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Outcome of patients with cleft lip and cleft palate operated at Mahosoth, Mitthaphab and Setthathirath Hospitals in Lao People's Democratic Republic.

BACKGROUND
Cleft lip and cleft palate or both are the most common orofacial congenital malformations found among live births. The causes of which are not clear but have a trend that includes 2 etiological factors, genetic and environmental. The incidence rate of cleft lip and palate is similar in every country worldwide and it stands at approximately 1-2/1,000 newborn. For instance, it is 1.09/1,000 in India, South Korea and Thailand. Estimate, in Lao PDR could be 0.02/1,000 newborn. Cleft lip and cleft palate and craniofacial anomalies are congenital defects with numerous sequels in dental, speech, hearing, body-image and psychosocial realms. Cleft lip and palate operation is still limited in many parts of Lao PDR.


OBJECTIVE
To study the outcome of patients with cleft lip and cleft palate, particularly the nasolabial appearance and quality of life, who were operated in Lao People 's Democratic Republic.


MATERIAL AND METHOD
The present study was reviewed and approved by the Ethics for Human Research, Khon Kaen University in Thailand and National Ethics Committee for Health Research in Lao PDR. This was a cross-sectional study of 50 persons who were chosen as samples and were divided into two age groups, group A, which included subjects between 5 and 15 years of age (31 persons) and group B composed of those above 15 years (19 persons). Data collection was done by means of a questionnaire and the latter was divided into three main headings: demographic characteristics, quality of life and nasolabial appearance. The list of patients with cleft lip and palate was obtained from the 3 Hospitals in Vientiane, the capital, and then entered directly as samples. Demographic data and quality of life were analyzed by means of percentage, frequency, mean and standard deviation with the help of SPSS for Window. Similarly, inter-rater reliability using kappa statistics was done for the evaluation of nasolabial appearance.


RESULTS
The inter-rater reliability for Nasolabial appearance was 0.2044 or 20.44% (p-value <0.0001). Average score in each dimension of nasolabial appearance (nasal form, nasal symmetry, vermillion border nasolabial profile) are scored 3.15, 3.13, 3.35 and 3.06 respectively. This placed it on fair level (3.17point). The quality of life: group (A) and (B) were whose have the quality of life on fair to good level for mentalities and satisfaction on fair level that is comparable.


CONCLUSION
The result of the research revealed that the rating of reliability of inter-rater was rather low. However each dimension of quality of life of both groups was at fair level.