title: Cleft care in international adoption.
abstract: BACKGROUND
  Standards of cleft care abroad differ from those in the United States, particularly in less developed countries, where international adoption rates are high. Children adopted from these countries present to plastic surgeons in the United States at various ages and states of repair. The operative and perioperative needs of these children are poorly understood. This study attempts to characterize the preadoption history, the postadoption course, and surgical outcomes of children adopted with cleft deformities.
  
  
  METHODS
  The authors performed a retrospective review of all adopted cleft lip-cleft palate patients presenting to an academic craniofacial referral center and compared outcomes among adopted children who were repaired abroad, adopted children who underwent repair performed by the two senior authors (C.R.D. and S.B.B.), and children born in the United States who underwent repair performed by one of the senior authors (S.B.B.)
  
  
  RESULTS
  : Between May of 1993 and August of 2010, 83 adopted children with cleft deformities were evaluated in the authors' craniofacial center. Average age at adoption was 30.5 months (range, 5.0 to 95.0 months). Comparing outcomes among adopted children repaired abroad, adopted children repaired by the senior authors, and children born in the United States who underwent repair in the United States, the authors found no statistically significant differences in lip revision rates, fistula rates, or velopharyngeal insufficiency.
  
  
  CONCLUSIONS
  Adopted cleft patients constitute a complex and variable population with high rates of revision and delayed presentation. Internationally adopted children with orofacial clefts fared no better or worse after undergoing primary cleft repair abroad or in the United States.
authors.affiliation: Chapel 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.
authors.forename: Jesse A
authors.initials: JA
authors.lastname: Goldstein
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Brown
authors.forename: Patrick
authors.initials: P
authors.lastname: Mason
authors.forename: Deniz
authors.initials: D
authors.lastname: Basci
authors.forename: Lora
authors.initials: L
authors.lastname: Hindenburg
authors.forename: Craig R
authors.initials: CR
authors.lastname: Dufresne
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Baker
mesh_terms: D000300:Adoption; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States