Management of congenital cleft lip: an eight-year experience

ABSTRACT

From1988 to1996, 461 patients with congenital cleft lip underwent a total of 505 surgical procedures. Most of the patients were operated upon in their childhood, but 16% underwent surgery in their teens and early adult life. A unilateral deformity was present in 384 patients, 73 had a bilateral cleft while 4 patients had a median cleft. The epidemiological data was consistent with that reported in literature. Millard repair was the commonest procedure for unilateral clefts being used in 86% cases. For the bilateral clefts an Hagedorn or a Millard procedure was used. The overall complication rate was 3%, with 3 perioperative deaths in the series. Results were assessed at a minimum of 6 months post-operatively. In 79% of patients, a good result was obtained. Secondary/revisional surgery was required in 33[7.2%] patients. About 25% of patients with bilateral clefts had a fractured premaxilla and it is recommended that surgery be performed early in these patients. Patients with incomplete clefts had a slightly higher percentage [83.1%] of good results as compared to complete clefts [77.2%]. This indicates that the more severe the deformity, the poorer the results. It was shown that results have more to do with the attention to detail and skill of the individual surgeon rather than any specific technique