Call for timely treatment for cleft lip

LAHORE

University of Health Sciences (UHS) Tuesday organised an international seminar on Recent Updates in Management of Cleft Lip and Palate for local surgeons and medical students that underscores the importance of seeking early intervention for surgical correction of the defect. 

The seminar organised by UHS Office of Research, Innovation and Commercialization (ORIC) in collaboration with Cleft Hospital, Gujrat was a part of a memorandum of understanding signed last week between the two institutions for cooperation in research and education.

Addressing the seminar, Consultant Pediatrician, Universities of Wolverhampton & Kentucky, USA, Prof A Rashid Gatrad said while timing and sequence of specific cleft-related care was essential to optimise outcomes, care should be individualised to meet the needs of each patient. 

“Children with cleft lip and palate should receive their specialty cleft-related care from a multidisciplinary cleft or craniofacial team with sufficient patient and surgical volume to promote successful outcomes”, he emphasised.

Cleft lip and cleft palate are among the most common birth defects. A cleft is a gap in the upper lip, the roof of the mouth, or sometimes both. Each year, approximately 250,000 babies worldwide are born with a cleft. In Pakistan, the incidence is around 2 out of 1000 live births.

Prof Gatrad was of the view that primary care pediatrician had an essential role in making timely diagnosis and referral; providing ongoing health care maintenance, anticipatory guidance and acute care; and functioning as an advocate and a liaison between the family and the cleft team. He gave a presentation on “Practical tips in detection of heart diseases in cleft patients”.

“A cleft can have detrimental effects on appearance, eating and speech as well as causes ear and dental complications. Most importantly, it impacts the confidence of the child,” said Annette Middleton, a registered theatre nurse from UK. 

She said that while surgeries are important milestones, children with cleft lip and palate needed close and ongoing attention to oral health, speech, hearing, growth and development. Good oral health and access to regular professional dental and orthodontic care were essential components of care for these children, she said.

Consultant plastic surgeon from UK, Dr Nicholas Hart said overall incidence of cleft deformity was significantly higher among males. It was also observed that the first born baby had more chances of getting afflicted more with this deformity followed up by second, third and fourth.

He said the right age of treatment of a child with a cleft lip is when a child is six-months old, and a one-year-old child should be treated for cleft palate.

Veteran speech and language therapist from Ireland, Rosemary Sleator said every child with a cleft palate should be evaluated and monitored by a speech-language pathologist on a consistent basis throughout the child's development and especially into the early school-age years. Not all children with cleft palate would need speech therapy. The speech-language pathologist would monitor the child's development and recommend on-going speech therapy, when and if appropriate.

Consultant plastic surgeon from Hull and East Yorkshire Hospital, UK, Dr Muhammad Riaz Malik, said the disorder might also cause social impairment, particularly if treatment is not timely undertaken. “Treatment of such defects involves a highly specialised team of plastic surgeons, maxillofacial surgeons, pediatric surgeons, otolaryngologists, orthodontists, paedodontists and speech therapists, ”he added.

UHS Vice Chancellor Prof Muhammad Aslam said that many NGOs and private sector institutions kept on inviting foreign and local surgeons and set up camps in various areas with affected population.

“They are the real angles as they perform surgeries and bring smile on the faces of children and their parents” he maintained.

UHS Medical Education department’s head, Prof IA Naveed, said UHS Office of Research, Innovation and Commercialization or ORIC aimed to serve as pivotal point, encompassing all the research activities, ranging from development of research proposal to the commercialisation of research products, under a single umbrella.

The CEO, Cleft Hospital, Gujrat, Dr Ijaz Bashir, gave a brief introduction of his hospital which has been established with the cooperation of philanthropists and the Japanese government.

Professor of Oral and Maxillofacial Surgery, Ankara University, Turkey, Prof Reha Kisnisci gave a talk on “Primary cleft palate repair using two stage narrow flap palatoplasty”. Moreover, Consultant Anaesthetist from Hull and East Yorkshire Hospital, UK, Dr Zahid Rafique, gave a presentation on “Challenges of Cleft Anaesthesia”.