Clinical profile, risk factors and current status of treatment: a hospital based study.
- c2016.
- 74p.
Research Report.
SUMMARY: Cleft treatment requires a multidisciplinary approach extended from the birth until adulthood. Many of these children are born in rural areas where resources for treatment and awareness on cleft care are limited. Consequently, many patients may receive limited or suboptimal care due to various reasons. This study was aimed at evaluating and identifying the patterns of the congenital defects of face, cleft lip and palate among patients visiting three major hospitals across Delhi and the National Capital Region (NCR). The objectives included establishing baseline data on a spectrum of clinical profile of cleft patients, treatment protocols, quality of treatment and their residual treatment needs. The experience gained from a study of these three target centres would then be used to lay a framework to conduct a nationwide multicentre study in terms of logistics, feasibility and difficulties. The study titled Cleft Lip and Palate anomaly in India: Clinical profile, Risk factors and Current status of treatment: a Hospital-based study was started in 2010 as a task force project of ICMR. The pilot phase, which started in 2012, encompassed three cleft centres across Delhi and NCR, namely, AIIMS, Safdarjung Hospital and Medanta-The MEDICITY. The relevant data for 126 subjects exhibiting non-syndromic cleft lip and palate was recorded on a specially designed performa. Each case was evaluated by a team of specialists comprising of a Plastic Surgeon, an Orthodontist, an ENT Surgeon, a Dental Surgeon, a Speech therapist and an Audiologist. Clinical records included the subject's profile and intraoral photos, dental study models, audiometric and speech evaluation data. The current report highlights that among the samples of the cleft patients assessed in the project, the treatment needs were significantly high. There was a wide variation in age at primary lip and palate surgery with a significant percentage of cases requiring lip and nose revision surgeries. Fifty five percent cases had post-surgical oro-nasal fistula and a large proportion of operated UCLP cases had complex orthodontic treatment needs. There seems to be an urgent need to devise strategies to improve the delivery of quality care to the afflicted subjects, with the joint efforts of all the experts and health care providers. It must be mentioned here that the data is not representative of the outcome of the three centres. It also tries to highlight that larger multicentre studies are needed in the Indian setup so that the patients not only receive treatment but also the quality of the treatment is monitored for better outcomes. The results indicate a lack of uniform protocol followed in providing care to cleft patients. A great variation was found in the quality of treatment received by many of the patients.
Cleft Lip. Palate Anomaly. Clinical Profile. Risk Factors. Treatment. India.