European Journal of Biomedical and Pharmaceutical Sciences

CHALLENGES IN MANAGING CLEFT LIP PATIENTS IN THE GAZA STRIP DURING WARTIME: A CASE SERIES

Ahmad Smadi*, Mohammed Nayef ALBdour, Mohammad Alibrahim, Mohammad Elayan Mohammad Aljbour and Ahmad Bani Salameh

ABSTRACT

Background: Cleft lip is a common congenital anomaly that requires timely surgical intervention to optimize functional and aesthetic outcomes. Delayed repair can lead to feeding difficulties, speech and language delays, and increased risk of postoperative complications. In conflict-affected regions, such as Gaza, disruptions in healthcare access further exacerbate these challenges. This study presents a case series of delayed cleft lip repairs and associated outcomes in a resource-limited setting. Methods: A retrospective review of 12 pediatric patients with cleft lip anomalies was conducted. Data on demographics, clinical presentation, surgical intervention, and postoperative outcomes were analyzed. Patients were evaluated for preoperative investigations, intraoperative complications, and postoperative recovery. Case presentation: Twelve infants (7 males, 5 females) aged 4 to 18 months were included. Nine patients (75%) underwent surgical repair, while three (25%) had surgery canceled due to respiratory findings, including bilateral lung infiltrates and patchy consolidation. Among those operated on, two (22%) had cheiloplasty using the anatomic subunit repair technique, while seven (78%) underwent cheiloplasty in addition to primary rhinoplasty. No intraoperative complications were noted, but postoperative issues included alar cinch suture failure due to trauma, croup, and dressing-related dermatitis. All completed procedures had successful outcomes. Conclusion: Delayed cleft lip repair in conflict-affected settings poses significant challenges, including increased postoperative complications and limited healthcare accessibility. Timely intervention remains critical for optimal functional and aesthetic results. Strategies to improve healthcare infrastructure and surgical access are necessary to mitigate delays and associated complications.

Keywords: Cleft lip, Delayed surgical repair, Plastic and Reconstructive surgery, War-related healthcare challenges, Gaza healthcare crisis.