The Treatment of 4-5 Year-Old Patients with Cleft Lip and Cleft Palate in Tawanchai Center: Follow-up
Suteera Pradubwong MSN*, Sumalee Pongpagatip MA* Benjamas Prathanee PhD**, Panida Thanawirattananit MA** Teeraporn Ratanaanekchai MD**, Bowornsilp Chowchuen MD, MBA***
Affiliation : * Division of Nursing,Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Department of Otolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand *** Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : The highest incidence of cleft lip and cleft palate in Thailand occurs in the Northeast Region. Tawanchai Center
was set up 10 years ago to be a specialized medical care center where an interdisciplinary team provides care for cleft lip and
cleft palate patients. There has never previously been a study about 4-5 year old patients treated and followed-up by the
multidisciplinary team.
Objective : To study the 4-5 year old patient’s with cleft lip and cleft palate who received treatment and follow-up in Tawanchai
Center, Srinagarind Hospital.
Material and Method: This retrospective study was conducted using data from every 4-5 years old cleft lip and cleft palate
patients’ medical record of the patients who had the continuous multidisciplinary treatment care at Tawanchai Center,
Srinagarind Hospital, Faculty of Medicine and Faculty of Dentistry, Khon Kaen University. The 123 case samples were
collected during the 3 months of April-June 2012. The research instrument was a form for general data record and follow-up
data record and then the data were analyzed by statistic and percentage.
Results : From the 123 cases of the 4-5 years old patients with cleft lip and cleft palate who received treatment at Tawanchai
Center, Srinagarind Hospital, it was found that 120 cases or 97.56 percent had an operation, 20 cases (16.26 percent) were
found where patients came from Khon Kaen Province, 10 cases of each male and female. For this treatment, the majority (108
cases) used government insurance cards. The patients with cleft lip and cleft palate were most common and found to be 74
cases consisted of 44 male and 30 female.
The diagnosis and follow-up of cleft lip and cleft palate patients were classified into 18 age ranges, with a total of
2,269 follow-up visits. The most common follow-up was for the 2-3 year old patients, which consisted of 410 times or 18.07
percent which consisted of 220 male and 190 female. Regarding the age range of the patients for the first diagnosis, the highest
amount was 38 cases or 30.89 percent of 0-1 month newborn which were 22 males and 16 females.
Regarding examination rooms used, the highest number of patients attended the out-patient surgical examination
room (969 times, 30.66 percent), of which 526 times were male and 443 times female. The second highest number of patients
attended the ENT room, 706 times or 22.33 percent of which 411 times were male and 295 female.
The 2 patients with the highest number of follow-up were 87 and 65 times respectively.
Conclusion : 123 cases of the 4-5 years patients had been continuously treated by the multidisciplinary team at Tawanchai
Center, Srinagarind Hospital. The highest number of visits was 87 or more than once per month, so it was a good opportunity
for such a team to improve the efficiency and for developing the follow-up system and the diagnosis process for a baby with
cleft lip and cleft palate before birth by use of ultrasound checking during pregnancy. Such a development was helpful for
providing counseling towards mothers and families’ preparation in order to give the most suitable age related treatment and
full co-operative support to the children with cleft lip-cleft palate and family.
Keywords : Cleft lip and cleft palate, Treatment, Follow-up, Tawanchai Center
