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Primary treatment for cleft lip and/or cleft palate in children in Japan
Takeshi Uchiyama1, Yukari Yamashita, Takafumi Susami
1Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2, Masago, Mihama-Ku, Chiba, 261-8502 Japan. uchiyama@tdc.ac.jp
Insights
This study reveals current primary treatment trends for cleft lip and/or palate in Japan. Findings indicate a need for more regional core hospitals and diverse treatment approaches for pediatric cleft care.
Area of Science:
- Craniofacial Surgery
- Pediatric Plastic Surgery
- Oral and Maxillofacial Surgery
Background:
- Cleft lip and/or cleft palate (CL/P) are common congenital conditions requiring specialized primary treatment.
- Understanding current treatment trends is crucial for improving patient outcomes and healthcare strategies in Japan.
Purpose of the Study:
- To investigate and delineate the contemporary practices in primary surgical repair of CL/P in children across Japan.
- To identify prevailing trends in the management of cleft lip and palate, including the use of infant palatal plates and surgical timing/techniques.
Main Methods:
- A nationwide retrospective study was conducted using data from 107 institutions in Japan.
- Data were collected via a booklet-style questionnaire detailing patient demographics, cleft type, laterality, infant palatal plate use, and primary repair timing/technique.
- The study analyzed records of 4349 children undergoing primary CL/P repair between 1996 and 2000.
Main Results:
- Infant palatal plates were used in 37.8% of 2874 CL/P patients.
- Over 90% of unilateral cleft lip repairs occurred between 2 to 6 months of age.
- One-stage repair was common for bilateral cleft lip (44.5%) and cleft palate (76.9%), while two-stage repairs were less frequent.
Conclusions:
- The study successfully clarified current primary treatment trends for CL/P in Japan.
- Results highlight a need for enhanced regional specialized centers and a broader spectrum of treatment options to optimize care for children with clefts.
Objective:
To investigate current trends in primary treatment for children with cleft lip and/or cleft palate in Japan.
Design:
Nationwide, retrospective study under the direction of the Academic Survey Committee of the Japanese Cleft Palate Association based on analysis of data obtained via a booklet-style questionnaire completed by institutions providing primary treatment for cleft lip and/or palate patients. PARTICIPANTS, PATIENTS: Patients were 4349 children undergoing primary repair for cleft lip and/or palate at 107 participating institutions between 1996 and 2000.
Main Outcome Measure(S):
Cleft type, laterality; use of infant palatal plate; and timing and technique of primary repair for cleft lip and/or palate were evaluated by cleft surgeons at 107 participating institutions.
Results:
Of a total of 2874 patients with cleft lip and palate or cleft palate only, infant palatal plates were used with 1087 (37.8%) and were not used with 1787 (62.2%). Primary unilateral lip repair was performed at the age of 2 to 6 months in more than 90% of patients. Bilateral cleft lip was treated by one-stage repair in 285 patients (44.5%) and by two-stage repair in 258 (40.2%). Primary one-stage palatal repair was performed in 2212 (76.9%) and two-stage palatal repair in 262 (9.1%) cleft palate patients. Information on treatment of the remaining 400 (14%) patients was unavailable.
Conclusion:
This investigation clarified current trends in primary treatment for cleft lip and/or palate in Japan. The results suggest the need for an increase in regional core hospitals and greater variation in treatment options.