Incidence and Surgical Repair of Cleft Lip and Palate at National Orthopaedic Hospital, Enugu

Cleft lip and palate (CLP) are the most common congenital craniofacial anomalies in Nigeria, with estimated birth prevalence rates higher than in most high-income countries. Despite this burden, access to corrective surgical repair remains inadequate in many Nigerian regions. This study determines the incidence, demographic pattern, and outcomes of surgical repair of cleft lip and palate at National Orthopaedic Hospital (NOH), Enugu State, South East Nigeria, from 2019 to 2023. A retrospective review of 110 pediatric CLP cases was conducted. Data captured included child age at presentation, type of cleft (unilateral, bilateral, or cleft palate only), timing of surgical correction relative to recommended age guidelines, anesthesia type, operative technique, and wound healing outcomes. Unilateral cleft lip with or without cleft palate was the most prevalent subtype (61%). The median age at presentation was 18 months, significantly exceeding international recommendations for repair before 3 months. Postoperative outcomes were satisfactory in 82% of cases, with wound dehiscence in 7% and lip asymmetry requiring revision in 9%. Delayed presentation was primarily attributed to parental unawareness and lack of financial resources. The study recommends free cleft repair outreach initiatives, community awareness campaigns targeting pregnant women and newborn care settings, and increased cadence of reconstructive surgery programs in South East Nigeria. Keywords: cleft lip, cleft palate, craniofacial, pediatric surgery, Enugu