Abstract
Objectives:
1) Discuss the safety, feasibility, and technical limitations of facial cleft repair performed on medical missions in developing countries. 2) Present several representative cases of oculofacial clefting which were successfully repaired and another that was deferred due to safety concerns and limited resources.
Methods:
Case series and literature review.
Results:
On two separate visits over a two-year period (2011-2013), 4 patients with orofacial clefts were evaluated. Three oculofacial clefts (Tessier 3 (n=1), Tessier 4 (n=1), and Tessier 4-10 (n=1)) were successfully repaired. One of these patients had over 1 year of follow-up. Another patient with frontonasal dysplasia and a wide Tessier 0-14 cleft was screened and operative intervention deferred.
Conclusions:
When feasible, a soft tissue-only repair of oculofacial clefts may offer an acceptable aesthetic result with a reasonable expenditure of resources as part of a larger cleft mission. Facial clefts that require pre-operative imaging, extended procedure time, bone grafting, significant blood loss, and/or neurosurgical involvement demand a greater expenditure of scarce resources and are not advisable in the context of a surgical mission in most areas of the developing world.
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