Social adaptation of post-operative cleft lip and cleft palate patients with overseas medical assistance in developing countries

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K10950
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Plastic surgery
• Research Institution: Showa University
• Principal Investigator: YOSHIMOTO SHINYA 昭和大学, 医学部, 客員教授 (90220748)
• Research Collaborator: HASHIMOTO SYOKO ; Timilsina Ram
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 口唇口蓋裂 / 発展途上国 / 手術時期 / 社会適応 / 言語障害 / 鼻咽腔閉鎖機能 / ケロイド

Outline of Final Research Achievements

Of the 1,000 people who underwent cleft lip and cleft palate surgery in Nepal, a questionnaire survey was conducted on about 200 people, and the post-operative social adaptation status of patients was examined. In patients with cleft palate, the group who underwent surgery before the age of 2 had better speech results than the group who had surgery later. Water intake and swallowing improved regardless of the age of surgery. Post-operative bullying and the like decreased considerably after surgery, but there are still many cases that remain. There were also situations such as being unable to get a good job due to speech problems and not being able to get married. The training of plastic surgeons, the creation of an environment where surgery can be performed early, and the training of speech therapists seems to be urgent issues. There was no difference in the occurrence rate of keloid between the patients in Nepal and ones in Japan.

Free Research Field

形成外科（小児形成外科）

Academic Significance and Societal Importance of the Research Achievements

3歳を過ぎてからの口蓋裂の手術では言語障害を残し易いが、学童期位までの患者では、手術後の言語訓練により改善することが多い。そのため、発展途上国における口唇口蓋裂のボランティア手術においては、年齢の低い患者を優先すべきである。また、2－3歳の患者では、口唇の手術より口蓋の手術を優先し、口唇の手術を後にすべきである。ただ、発展途上国には、言語の治療を行う言語聴覚士が殆どいないため、形成外科医と共に言語聴覚士の育成も重要である。
黒人の患者では口唇裂の手術後にケロイドを発生することが多い。ネパールは色の黒い人種が多いが、今回の調査では、ケロイドが多く発生する傾向はなく、遺伝子の差であると思われた。