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An Outcome Study of Functional and Aesthetic Results of Cleft Lip Surgery in The Travelling Charity Surgery Setting

Background: Indonesia Association of Plastic Reconstructive and Aesthetic Surgeon has done 103 charity works on cleft lip (with or without palate) repair since 1997, with a total of 5,662 patients have undergone the cleft lip repair all over Indonesia. Several techniques have been used by a majority of advancement rotation (Millard) with its modification (Onizuka). However there has not been any report was made to evaluate the surgical outcome of those charity programs in travelling setting. Objective: The aim of this study is to know the outcomes of charity surgery for cleft lip in terms of aesthetic and functional aspects. Methods: Several regions where charity surgery for cleft lip were held during the last 5 years were chosen based on convenient sampling. Patients who had undergone charity surgical repair were contacted for evaluation. Photographs of long term postoperative results in antero-posterior, lateral and worm eye view with the ruler adhere next to the lips/nose were taken then evaluated for functional, aesthetic and biometrical outcomes. El-Noamany scoring system and Prasetyono measurement was applied to evaluate those photos. Parents’ satisfaction and the need for secondary surgery were also evaluated. Result: Among 341 patients who can be identified, 30 patients had been evaluated. Male predominant to female patients with about 90% had unilateral cleft lip. In term of aesthetic, only 40% of the surgery resulted in good aesthetical outcome. The majority of the subjects had fair oral orbicular muscle function. More than 95% subjects’ parents declared their satisfaction with the surgery outcome. There were no statistically significant association found between the characteristics of subjects and the surgery outcome. Conclusion: Less than half of the charity surgery resulted good aesthetical outcome. In terms of oral muscle, most of the subjects fair function. However, almost all patients’ parents were satisfied with the surgery outcome.