Download - PSO-HNS

PROFILE OF THE FILIPINO CHILD WITH A Significantly, 57% of the respondents have a -
CLEFT
family history of clefts occuring in relatives, parents,
or siblings. These shows a strong generic trend in
Having gone over the country, what is the profile the pathogenesis of these cleft.
ofthe Filipino child with a cleft
Parental concepts of cause also gauged in our
Although there are some numbers of epidemiol- survey because they play a role in the management
ogical studies on cleft lip and palate in Western of cases. They were asked the question: "What do
literature, no local studies on the _Filipino patient you think caused your baby to develop such adeformity
seems to be available.
" The 97 who responded had the folllowing answers-
From our available records and survey conducted 1. Inherited - 35%
on our patients in the past 2 years, we have come 2. Slipped and fell while pregnant - 25.7%
up with the following. This data tallies with epide- 3. Does not know - 15.4%
miological studies done abroad such asthe Fogh- 4. "napaglihian"- 6.1%
Anderson series. 5. Intake of medicine during pregnancy - 4.1%
6. Traveling during pregnancy - 2%
Perhaps because it is such an obvious deformity, 7. "Menopause baby" - 2%
most cases are first seen in the below 5 age group 8. "gulat" - I%
as shown in figure one.
The youngest patient operated on was a 3 mos. CONCLUSION:
old infant while the oldest was a 73 year old female
from Candon, Uocos Sur who requested for a lip In summary we have a)described how we have
repair after seeing repairs done on the younger patients, reached our target population, b) described our standard
In the series, more males are seen than females at procedures and techniques, and c)described a profile
a ratio of 1:5.
of the Filipino child with a cleft lip and/or palate based
on our own survey and available data.
As in studies done abroad, Cleft lips with palate
are more often seen than either cleft lip 'alone or Admittedly, there are disadvantages to aour
cleft palate alone. Figure 2 also shows that cleft working set up. Foremost among thoeme are a)
lip alone are more frequently seen than cleft palate impracticality of long term follow-up and treatment
alone. There are more males than females are seen of cases so important in plastic repair, and b) working
than males with cleft palate alone, under SUBOPTIMAL conditions of sterelity and
competence of assisting personnel.
Of the UNILATERAL CLEFT LIPS (N=71) seen,
they are more often found on the left than on right But then again we live in the third world where '
at a ratio of 2.3:1. conditions are NORMALLY suboptimal. Any facial
deformities, which are not only physical but psycho-
A search for possible precipitating factors in cleft logical disabilities as well, are an added weight to
lip and palate genesis may show that family history the already heavy burden of poverty.
may be more revealing than the maternal history
during the trimester as shown in figure 3. Family On the bright side of it, such a Set up has its
or maternal histories was not significant in 18.9% advantages: a) many cases, otherwise hidden for
of respondents. Maternal history revealed 6.3% had various reasons, are brought out for treatment, b)
taken medications during the first trimester of it is always a learning opportunity for both the
pregnancy. These medications however are not community and the visiting surgeon, ¢) it is a good
known teratogens (acetaminophen, aspirin, vitamins) opportunity to introduce our specialty to the people,
unlike Valium and Dilantin which are implicated in and d) perhaps above all, it is an opportunity to
the genesis of these deformities. It is the FAMILY specialists like us, to be of service to the people.
HISTORY however that is a revelation.
55