Cleft lip and cleft palate operated in Noma Children Hospital

Objective: Noma Children Hospital in Sokoto is a hospital set up for the surgical treatment of Noma (Cancrum Oris) in Children and adults, coming manly from Northern Nigeria, and operates also a big number of cleft lips and palates Operations are performed by visiting teams of maxillofacial surgeons, as well as by the resident surgeons of the hospital. Objective of present report is to review cases operated from 1999 to 2003. Method: Review of patients files as of the above period, with screening for age, sex, type of cleft, provenience of patient, surgeon operating (resident or visiting), complications and management of complications. Results: A total of 667 patients had been operated on, half by visiting surgeons, half by the resident surgeons. A total of 23 (3,4%) re-operations were necessary, mainly for traumatic wound breakdown, infection and scar correction. Other complications included minor wound infections (conservative treatment), and minor wound dehiscence. Conclusions:Cleft lips and cleft palate represent a major number of congenital malformations, often with treatment delayed into adulthood. A ratio of cleft lip to cleft palate of about 20:1 was observed upon presentation at the hospital, with almost equal sex distribution. Patients treated at Noma children Hospital had a good success rate, with complications being a small percentage and being handled with good final results. Results were equally good for the visiting plastic/maxillofacial surgeons as for the locally trained surgeons. As there is a big backlog of patients, training for more surgeons in the area is mandatory for this disfiguring congenital malformation that, with adequate training, can be handled fairly easily with a low level of technical equipment.