Globalizing Cleft Orthognathic Surgery: Technical Guidance and a Multidisciplinary Roadmap

Area of Science:

• Craniofacial surgery
• Patient outcomes
• Global health equity

Background:

• Cleft lip and/or palate (CLP) management extends beyond primary surgeries, requiring interventions aligned with craniofacial development.
• Orthognathic surgery is a critical, late-stage intervention for CLP patients, addressing midfacial deficiencies.
• Up to 70% of CLP patients in high-income countries may require orthognathic surgery, highlighting its importance.

Purpose of the Study:

• To provide a streamlined roadmap for establishing orthognathic surgery programs in low- and middle-income countries (LMICs).
• To demonstrate the positive impact of orthognathic surgery on patient outcomes in CLP care.
• To empower locoregional healthcare providers in LMICs through enhanced surgical capabilities.

Main Methods:

• The study outlines a strategic approach to program development, focusing on consolidating essential components.
• It emphasizes the integration of orthognathic surgery within existing cleft care timelines.
• The roadmap is designed for resource-conscious implementation in LMIC settings.

Main Results:

• Orthognathic surgery offers substantial benefits, including improved mastication, speech, breathing, and psychosocial well-being.
• Successful program deployment indicates a high-functioning CLP team, comparable to high-income country standards.
• The study highlights the feasibility of resource-efficient program establishment.

Conclusions:

• Establishing orthognathic surgery programs in LMICs is crucial for comprehensive CLP care and achieving outcomes on par with high-income countries.
• These programs significantly enhance patient function and psychosocial domains.
• The proposed roadmap facilitates the sustainable integration of advanced surgical care in underserved regions.