The incidence and management of the rehabilitation of patients with cleft lip and palate

Abstract

Introduction: Cleft lip and palate (CLP) is a facial malformation resulting from the incomplete fusion of the facial buds during the intrauterine period between the fourth and ninth week of pregnancy. CLP globally occurs in approximately 1 in 700 newborns, and the rehabilitation of these patients is lifelong. Objective of the study: Evolutionary estimation of the number of children born with facial fusion pathology and their management. Material and Methods: A retrospective study of patients with CLP was carried out through the analysis of the Electronic Register Archive of the IMSP Mother and Child Institute, „Emilian Coțaga” Clinic, who were referred in the period 2018-2022 within the Department of OMF Pediatric Surgery; The database of the National Bureau of Statistics in the Republic of Moldova. The comparative analysis of the results of previous studies from the years 1996-2000 (Lupan I.) and 2011-2015 (Railean S.) was carried out. Results: In the period 2018-2022, 454 patients with congenital malformations were detected in the OMF region: cleft palate 27.5%; cleft lip 13.7%; CLP 58.8% (p=0.046). Of these, 68.5% were up to 3 years, 11.5% - 4-7 years, 6.4% - 8-12 years, ≥13 years - 13.7%. 59.5% - benefited primary interventions, 25.8% - secondary interventions, 14.8% - rehabilitation (p<0.05). According to retrospective incidence data, compared to the previous 2 studies the number of live newborns decreases from 42,844 to 30,813.2 average children/ year, but the incidence of congenital facial malformations (1.97:1000) is increasing in the study from 20112015 and CLP (0.9:1000) in our study are increasing. Conclusions: According to the evolutionary data of the number of children born with facial fusion pathology - facial clefts in children and adolescence from the period 1996-2000, 2011-2015 and 2018-2022 cause an increase in the incidence of facial clefts and especially of the most serious forms in the Republic of Moldova in relation to the birth of registered live newborns who require a long period of rehabilitation throughout their lives.