Cleft lip (cleft palate) surgery and reconstrruction
Cleft lip and cleft palate are birth abnormalities of the mouth and lip. Cleft lip and cleft palate occur early in pregnancy when the sides of the lip and the roof of the mouth do not fuse together as they should. A child can have cleft lip, cleft palate, or both. Cleft lip and cleft palate together are more common in boys. It is also important to know that most babies born with a cleft are otherwise healthy with no other birth abnormalities
Children born with clefts or other craniofacial conditions often require complex and specialized health care from infancy to young adulthood. dovtor tarzi declare: Experience has shown that this care is best managed when doctor work with the family to develop and follow a treatment plan . this abnormality can simply improve by surgery . The family has the option of scheduling a consultation with a facial cosmetic surgeon. At that consultation surgeon will describe the types of surgery, explain the anticipated time frame for surgery and answer any other questions parents may have.
cleft lip and cleft palate
Cleft palate occurs when the roof of the mouth does not completely close, leaving an opening that can extend into the nasal cavity. The cleft may involve either side of the palate. It can extend from the front of the mouth (hard palate) to the throat (soft palate). Often the cleft will also include the lip. Cleft palate is not as noticeable as cleft lip because it is inside the mouth. Cleft lip is an abnormality in which the lip does not completely form during fetal development. The degree of the cleft lip can vary greatly, from mild (notching of the lip) to severe (large opening from the lip up through the nose). As a parent, it may be stressful to adjust to the obvious abnormality of the face, as it can be very noticeable. Cleft lip and cleft palate may occur together in an infant, or separately. The degree of the abnormality of both cleft lip and cleft palate can vary greatly. The most common early problem associated with these abnormalities is feeding your baby.
Causes of cleft lip and cleft palate
The exact cause of cleft lip and cleft palate is not completely understood. Cleft lip and/or cleft palate are caused by multiple genes inherited from both parents, as well as environmental factors that scientists do not yet fully understand. When a combination of genes and environmental factors cause a condition, the inheritance is called “multifactorial” (many factors contribute to the cause.
The symptoms of these abnormalities are visible during the first examination by your infant’s doctor. Although the degree of the abnormality can vary, on inspection of the mouth and lips, the abnormality can be noted, as there is an incomplete closure of either the lip, roof of the mouth, or both.
complications with cleft lip and cleft palate
Feeding difficulties occur more with cleft palate abnormalities. The infant may be unable to suck properly because the roof of the mouth is not formed completely.
Ear infections and hearing loss
Ear infections are often due to a dysfunction of the tube that connects the middle ear and the throat. Recurrent infections can then lead to hearing loss.
Speech and language delay
Due to the opening of the roof of the mouth and the lip, muscle function may be decreased, which can lead to a delay in speech or abnormal speech. Referral to a speech therapist should be discussed with your child’s doctor.
Surgery for cleft lip and cleft palate
Medications are administered for your child’s comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. doctor will recommend the best choice for your child.
cleft lip procedure
The goal of cleft lip surgery is to close the separation in the lip and to provide a more normal function, structure and appearance to the upper lip. Incisions are made on either side of the cleft to create ﬂaps of tissue that are then drawn together and stitched to close the cleft.
After the surgery
Your child may be irritable following surgery. Your child’s doctor may prescribe medications to help with this. Your child may also have to wear padded restraints on his or her elbows to prevent him or her from rubbing at the stitches and surgery site. Your child’s upper lip and nose will have stitches where the cleft lip was repaired. It is normal to have swelling, bruising, and blood around these stitches.
Cleft palate procedure
The repair of a cleft palate requires careful repositioning of tissue and muscles to close the cleft and rebuild the roof of the mouth. Incisions are made on either side of the cleft and specialized ﬂap techniques are used to reposition muscle and the hard and soft components of the palate. The repair is then stitched closed, generally at the midline of the roof of the mouth, providing enough length of the palate to allow for normal feeding and speech development, and continued growth throughout life. Cleft lip and palate incisions can be closed with removable or absorbable sutures.
After the surgery for cleft palate
This surgery is usually more involved and can cause more discomfort and pain for the child than cleft lip surgery. Your child’s doctor may order pain medicine to help with this. As a result of the pain and the location of the surgery, your child may not eat and drink as usual. There will be some swelling at the surgery site, which will diminish substantially in a week.
Treatment after surgery
It is important to understand that while a cleft may be surgically repaired in a single surgery procedure, treating a child born with a cleft continues through adolescence and sometime even adulthood. As a child grows, secondary cosmetic surgery procedures to improve function and appearance may be required. The resulting external scars of a cleft repair are generally positioned in the normal contours of the upper lip and nose. Over time, these will fade and your child’s ability to grow and function normally will continue to improve.
Activity after surgery
Your child can walk or play calmly after surgery. He or she should not run or engage in rough play (i.e., wrestling, climbing) or play with “mouth toys” for one to two weeks after surgery. Your child’s doctor will advise you when your child can safely return to regular play. Follow-up with your child’s surgeon and the cleft team is very important. This will be discussed with you. Your child’s doctor will also be an important part of the child’s overall health management after the surgery.
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