The Early Operative Burden for Children Born with Cleft lip and Palate

Area of Science:

• Paediatric Surgery
• Craniofacial Surgery
• Otolaryngology

Background:

• Non-syndromic cleft lip and palate (CLP) is a common congenital condition requiring complex surgical management.
• The surgical pathway for CLP involves primary repair and potential secondary interventions, impacting long-term outcomes.
• Auditing surgical management is crucial for optimizing care in specialized cleft units.

Purpose of the Study:

• To audit the surgical management of infants with non-syndromic cleft lip and palate (CLP).
• To evaluate surgical techniques, complication rates, and secondary procedures in a tertiary Australian cleft unit.
• To compare outcomes with international benchmarks.

Main Methods:

• Retrospective cohort study of 193 infants with non-syndromic CLP.
• Data collected on primary repair timing, surgical techniques, postoperative complications, and secondary surgeries between 2009 and 2020.
• Analysis of cleft-related operations, including ear, nose, and throat (ENT) and dental procedures.

Main Results:

• Four surgical techniques were employed by six surgeons; postoperative complications were infrequent.
• Rates of oronasal fistula and velopharyngeal insufficiency surgery were comparable internationally and not significantly different between repair groups.
• Children underwent an average of four operative procedures, with Eustachian tube dysfunction surgery being most common post-primary repair.

Conclusions:

• Infants with non-syndromic CLP experience a significant early operative burden.
• Surgical outcomes for CLP repair are consistent across different techniques and surgeons.
• This audit highlights the need for comprehensive surgical planning and management in cleft care.