Cleft Repair in the Elderly Population - the South Wales Experience

Abstract

Introduction/Aims: Surgical repair of cleft in the elderly population is controversial. Some cleft surgeons are of the opinion that the outcomes of repairing cleft in elderly patients are poor and as such, this group of patients should not be treated surgically. However, there is very little evidence in the medical literature published to support this. We report the outcomes of surgical repair of cleft in a series of elderly patients with unrepaired cleft lip and or palate. Materials/Methods: We review the South Wales experience of treating elderly patients with unoperated cleft lip and or palate. We document the presence of speech impairment, behavioral problems, depression and low self esteem due to teasing about their facial appearance and ability to communicate. Results/Statistics: our results confirm an improvement in speech, quality of life and aesthetic outcomes after surgical repair of cleft in this series of elderly patients with unrepaired cleft lip and or palate. Conclusions/Clinical Relevance: We advise the cleft team to consider surgical repair of the untreated cleft lip and or palate in the elderly population. Further research is needed to objectively detect the primary aesthetic needs of elderly patients with cleft lip and or palate, which along with the subjective needs defined by the patient, should determine the aim of the planned treatment interventions in this patient group.