Aspects of Cleft Lip and Palate from Northern Finland Clefts in Northern Finland

Children born with a cleft lip and or palate face numerous difficulties during the course of their lives. Their families must respond to the challenge of a high level of burden of care required by these patients. The studies listed in this thesis benchmark the characteristics of cleft lip and palate in a cohort of patients living in Northern Finland. These studies strived to consider epidemiologic aspects, speech results, palatal fistula rates and hearing outcome. Records of a total of 214 patients treated between 1998-2011 at the Oulu Cleft Lip and Palate Center were assessed on a retrospective basis. Cleft palate (68.7%) was most frequent followed by cleft lip and palate (18.7%) and cleft lip with or without alveolus (12.6%). Cleft palate occurred more frequently in females (63%) and cleft lip and palate was more frequent in males (62.5%) most commonly affecting the left side (82%). The overall frequency of speech operations following primary palatoplasty was 21%. This was significantly higher for girls (27%) than for boys (13%). Patients with cleft lip and palate were more likely to require speech improvement surgery (24%) than patients with isolated soft or soft and hard palate clefts (20%). The overall frequency of postoperative fistulas following primary palatoplasty was (9.6%). Patients with cleft lip and palate were more likely to develop postoperative palatal fistulas (20%) than patients with cleft palate (6.6%). The severity of the cleft, the surgical technique used to repair the palate, hearing outcome, and the need for ventilation tube placement were determined retrospectively. At least mild hearing loss was found in 3.3% of cleft patients. Neither the surgical technique used to repair the cleft palate nor the severity of the cleft were found to be significant factors related to hearing loss or to the number of ventilation tubes required. Hearing improved significantly with increasing age over a span of 6 years.