Background: Unlike developed countries
where adult primary cleft lip and palate cases are barely nonexistent,
developing countries still have a backlog of adults with unrepaired cleft lip
and palate.Method: A retrospective review of
adult/adolescent cleft lip repair under local anesthesia was performed between
2012 and 2015.Results:Fifty six (56) adolescent and adults were seen comprising 35 females and 21
males. Forty two patients presented with unrepaired unilateral
cleft lip of which only 6 were complete; 4 were unrepaired bilateral cleft lip
and 10 were revisions. The lowest age was 13 years (two patients) and the
highest age was 66years (one patient). The mean weight was 54kg. The mean anaesthetic time including waiting time was 12.94 minutes
and mean operation time was 56.52 minutes. Majority of the patients were
discharged same day except for five who needed to stay overnight because of
distance from their home. There were no reported early postoperative
complications and wound healing was uneventful for all the patients.Conclusion:Cleft lip repair in adults under local anesthesia is
safe, effective and less expensive. A modification in technique with minimal
dissection and efficiency is essential in such cases.
References
[1]
Eberlin, K.R., Vyas, R.M., Abi-Haidar, Y., Sethna, N. and Hamdan, U.S. (2013) Adult Cleft Lip Repair under Local Anesthesia: An Effective Technique in Resource-Poor Settings. The Cleft Palate-Craniofacial Journal, 50, 59-63. http://dx.doi.org/10.1597/11-256
[2]
Hodges, S.C. and Hodges, A.M. (2001) A Protocol for Safe Anasthesia for Cleft Lip and Palate Surgery in Developing Countries. Anaesthesia, 55, 436-441.
http://dx.doi.org/10.1046/j.1365-2044.2000.01371.x
[3]
Tremlett, M. (2004) Anaesthesia for Cleft Lip and Palate Surgery. Current Anaesthesia and Critical Care, 15, 309-316. http://dx.doi.org/10.1016/j.cacc.2004.09.003
[4]
Olasoji, H.O., Dogo, D. and Arotiba, G.T. (2002) Experience with Unoperated Cleft Lip and Palate in a Nigerian Teaching Hospital. Tropical Doc, 32, 33-36.
[5]
Aziz, S.R. and Rhee, S.T. (2009) Redai Cleft Surgery in Rural Bangladesh: Reflections and Experiences. Journal of Oral and Maxillofacial Surgery, 67, 1581-1588.
http://dx.doi.org/10.1016/j.joms.2008.11.021
[6]
Schwarz, R. and Khadka, S.B. (2004) Reasons for Late Presentation of Cleft Deformity in Nepal. The Cleft Palate-Craniofacial Journal, 41, 199-201. http://dx.doi.org/10.1597/03-016
[7]
Nwoku, A.L. (1974) Experience on Repair of Unoperated Cleft Patients. Nigerian Medical Journal, 6, 417-421.
[8]
Donkor, P., Bankas, D.O., Agbenorku, P., Plange-Rhule, G. and Ansah, S.K. (2007) Cleft Lip and Palate in Kumasi, Ghana: 2001-2005. Journal of Craniofacial Surgery, 18, 1376-1379. http://dx.doi.org/10.1097/01.scs.0000246504.09593.e4
[9]
Adeyemo, W.L., Ogunlewe, M.O., Desalu, I., Ladeinde, A.L., Mofikoya, B.O., Adeyemi, M.O. and Adepoju, A.A. (2009) Cleft Deformities in Adults and Children Aged over Six Years in Nigeria: Reasons for Late Presentation and Management Challenges. Clinical, Cosmetic and Investigational Dentistry, 2009, 63-69.
https://dx.doi.org/10.2147/CCIDE.S6686
[10]
Adekeye, E.O. and Lavery, K.M. (1985) Cleft Lip and Palate in Nigerian Children and Adults: A Comparative Study. British Journal of Oral and Maxillofacial Surgery, 23, 398-403. http://dx.doi.org/10.1016/0266-4356(85)90023-3
[11]
Ahmad, M. (2008) Cleft Lip Repair under Local Anesthesia in Adults. Journal of Surgery Pakistan, 13, 170-172.