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Routine Screening Ultrasound in Children With Cleft Palate and/or Lip: A Single Center Experience
Man Yee Paula Tang1, Sik Yin Nicholas Chao, Wai Yip Michael Leung
1*Department of Surgery, Division of Paediatric Surgery, Queen Elizabeth Hospital and United Christian Hospital †Department Of Paediatric Surgery and Adolescent Medicine, United Christian Hospital, Hong Kong.
Insights
Routine ultrasound screening for heart, urinary, and central nervous system (CNS) anomalies is often unnecessary for infants with cleft lip or palate. Most infants showed normal results, suggesting targeted screening may be more appropriate.
Area of Science:
- Pediatric Surgery
- Medical Imaging
- Congenital Disorders
Background:
- Cleft lip and/or palate deformities are common congenital conditions.
- Associated congenital anomalies in the heart, urinary system, and central nervous system (CNS) can occur.
- Screening ultrasound is often used to detect these potential anomalies.
Purpose of the Study:
- To evaluate the incidence of associated congenital anomalies detected by screening ultrasound in children with cleft palate and/or lip.
- To assess the necessity of routine cardiac, urinary, and CNS ultrasound screening in this population.
- To inform screening guidelines in resource-limited settings.
Main Methods:
- Retrospective study of 225 children with cleft deformities (2009-2013).
- Screening echocardiogram performed on 91% of participants.
- Screening ultrasound of the urinary system and CNS performed on 85% of participants.
Main Results:
- 98% of screening echocardiograms showed normal findings.
- 99% of urinary system and CNS ultrasounds showed normal findings.
- Medium-term follow-up revealed no significant missed structural anomalies.
Conclusions:
- Routine ultrasound screening of the heart, CNS, and urinary system may not be required for asymptomatic, nonsyndromic infants with cleft deformities.
- Screening may be particularly unnecessary for infants with "lip-only" cleft deformity.
- Recommendations support a more targeted approach in resource-limited settings.
Abstract:
The aim of this study is to evaluate the incidence of associated congenital anomalies that is picked up by screening ultrasound of the heart, urinary system, and central nervous system (CNS) of children with cleft palate and/or lip deformities in a single regional center. A total of 225 children with cleft deformities were recruited in the study in 2009 to 2013, 91% of them underwent screening echocardiogram and of these, 98% of them were normal findings that do not require further follow-up ultrasound or treatment. Total 85% of the children underwent screening ultrasound of the urinary system and CNS, and of these, 99% were reported to have normal findings. Medium term follow-up of these children did not reveal any significant structural anomalies in the heart, brain, and urinary system that might have missed in the initial ultrasound screening. The authors suggest that in resource-limited settings, routine ultrasound screening of the heart, the CNS, and the urinary system may not be required in asymptomatic and nonsyndromic infants with cleft deformities and in those with "lip-only" cleft deformity.
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