Current trends in the management of patients with cleft lip and cleft palate

Overview

Introduction: The paper deals with the management of patients with cleft lip and patients with cleft lip and palate since prenatal to postoperative period at ENT department of the Children‘s University Hospital in Košice. We discuss reasonable planning of surgical procedures with respect to anaesthetic care. Methods: We retrospectively analysed the clinical data of 144 patients. We performed a primary lip suture in a group of 70 patients and 74 patients underwent palatoplasty since 2015 to 2021. We evaluated a number of patients in different groups, age of patients in a time of surgery, gender ratio, occurrence of pathology and a type of surgery method. We compare our results with literature. Results: A group of 54 patients had primary lip suture for unilateral cleft lip and 16 patients for bilateral cleft lip. We noticed left cleft lip and palate as the most often pathology – 38 patients. The authors prefer early intervention in the case of cleft lip, while in the case of unilateral cleft lip they use the technique according to Millard mainly because of its universality. In the case of a bilateral cleft, they prefer the technique according to Black. Within a month, 55% of patients are operated on for unilateral and bilateral cleft lip. 78% of patients with cleft palate are operated on within a year with two-lobe plastic surgery according to Bardach, most often in the period 7–9 month. Conclusion: Patients with cleft lip and cleft lip and palate usually undergo multiple surgeries during their lifetime. Reasonable planning and reduction the number of general anaesthesia by combining procedures is important. Multidisciplinary collaboration is necessary to ensure comprehensive care.

Keywords:

cleft lip – cleft palate – primary lip suture – palatoplasty