PDF(Pubmed)
Abstract：
BACKGROUND: Bilateral transverse facial cleft is the most common of the rare facial clefts and early presentation is a key element for successful management and prevention of possible complications like poor esthetics, speech and eating difficulties. Though several studies have documented reasons for late presentation, none has highlighted non-referral due to missed diagnosis by healthcare workers as a reason.
METHODS: A nine-year-old girl was brought by her parents to the Primary Oral Health Clinic on account of \"very wide mouth\" noticed at birth. The mother noticed the anomaly few hours after she gave birth to her and immediately pointed the attention of the nurses and birth attendants to it but they dismissed her concern. Subsequently, the mother took the girl to the maternity centre for routine immunization appointments, but none of the healthcare workers she encountered recognized the birth defect. The parents further reported that the girl received jests and abuses from her peers. A diagnosis of Isolated Bilateral Tessier number 7 cleft was made based on clinical examination findings. She was referred to a cleft centre where the repair was successfully carried out at no cost to the patient through the Smile-Train® sponsorship program. Subsequent follow-up visits to the primary healthcare clinic in the sixth and ninth month post-surgery revealed remarkable improvement in both patient\'s and parents\'self-reported psycho-social wellbeing.
CONCLUSIONS: This case report presents a rare presentation of delayed isolated congenital bilateral macrostomia because of healthcare workers failure to diagnose.
METHODS: A nine-year-old girl was brought by her parents to the Primary Oral Health Clinic on account of \"very wide mouth\" noticed at birth. The mother noticed the anomaly few hours after she gave birth to her and immediately pointed the attention of the nurses and birth attendants to it but they dismissed her concern. Subsequently, the mother took the girl to the maternity centre for routine immunization appointments, but none of the healthcare workers she encountered recognized the birth defect. The parents further reported that the girl received jests and abuses from her peers. A diagnosis of Isolated Bilateral Tessier number 7 cleft was made based on clinical examination findings. She was referred to a cleft centre where the repair was successfully carried out at no cost to the patient through the Smile-Train® sponsorship program. Subsequent follow-up visits to the primary healthcare clinic in the sixth and ninth month post-surgery revealed remarkable improvement in both patient\'s and parents\'self-reported psycho-social wellbeing.
CONCLUSIONS: This case report presents a rare presentation of delayed isolated congenital bilateral macrostomia because of healthcare workers failure to diagnose.
摘要：
背景：双侧横向面裂是最常见的罕见面裂，早期表现是成功治疗和预防可能的并发症如美学不良的关键因素，言语和饮食方面的困难。尽管有几项研究记录了延迟演示的原因，没有人强调因医护人员漏诊而未转诊的原因.
方法：一名9岁女孩因出生时注意到“非常宽的嘴”而被父母带到初级口腔健康诊所。这位母亲在生下她几个小时后就注意到了这种异常现象，并立即引起了护士和助产士的注意，但他们驳回了她的担忧。随后，母亲将女孩带到产妇中心进行常规免疫接种，但是她遇到的医护人员都没有意识到出生缺陷。父母进一步报告说，这名女孩收到了同龄人的笑话和虐待。根据临床检查结果诊断为孤立的7号双侧Tessier裂。她被转诊到一个裂口中心，在那里通过Smile-Train®赞助计划免费对患者进行了成功的修复。随后在术后第六个月和第九个月对初级保健诊所进行的随访显示，患者和父母自我报告的心理社会健康状况均有显着改善。
结论：该病例报告显示，由于医护人员无法诊断，罕见的孤立性先天性双侧巨大口炎。
方法：一名9岁女孩因出生时注意到“非常宽的嘴”而被父母带到初级口腔健康诊所。这位母亲在生下她几个小时后就注意到了这种异常现象，并立即引起了护士和助产士的注意，但他们驳回了她的担忧。随后，母亲将女孩带到产妇中心进行常规免疫接种，但是她遇到的医护人员都没有意识到出生缺陷。父母进一步报告说，这名女孩收到了同龄人的笑话和虐待。根据临床检查结果诊断为孤立的7号双侧Tessier裂。她被转诊到一个裂口中心，在那里通过Smile-Train®赞助计划免费对患者进行了成功的修复。随后在术后第六个月和第九个月对初级保健诊所进行的随访显示，患者和父母自我报告的心理社会健康状况均有显着改善。
结论：该病例报告显示，由于医护人员无法诊断，罕见的孤立性先天性双侧巨大口炎。
