Impact of cleft lip and/or palate in children on family quality of life before and after reconstructive surgery.

BACKGROUND: The aim of the study was to evaluate the impact of cleft lip/palate children together with consequent treatment on quality of family life using standardized questionnaire. Different to previous studies the evaluation of quality of family life by questionnaire was realized twice in the same group of families (before the reconstructive surgery and several months after palatoplasty). METHODS: The study was conducted in 40 families divided in two groups: 20 families with children with cleft lip (CL), 20 families with children with cleft lip and palate (CLP). The questionnaire of the Impact on Family Scale was used for evaluation of the influence of orofacial clefts on parent´s quality of life. Evaluations were made at the second month of child´s life and at one year of child´s life with reciprocally comparison. RESULTS: The higher impact of children with CLP on quality of family life was noted at 2 months and 1 year of child's age as compared to the impact of children with CL. The reduction of impact on quality of life after surgical correction was observed in families of children with CL at one year of child's age. This decrease of influence on family quality of life was due to significantly lower impact in strain and economic dimensions in families with CL children after operation. However, in the group of families with CLP children no significant changes in the impact on family quality of life were noted when compared to the values before and shortly after the reconstructive surgery. CONCLUSIONS: This study showed that orofacial clefts in children influence markedly the quality of their family life. The higher impact of children with CLP on quality of family life as compared to children with CL was noted and this impact in CLP group was not influenced shortly after reconstructive surgery. It is suggested that appropriate medical care in Cleft Centre with special psychological support may lead to improvement in quality of life for families with cleft lip and palate children (Tab. 2, Fig. 2, Ref. 14).

Timing of primary lip repair in cleft patients according to surgical treatment protocol.

OBJECTIVES: The goal of this article is to focus on the results of meeting the primary lip repair timing in compliance with the surgical treatment protocol used at the Cleft Center, Bratislava. METHODS: Retrospective analysis of 45 initial lip repairs among all cleft operations in a period of 3 years (2006-2008). The object of the analysis was the "day of surgery after birth". The defined time period was that of 90th-180th day (3-6 months) for the initial lip surgery according to surgical protocol. Histories of patients who underwent surgery before the 90th or after the 180th day were examined. RESULTS: 40 patients (89%) underwent primary lip surgery in the defined time period of 3-6 months following the surgical treatment protocol. 5 patients (11%) underwent primary lip surgery at a later age than 6 months only because of pediatric reasons: recurrent bronchopneumonia (3 patients), recurrent respiratory infections plus prematurity (1 patient) and sideropenic anaemia (1 patient). There were no operative and postoperative surgical or anesthesiological complications. There were only serious pediatric reasons for surgery delays. CONCLUSION: The determined timing of primary lip closure in 3-6 months is considered adequate according to the achieved results. In most of the cases this timing offers reliable conditions to perform early surgery in baby patients. The successfull realisation of the primary lip repair in the defined time period of 3-6 months is very important for proper timing of subsequent surgeries as well as for that of consecutive completion of treatment (Tab. 1, Fig. 1, Ref. 8).

Fifty years of the Cleft Centre in Bratislava.

In our paper, we would like to present and analyse the activities in the Cleft Centre in Bratislava between 1952 and 2001. We document the gradual development of the complex treatment and the important changes in the usage of the operative techniques and in the primary and secondary operations timing, as well as the application of the new trends in the field of plastic surgery, maxillofacial surgery, anaesthesiology, orthodontics, speech therapy, paediatrics, human genetics and psychology.