Advantages of early management of facial clefts in Africa

摘要

Objective: Facial clefts are frequent morphological accidents occurring during the 2nd embryonic month. The management period of these affections varies, depending on the area or on the treatment habits. In the African context, there is lot of stigma surrounding this condition, often leading to rejection or even infanticide of the affected newborn. Such a psychosocial environment requires us to adapt our treatment schedule by initiating an early management. The aim of this study was to show our experience in the early treatment of facial clefts through 70 children operated in their neonatal period. Methods: It was a retrospective study conducted over 3 years, from 2004 to 2006 at the department of Maxillo-facial surgery and Stomatology in a teaching hospital (CHU Treichville Abidjan) and in a general hospital (Dabou, C?te d'Ivoire). Newborn aged 0 to 28 days, affected with facial cleft and operated in the neonatal period were considered for this study. Results: 70 newborn suffering from facial clefts among which one at least was suffering from cleft lip were selected and operated. The study population was predominantly male (43 out of 70, meaning 61.4%). The distribution according to anatomo-clinical aspect showed 39 cases (55.7%) of cleft lip, 23 cases (32.9%) of cleft lip-alveolar process and 8 cases (11.4%) of cleft lip alveolar process and palate. The results achieved by the early surgical treatment of these affections are not very different from those of the schools which advocate that children should be a little bit older before the surgery. Conclusion: The earliness of surgical treatment of facial clefts is borne out by the sociological and psychological context of African environment that promotes rejection and infanticide. Some factors such as anesthetic safety, physiology and anatomy favor an early surgery intervention on facial clefts.