Cleft lip and palate treatment of 530 children over a decade in a single centre.
OBJECTIVE
We sought to evaluate the process of care and the outcomes of cleft lip and palate operations carried by a multidisciplinary team at a centre of craniofacial anomalies with a high patients' volume.


METHODS
A retrospective review of all cleft lips and/or palates cases treated in the centre from 1995 to 2007 was performed. Direct and long term complication rates, clinical, audiologic, speech intelligibility and dental arch assessments were analyzed.


RESULTS
A total of 530 children have been operated this period in the centre (64 isolated cleft lip closures). A detailed presentation of the outcomes is performed in relation to the various types of cleft lip and palates. The majority of parents (70%) reported very good or excellent results 2-5 years after the lip closure with the Millard technique, although those with bilateral clefts were significantly less satisfied (P<0.002). Forty-two percent of children with cleft palate and otitis media with effusion were self-improved 2-8 months after palate reconstruction and 83.3% of children treated with the two flaps palatoplasty technique had a rather high or very high intelligibility score. Muscles' retropositioning had a significant effect on intelligibility (P=0.04).


CONCLUSIONS
Children with cleft lips and palates have a variety of conditions and functional limitations even after the surgical correction of their problem that need to be evaluated and treated by several specialists. The treatment protocol utilized by the multidisciplinary team of our centre is efficient with a relative low percentage of complications and unfavorable results.
Vlastos
I M
IM
Center of Craniofacial Anomalies, Department of Otolaryngology, Head and Neck Surgery, Aghia Sophia Children Hospital of Athens, Greece. giannisvlastos@yahoo.gr
Koudoumnakis
E
E
Houlakis
M
M
Nasika
M
M
Griva
M
M
Stylogianni
E
E
D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000453:epidemiology / Q000601:surgery*; D002972:Cleft Palate / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010033:Otitis Media / Q000453:epidemiology; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013064:Speech Disorders / Q000453:epidemiology; D013065:Speech Intelligibility; D016896:Treatment Outcome