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Method of Studying Palatal Fusion using Static Organ Culture
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Cleft care in international adoption.

Jesse A Goldstein1, Benjamin J Brown, Patrick Mason

  • 1Chapel Hill, N.C.; Washington, D.C.; Falls Church, Va.; and Dallas, Texas From the Department of Plastic Surgery, University of North Carolina; the Department of Plastic Surgery, Georgetown University Hospital; Inova Fairfax Hospital for Children Craniofacial Clinic; and the Department of Plastic Surgery, University of Texas Southwestern.

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Internationally adopted children with cleft deformities have variable needs. Primary cleft repair abroad or in the US showed no significant outcome differences in revision rates, fistulas, or velopharyngeal insufficiency.

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Area of Science:

  • Plastic Surgery
  • Craniofacial Surgery
  • Pediatric Surgery

Background:

  • International adoption rates are high, particularly from less developed countries with varying cleft care standards.
  • Adopted children present with complex cleft deformities at different ages and repair stages.
  • The unique surgical and perioperative needs of internationally adopted cleft patients are not well understood.

Purpose of the Study:

  • To characterize the pre-adoption history, post-adoption course, and surgical outcomes of internationally adopted children with cleft deformities.
  • To compare surgical outcomes of cleft repair performed internationally versus domestically.

Main Methods:

  • Retrospective review of 83 internationally adopted cleft lip-cleft palate patients.
  • Comparison of outcomes among three groups: repaired abroad, repaired by senior authors, and US-born patients repaired by senior authors.

Main Results:

  • No statistically significant differences in lip revision rates, fistula rates, or velopharyngeal insufficiency were found among the groups.
  • Average age at adoption was 30.5 months (range, 5.0-95.0 months).
  • 83 adopted children with cleft deformities were evaluated between May 1993 and August 2010.

Conclusions:

  • Internationally adopted cleft patients represent a complex population requiring specialized care.
  • Primary cleft repair outcomes are comparable regardless of whether repair is performed abroad or in the United States.