Abstract
Background: Unlike developed countries where adult primary cleft lip and palate cases are barely nonexistent, developing countries still have a backlog of adults with unrepaired cleft lip and palate. Method: A retrospective review of adult/adolescent cleft lip repair under local anesthesia was performed between 2012 and 2015. Results: Fifty six (56) adolescent and adults were seen comprising 35 females and 21 males. Forty two patients presented with unrepaired unilateral cleft lip of which only 6 were complete; 4 were unrepaired bilateral cleft lip and 10 were revisions. The lowest age was 13 years (two patients) and the highest age was 66 years (one patient). The mean weight was 54 kg. The mean anaesthetic time including waiting time was 12.94 minutes and mean operation time was 56.52 minutes. Majority of the patients were discharged same day except for five who needed to stay overnight because of distance from their home. There were no reported early postoperative complications and wound healing was uneventful for all the patients. Conclusion: Cleft lip repair in adults under local anesthesia is safe, effective and less expensive. A modification in technique with minimal dissection and efficiency is essential in such cases.
Highlights
Unlike developed countries where adult primary cleft lip and palate cases are barely nonexistent, developing countries still have a backlog of adults with unrepaired cleft lip and palate
In contrast to developed countries where adult primary cleft lip and palate cases are barely nonexistent, developing countries still have a backlog of adults with unrepaired cleft lip and palate
We present our experience with adult cleft lip repair under local anesthesia (LA) alone without intravenous (IV) sedation
Summary
Cleft lip and palate is among the most common congenital malformations with complex multifactorial etiology including both genetic and environmental factors [1]. S. Obiri-Yeboah et al 28 completing primary repair of the lip and palate by the age of two years [2]. Patients often present to the surgeon far past the optimal time for closure of the cleft deformities [2] [3]. Developing countries often lack the equipment and personnel to provide general anaesthesia for all patients. General anaesthesia is expensive, and more time and personnel are required, a safe technique for repair under local anaesthesia would be useful. We present our experience with adult cleft lip repair under local anesthesia (LA) alone without intravenous (IV) sedation
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