Assessment of Cleft Lip and Palate Cases Managed at the University of Nigeria Teaching Hospital, Enugu

Cleft lip and palate is the most common congenital facial anomaly in sub-Saharan Africa, and retrospective clinical audits of cases managed at referral centres provide essential epidemiological and service quality data. This study assessed cleft lip and palate cases managed at the Oral and Maxillofacial Surgery Department of the University of Nigeria Teaching Hospital, Enugu, South East Nigeria, between 2017 and 2022. A retrospective clinical audit was conducted using patient records. Data extracted included patient demographics, cleft type, age at presentation, gestational and birth history, surgical management received, complications, and follow-up attendance. A total of 148 cases were reviewed. Cleft lip only was present in 29.7 percent, cleft palate only in 22.3 percent, and combined cleft lip and palate in 48.0 percent. The mean age at surgical repair was 18.4 months, above the recommended 12 months. Males constituted 57.4 percent of cases. The majority were from rural Enugu and Imo States. Nutritional challenges and failure to thrive were documented in 31.1 percent of pre-surgical cases. Post-operative complications occurred in 15.5 percent, including wound dehiscence and infection. Follow-up attendance beyond three post-operative visits was poor at 42.6 percent. The study identifies delayed presentation and inadequate follow-up as major service challenges. Recommendations include a national cleft registry, community awareness to promote early presentation, and a multidisciplinary cleft team expansion at UNTH Enugu.

Keywords: cleft lip, cleft palate, retrospective audit, UNTH Enugu, congenital anomaly