Single-stage Repair of Cleft Lip and Palate – The Experience of Two Centers in Nigeria
Ifeanyichukwu Igwilo Onah, Chinedu Michael Okoli, Chinedu Nnaemeka Ilokanuno, Samuel Chinedu OkpechiAbstract
Background:
The default rate for palatoplasty after cheiloplasty is high in developing countries. Some surgeons perform single-staged cheilo-palatoplasty. This study aims at sharing techniques, complications, and outcomes in two hospitals for the single-stage repair of cleft lip and palate.
Methods:
This is a retrospective review of single-staged cheilo-palatoplasties at the National Orthopedic Hospital, Enugu (NOHE) and The Good Shepherd Specialist Hospital, Enugu (TGSSHE) from 2008 to 2022. Data included the type of cleft, patient age at surgery, repair technique, and the immediate and late outcomes following repair. Patients with staged palatoplasty and “redo” palate were excluded.
Results:
Twenty-six patients had primary palatoplasty with cleft lip surgery. Sixteen had single-staged primary cheilo-palatoplasty in the period; nine in NOHE and seven in TGSSHE. The age at surgery ranged from 7 weeks to 27 years (average of 7.3 years). Nine presented with unilateral cleft lip, six with bilateral, and one with midline cleft lip. Thirteen presented with a complete cleft lip and three with an incomplete cleft lip. Four had Veau Type 4 palate defects. Millard’s and the Mohler’s modification were used for unilateral cheiloplasty. Intravelarveloplasty, Bardach, and Von Langenbeck were employed for palatoplasty. Twelve patients had intravelarveloplasty done alone or in combination with other techniques. Five patients had wound breakdown after surgery. One patient had blood transfusion. All who had a fistula and most frequent complications had Veau 4. Ten other patients had primary palatoplasty with lip revision.
Conclusion:
Single-staged cheilo-palatoplasty is done in Nigeria safely.