J Med Assoc Thai 2013; 96 (9):1

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Treatment of 4-5 Year Old Patients with Cleft Lip and Cleft Palate in Tawanchai Center
Pradubwong S Mail, Volrathongchai K , Chowchuen B

Background: The occurrence of Cleft Lip/Palate condition in Thailand reaches a rate of 2.49% of child births, with estimates of 800 new cases per year in the Northeastern region. The healthcare process emphasizes interdisciplinary teamwork at each stage of the planning of treatment and services with the primary goal of achieving patient satisfaction and ability to live normally in society. The first 5 years are particularly important, with a focus on quality of care and ability to adapt to the environment before entering school.
Objective: To study the treatment of patients with cleft lip and palate in Tawanchai center, in the 4-5 year age range.
Material and Method: A retrospective study of the clinical records was led, concerning the 123 cleft lip and cleft palate patients aged 4-5 years under treatment in Tawanchai center, Srinagarind Hospital. Data was collected during three months from October to December 2011, using the admission records of the interdisciplinary team. Percentages and mean values were calculated from these data.
Results: 120 of the 123 patients were operated, giving a ratio of 97.56%. 108 cases were under government universal health coverage regime, corresponding to 87.80% of cases. 74 cases (60.16%) presented both cleft lip and palate condition, and an average of 5-night stay in hospital per person. Medical services by the interdisciplinary team were provided as follows: (1) of 30 patients with cleft lip aged 3-4 months, 30 (100%) received pre and post-surgery care counseling, 29 (96.67%) received surgery; (2) of 19 patients with cleft palate aged 10-18 months, 17 (89.47%) received treatment information, pre and postsurgery counseling and were operated according to the protocols; (3) of 74 patients with cleft lip and palate, 53 (71.62%) received counseling for pre and post-surgery care for lip repair at the age of 3-4 months, 52 (70.27%) were operated following the protocols, while at the age of 10-18 months 63 patients (85.14%) received treatment information, pre and postsurgery care counseling, and surgical intervention for palate repair.
Conclusion: Results of cleft lip and palate continuous treatment by interdisciplinary team in Tawanchai center for patients aged 4-5 years are reported. The highest percentage of patients to follow the treatment protocol, with pre and post-surgery care counseling and surgical intervention was achieved for cleft lip only cases, followed by cleft palate cases. Patients with both cleft lip and palate condition achieved the lowest percentage. In all cases, patients accepted within the center were treated at an 85.39% rate.

Keywords: Treatment of 4-5 years-old, Cleft lip and cleft palate, Tawanchai center


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