Cleft lip and palate in Nigerian children: a scoping review of surgical access and postoperative outcomes

Abstract

Abstract Background Cleft lip and palate (CLP) are congenital conditions of the craniofacial region affecting millions of Nigerian children. Timely surgical access is necessary to restore quality of life and prevent complications such as speech impairment, poor development, long-term disability, social stigma, and psychosocial distress. This scoping review explores the access to surgical care and postoperative outcomes in Nigerian children with cleft lip and palate. Methods A comprehensive search was conducted across multiple electronic databases, including PubMed, Google Scholar, and the Directory of Open Access Journals for studies published between 1995 and 2024. Additional insights were reviewed from internal platforms such as the Smile Train Express. Sixteen eligible studies were included. Data extraction covered study design, geographic location, patient demographics, surgical timing, nutritional factors, outcomes and complications. Results Across the studies, 2,162 patients with cleft lip and/or palate were included. Most patients were under three years of age, although the age at surgery ranged from 3 months to 65 years. Only 68% of eligible children underwent surgery. Malnutrition was seen in up to 40.2% of patients and was linked to suboptimal surgery outcomes, especially among older children and children with stunted growth. Complication rates reached up to 30% with oronasal fistulas and wound breakdown being commonly reported postoperative issues. Conclusion Surgical care for cleft lip and palate in Nigeria is limited by delayed presentation, malnutrition, poor referral systems, a shortage of the surgical workforce, poor infrastructure, and policies. Long-term improvement necessitates comprehensive policy and healthcare systems reform to ensure timely presentation, early detection, improved awareness, optimized and sustained NGO involvement, and a multidisciplinary approach to care.