: introduction and treatment experience. Cleft Palate Craniofac J 2005;42:64-8.
  • 19 Sandy JR, Williams AC, Bearn D, Mildinhall S, Murphy T, Sell D, et al. Cleft lip and palate care in the United Kingdom--the Clinical Standards Advisory Group (CSAG) Study. Part 1: background and methodology. Cleft Palate Craniofac J 2001;38:20-3.
  • 20 Amstalden-Mendes LG, Magna LA, Gil-da-Silva-Lopes VL. Neonatal care of infants with cleft lip and/or palate: feeding orientation and evolution of weight gain in a nonspecialized Brazilian hospital. Cleft Palate Craniofac J 2007;44:329-34.
  • 21 Oliver RG, Jones G. Neonatal feeding of infants born with cleft lip and/or palate: parental perceptions of their experience in south Wales. Cleft Palate Craniofac J 1997;34:526-30.
  • 22 Gunawardana RH, Gunasekara SW, Weerasinghe JU. Anesthesia and surgery in pediatric patients with low hemoglobin values. Indian J Pediatr 1999;66:523-6.
  • 23 Shinde VS, Tambvekar S. Anaesthetic problems of cleft lip and palate surgery in India. Prog Pediatr Surg 1982;15:25-30.
  • 24 Hodges AM, Hodges SC. A rural cleft project in Uganda. Br J Plast Surg 2000;53:7-11.