SRINAGARIND MEDICAL JOURNALVolume 35, No. 06, Month NOVEMBER, Year 2020, Pages 700 - 706
Update interdisciplinary clinical practice guideline for patients with cleft lip and palate at prenatal until 5 years
Suteera Pradubwong, Darawan Augsornwan, Suntaree Namjaitaharn, Orathai Saenbon, Jamras Wongkham, Tippawan Muknumporn, Chanatiporn Chonprai, Niramol Patjanasoontorn, Patimaporn Pungchanchaikul, Aggasit Manosudprasit, Poonsak Pisek, Benjamas Prathanee, Kengkart Winaikosol, Bowornsilp Chowchuen
Abstract Download PDFBackground and Objective: Patients with cleft lip
and palate require long-term care from
interdisciplinary team. The important phase of
treatment is pre-natal until 5 years. Update clinical
practice guideline therefore important.
Methods: This participation action research were
performed by 30 members of interdisciplinary team
in Tawanchai Center which comprises of 10 disciplines.
Participated in analyzing the problem and updating
the guideline by 24 members, 2 times, sending the
guideline to 3 disciplines which are pediatricians,
obstetricians and psychiatrists not attending the
meeting to give suggestions. And content validity was
checked by 5 experts with updated guidelines applied and clinical outcome evaluation. Study was
conducted for 4 months (January - April 2019),
summarizing data and content analysis.
Results: It was found that during the 6 weeks before
pregnancy, update by giving folic acid, between the
ages of 3-6 months, adding the support for the shape
of the nose after Cheiloplasty by nasal creator device.
Consultation for pediatric dentists and send for the
assessment, promoting language and speech development
no. 1, cancel follow-up treatment according
to the online registration system. Between the ages
of 10-18 months, adding evaluating the development
of alveolar and maxilla with oral health before
palatoplasty, between the ages of 1 and a half-3 years
and 4-5 years. Adding evaluation of the middle ear,
repeated every 3 months. If not otitis media, repeat
every 6 months until the age of 7 years until Eustachian
work well. And cancel follow-up treatment according
to the online registration system.
Conclusions: The updated guideline covers all
interdisciplinary team care, from pre-natal until 5 years
and evaluating results over the 5 years. There most
beneficial to patients, and could be applied to other
centers that has a similar context
Clinical Practice guideline Cleft lip and palate Interdisciplinary team Tawanchai Center