Publication: Impact of Geopolitical Unrest on Surgical Delays and Outcomes in Immigrant Populations With Cleft Lip and Palate
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Date
2024-01-01
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Abstract
Background: Geopolitical conflicts in the Middle East have led
to mass migrations, with Turkey becoming a major host
country. This influx has strained the health care system, particularly
regarding specialized care for conditions like cleft lip
and palate (CLP). Timely intervention is crucial for optimal
outcomes, but cultural, socioeconomic, and logistical barriers
often cause delays, impacting physical, functional, and psychosocial
development.
Methods: This retrospective study analyzed 72 immigrant pediatric
CLP patients treated in Turkey between 2012 and 2022.
Data on demographics, medical history, surgical interventions,
complications, and treatment delays were collected. Surgical
timing was compared with American Cleft Palate Craniofacial
Association guidelines, and the impact of socioeconomic status
on delays was assessed.
Results: Seventy-two patients underwent a total of 91 surgical
interventions, including 29 cleft lip repairs, 22 cleft palate repairs,
6 pharyngeal flaps, 15 fistula closures, 8 corrections of secondary
lip scars and whistling deformities, and 11 alveolar bone graftings.
A majority (73.6%) had poor socioeconomic status. The
average delays for cleft lip, cleft palate, and alveolar bone grafting
surgeries were 5.3±4, 7.3±6.1, and 34.1±23.5 months, respectively,
and were significantly longer for patients with poor
socioeconomic status (P=0.00502, 0.030741, and 0.041878).
The average delay for pharyngeal flap surgery, performed in
patients with poor socioeconomic status (except for one), was
43.7±14.1 months.
Conclusions: This study highlights the challenges and disparities
in CLP care for immigrant children in Turkey due to geopolitical
conflict. While surgical complication rates are similar
to established data, delays in treatment, especially among those
with lower socioeconomic status, are a significant concern. The
findings emphasize the need for comprehensive, culturally sensitive
care and systemic interventions to improve access and
outcomes for this vulnerable population.
Key Words: Cleft lip and palate, geopolitical conflict, health
care access, immigrant, refugee, socioeconomic status, surgical
outcomes, treatment delay, Turkey
Description
Keywords
Tıp, Cerrahi Tıp Bilimleri, Kulak Burun Boğaz, Sağlık Bilimleri, Medicine, Surgery Medicine Sciences, Otolaryngology, Health Sciences, Klinik Tıp (Med), Klinik Tıp, Cerrahi, Clinical Medicine (Med), Clinical Medicine, Surgery, Otorhinolaryngology, Cleft lip and palate, geopolitical conflict, health care access, immigrant, refugee, socioeconomic status, surgical outcomes, treatment delay, Turkey
Citation
GÜRAY Ş., EVİN N., Sifil M. K., YILDIZ K., Güneren E., "Impact of Geopolitical Unrest on Surgical Delays and Outcomes in Immigrant Populations With Cleft Lip and Palate", Journal of Craniofacial Surgery, 2024