Clinical Statistical Study Of Cleft Lip And Palate Surgery Files Funded By The Smile Strain

The study was a cross-sectional study from 2000-2002 and 2004. And the objective of this study was to assess the epidemiology and some genetic aspects of cleft lip and palate and surgical outcome in a Chinese population funded by The Smile Train. The participants were 8000 China Charity federation Cleft Lip and Cleft Palate Surgery Files funded by The Smile strain from 2000-2002. Information about the patients including general information, family history, type of clefts, associated malformations, grading of the pre-operative and pre-operative photos of patients with cleft lip was input to the computer and then managed statistically. Another 1000 patients were selected from The Smile Train Express Database to evaluate surgical outcome.Our findings were :1. 59.5%(4671 cases) of the 7848 clearly recorded patients were CL+P, 17% (1333 cases) were CP and 23.5% (1844 cases ) were CL;2. Unilateral were more common than bilateral (4.35:1). The ratios of unilateral to bilateral of CL and CL+P were 10.4:1 and 3.43:1 respectivelyand there was significant difference between them;3. Left-sided defects were more common than right-sided defects regardless of sex and severity of defect, the left-to-right ratio was 1.899:1 in CL and 1.96:1 in CL+P and the difference between them had no significant difference;4. CL and CL+P were more common in males than in females (male to female ratios were 1.84:1 and 2.87:1 respectively), CP was more common in females than in males (male to female ratio was 0.76: 1) ;5. Cases born in November to January were less than in other months. A significant tendency for patients with CP or CL+P to be born less often in the winter than in the summer was found;6. 7.4% of all clearly recorded cases had a family history of clefts and the percentage of CL+P (8.22%) was significantly higher than that of CL and CP's(6.12%);7. 3.1% of all clearly recorded cases had associated malformations (more frequent in CL+P). The percentage of CL+P (5.7%) was higher than that of CP (2.6%), and the percentage of CL (1.7) was the lowest;8. Surgical outcome was statistically associated with severity of the clefts and the tendency was found in patients operated in 2000-2002 and in patients operated in 2004. For patients with cleft lip graded as 1 or 2 pre-operatively, the surgical outcome of those who were operated in 2000-2002 was better than those operated in 2004(P<0.05). There was no significant difference between patients in 2000-2002 and 2004, graded as 3 or 4 pre-operatively.Our study was based on a large sample of 8000 China Charity federationCleft Lip and Cleft Palate Surgery Files funded by The Smile strain which covering most of the Chinese Provinces and thus it presented the epidemiology aspect of some low- socioeconomic Chinese patients with clefts. Our study found some epidemiology aspects consistent with other reports: patients with CL+P were the most; unilateral were more common than bilateral and left-sided defects were more common than right-sided defects; There was a significant male excess in the CL and CL+P groups, but CP were more common in females than in males. We also found the rate of associated malformations was much lower than other reports and associated malformations were more common in CL+P than in CP, which was not consistent with average reports. Our study also revealed that cases born in November to January were less than in other months and some cases had a family history of clefts; and surgical outcome of cleft lip was statistically associated with severity of the clefts and it was better in 2000-2002 than in 2004.