Clinical Study of Cleft Lip and Cleft Palate

Kim, Soon Jin; Shin, Jong In; Ahn, Hee Chang

Abstract

Incidence of congenital anomalies decreased due to decrease in birth rate and popularization of prenatal examination. But there has been relatively high incidence of congenital cleft lip and cleft palate among congenital anomalies. In spite of many studies, the cause of clefting has not been clarified yet. Purpose of this study is to investigate clinical status and etiologic factors of cleft lip and cleft palate. We reviewed clinical records of 1111 cases of cleft lip and palate patient who were treated with primary cheiloplasty and palatoplasty at Hanyang University Hospital from January, 1990 to December, 2002. Clinical analysis of these 1111 cases of cleft lip and palate patients were carried out and summarized as follows. The rate among cleft lip, cleft lip & palate, and cleft palate were 1.5:1.4:1. The rate among left side, right side, and bilateral were 2.5:1.5:1. Male versus Female was 1.3:1. In cleft palate group, the ratio was 0.7:1, conversely. 1st baby was most common in patient group. 5.9 % of patients had congenital anomalies. Medication was the most possible factor with cleft lip and palate in pregnancy. 6.4 % of patients had history of cleft lip or palate in their family trees. For the closure of cleft lip, Millard's rotation advancement method was most commonly used at about 3months of age. In cleft palate group, pushback palatoplasty was most popular method and the timing of surgery was at about 12-18 months of age. Based on the above data, it may be concluded that outbreaks of cleft are affected by multiple factors and that there is no significant difference of clinical status and treatment modalities between this and other investigations. To investigate the correlation between proposed factors and effects, prospective study method is more suitable than retrospective study like this. Good study design for data collection and appropriate control group are also required. For this purpose, I propose construction of new data collecting system and multi-center study for birth monitoring system.