CLEFT LIP AND PALATE: THE JOS EXPERIENCE

Abstract

Objective: To determine the pattern of occurrence of cleft lip/palate and the factors
that may have influenced treatment outcome.
Design: Descriptive Study.
Setting: Jos University Teaching Hospital, Jos, Nigeria.
Subject: This study included 107 consecutive patients with cleft lip/palate managed
between January 1991 and June 1997.
Main outcome measures: The pattern of occurrence of cleft lip/palate, the peculiarities
of the malformation in this environment as well as factors that influenced treatment
outcome.
Results: The 107 patients were aged between one day and twenty-six years at
presentation. There were three adults aged between 18 and 26 years with a mean of
22.3 years and 104 children with a mean age of 9.5 months. The male/female ratio was
1. 1:1, the anomaly was 2.4 times commoner on the left and the cleft lip alone was
the most frequent mode of presentation (52%). The incidence was higher in the 3rd
and 4th siblings. In 13% of these patients, there were other associated congenital
anomalies such as Van der Woude’s Syndrome, Down’s Syndrome and congenital heart
disease. Complications were noted in 16(14.9%) patients and these included dehiscence
after repair in 8(7.5%) patients, oronasal fistulae in 2(1.9%), nasal speech in 4(3.7%)
and hypertrophic scar in 2(1.9%). Eighty nine percent of these repairs were satisfactory
to the parents of the affected children. All the adult patients were satisfied with their
repair.
Conclusion: The low incidence of this anomaly in our environment may be due to underreporting
in the rural areas. Public enlightenment programs should help improve early
presentation.