Clinical Follow-Up in Orofacial Clefts—Why Multidisciplinary Care Is the Key

Abstract

(1) Background: Although most clinicians involved in the treatment of cleft patients agree upon the major importance of interdisciplinary cooperation and many protocols and concepts have been discussed in the literature, there is little evidence of the relevance of continuous interdisciplinary care. We aimed to objectify the type and number of therapeutic decisions resulting from an annual multidisciplinary follow-up. (2) Methods: We retrospectively analyzed the data of all 1126 patients followed up in the weekly consultation hours for cleft patients at university clinics in Leipzig for the years 2005–2020. We assessed the clinical data of every patient and specifically evaluated the treatment decisions taken at different points in time by the participating experts of different specialties. (3) Results: In total, 3470 consultations were included in the evaluation, and in 70% of those, a therapeutic recommendation was given. Each specialty showed certain time frames with intense treatment demand, which partially overlapped. Nearly all therapy recommendations were statistically attached to a certain age (p < 0.001). (4) Conclusions: There is an exceptionally high need for the interdisciplinary assessment of patients with cleft formation. Some developmental phases are of particular importance with regard to regular follow-up and initiation of different treatment protocols. The therapy and checkup of cleft patients should be concentrated in specialized centers.

Perfil epidemiológico y presencia de polimorfismos IFR6 (rs2235371), TGFA (rs3771494) en individuos con labio y paladar hendido no sindrómico

“…Además de lo anterior, diferentes estudios han identificado alteraciones en diversos órganos y sistemas como el musculo esquelético, cardiaco y nervioso, así como malformación de estructuras que complementan la zona facial como asimetrías, problemas auditivos, deformaciones nasales e incluso disfunciones articulares mandibulares, por mencionar algunos [30][31][32] , siendo las afecciones cardiacas las que tienen mayor relevancia clínica y quirúrgica en presencia de HO [33][34][35] . Sin embargo, ninguna de las alteraciones sistémicas y afecciones de interés se presentó en este estudio, solo llama la atención un alto porcentaje de deformaciones nasales en la población estudiada, algo que tiene relación con el alcance de afectación que pueden presentar las HO.…”

Continuous Multidisciplinary Care for Patients With Orofacial Clefts—Should the Follow-up Interval Depend on the Cleft Entity?

“…Patients are asked to return in their birth month every year; as this is easy to remember it is meant to increase attendance rate and guarantee a close supervision. Analyzing the data of our follow-up program from the years 2005 to 2020 we had found that the scheduled examinations led to an important therapy recommendation in a high proportion of all 3470 consultations considered (Lethaus et al, 2021). On the other hand, we had to take notice of the fact that the majority of patients did not attend annually.…”

“…In a previous study Lethaus et al looked into the general treatment demand of patients with cleft lip with or without palate (CL/P) during growth, identified in the clinic's annual interdisciplinary follow-up (Lethaus et al, 2021). The aim of the present study was to determine significant differences in treatment needs depending on the anatomical structures affected by cleft formation.…”