Abdurrazaq Taiwo O, Micheal Adeyemi O, Lanre Adeyemo W, Olugbenga Ogunlewe M, Akin Ladeinde L
Department of Surgery/Dental and Maxillofacial Surgery, College of Health Sciences, Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
Afr J Paediatr Surg. 2013 Oct-Dec;10(4):345-57. doi: 10.4103/0189-6725.125447.
Measurement of treatment outcome is important in estimating the success of cleft management. The aim of this study was to assess the surgical outcome of cleft lip and palate surgery.
The surgical outcome of 131 consecutive patients with cleft lip and palate surgeries between October 2008 and December 2010 were prospectively evaluated at least 4 weeks postoperatively. Data collected included information about the age, sex, type of cleft defects, and type of surgery performed as well as postoperative complications. For cleft lip repair, the Pennsylvania lip and nose (PLAN) score was used to assess the surgical outcome, while the integrity of the closure was used for cleft palate repair.
A total of 92 patients had cleft lip repair and 64 had palate repair. Overall, 68.8% cases of cleft lip and palate repair had good outcomes; 67.9% of lip repairs had good lip and nose scores, while 70.2% of palatal repair had a good surgical outcome. Oro-fistula was observed in 29.8% of cleft palate repairs Inter-rater reliability coefficient was substantially significant.
The fact that 25.7% of those treated were aged >1 year suggests a continued need to enlighten the public on the availability of cleft lip and palate expertise and treatment. Although an overall good treatment outcome was demonstrated in this study, the nasal score was poorer than the lip score. Complication rate of about 14% following surgical repair is consistent with previous reports in the literature.
治疗效果的评估对于判断唇腭裂治疗的成功与否至关重要。本研究旨在评估唇腭裂手术的治疗效果。
对2008年10月至2010年12月期间连续接受唇腭裂手术的131例患者的手术效果进行前瞻性评估,评估时间为术后至少4周。收集的数据包括患者的年龄、性别、腭裂缺损类型、所施行的手术类型以及术后并发症。对于唇裂修复,采用宾夕法尼亚唇鼻(PLAN)评分来评估手术效果,而对于腭裂修复,则以闭合的完整性作为评估指标。
共有92例患者接受了唇裂修复,64例接受了腭裂修复。总体而言,68.8%的唇腭裂修复病例效果良好;67.9%的唇裂修复在唇鼻评分方面表现良好,而70.2%的腭裂修复手术效果良好。在29.8%的腭裂修复病例中观察到口鼻腔瘘。评分者间信度系数具有显著意义。
25.7%的接受治疗者年龄大于1岁,这表明仍需继续向公众宣传唇腭裂专业知识和治疗的可及性。尽管本研究显示总体治疗效果良好,但鼻评分低于唇评分。手术修复后的并发症发生率约为14%,与文献中先前的报道一致。