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A status report on management of cleft lip and palate in India
A Gopalakrishna1, Karoon Agrawal
1Department of Plastic Surgery, Deccan College of Medical Sciences and Allied Hospitals, Hyderabad, Andhra Pradesh, India.
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.
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