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 under-reporting in the rural areas. Public enlightenment programs should help improve early presentation.