Evaluation of cleft lip and palate management in Erbil

* Department of plastic surgery, college of medicine, Hawler medical university, Erbil, Iraq. Introduction Cleft lip and palate are congenital deformities that affect the primary and secondary palates during embryogenesis. Cleft lip and palate are the most common facial malformation in all populations and ethnic groups, accounting for 65% of all head and neck anomalies. Every day some 700 newborn with cleft lip and/or cleft palate are born in the world, which means that a baby with such a cleft is born every two minutes. The reported incidence varies according to geographic location, ethnicity, gender, and socioeconomic status. Cleft lip and palate is most prevalent among Asians, least in Africans, and in Caucasians its prevalence is intermediate. Among the cleft lip and palate population, the most common diagnosis is cleft lip and palate at 46%, followed by isolated cleft palate at 33%, then isolated cleft lip at 21%. Unilateral clefts are nine times as common as bilateral clefts, and occur twice as frequently on the left side than on the right. Males are predominant in the cleft lip and palate population, whereas isolated cleft palate occurs more commonly in females. The aetiology of cleft lip and palate is not fully understood, but the best evidence today suggests a multifactorial origin for this type of birth defect, with both genetic and environmental causal factors. Intrauterine exposure to the anticonvulsant Background and objective: Cleft lip and palate are congenital deformities that affect the primary and secondary palates during embryogenesis. The objectives of this study was to record the pattern of presentation of cleft lip and palate in Erbil, the types of surgical procedures, the outcome and complications, hence making recommendations to ensure improved care. Methods: This is a prospective study conducted in Erbil city, in the Department of Plastic Surgery at Rezgary Teaching Hospital and Rapareen Pediatric Hospital from March 2009 to May 2013. A total of 164 patients with cleft lip/palate were included in this study. Statistical package for the social sciences (version 18) was used for data entry and analysis. Results: The age ranged from birth to 24 years. The ratio of male to female was 1.4:1. The combined cleft lip and palate was the commonest type (87 cases, 53%). The commonest risk factor was poor family (105 cases, 64%), followed by consanguinity (97 cases, 59%). The commonest procedure for cleft lip repair was Millard (67 cases) and that for cleft palate repair was Furlow palatoplasty (57 cases). The commonest complication of cleft lip repair was wide scar (9 cases, 7.5%) mostly below one year of age. Ninety-one percent of the parents were satisfied with the children’s appearance of the lip and 86% of parents were satisfied with palatoplasty result. Conclusion: The high degree of association of consanguinity with the cleft lip and palate emphasizes the importance of education about discouraging consanguineous marriage. Millard repair is still the commonest procedure for cleft lip repair.