Cleft commonly refers to a division and is a rare anomaly which develops during the developing stage of an embryo (a child in the womb) where the two structures are supposed to fuse. Cleft lip and cleft palate are such fusion defects where either the lips do not fuse or the roof of the mouth is open making it a direct communication with the nose and the sinuses. Cleft palate and repair can be corrected at a very early age and do no cause grave complications. Since it is a developmental anomaly it is highly expected of the parents to be aware of it and get their child treated at the earliest.
How does a cleft lip and palate affect a child ?
A cleft lip or a palate does not give a pleasing appearance and at the same time various day to day activities are affected if the problem is not corrected at an earlier age. Hence the cleft lip and palate repair is essential to improve aesthetics as well as functionality thereby improving the day to day life.
What are the causes of cleft lip and palate ?
Cleft lip and palate are developmental disturbances and hence are associated with genetic and environmental conditions. Few of the commonly associated causes are mentioned as under.
- A genetic predisposition to cleft lip and cleft palate
- If the pregnant mother smokes cigarettes or consumes alcohol, the incidence of the child developing cleft lip and cleft palate are higher
- Use of certain drugs during pregnancy
- Males are slightly more affected as compared to women
- Rare causes include uncontrolled gestational diabetes and obesity during pregnancy
These above mentioned are the incidences when there’s an increased chance of the child to be affected with cleft lip or cleft palate or both, but there might be cases where the exact cause of the clefting is not known. Ask your treating physician or consultant for the common causes of cleft lip and palate.
Do cleft lip and cleft palate always occur together ?
No, cleft lip and cleft palate are two different anomalies and can sometimes occur synchronously. Cleft lip can occur as a small groove on the upper lip or a complete separation of the right and left of the lip at the philtrum (below the nose), making a direct communicating passage between the nose and the mouth.Cleft palate on the other hand could be because of the failure of fusion of the developing structures which form the future maxilla (upper jaw) and the roof of the mouth, thereby there is a communication passage created between the nasal cavity and the mouth.Cleft lip and cleft palate can occur together affecting either only one side or both the sides.
What complications are associated with cleft lip and cleft palate ?
A child who is born with cleft lip and/or cleft palate defect are prone to serious complications and hence the treatment of the same is required at the earliest. Complications are associated with difficulty in feeding, swallowing, speech, development of teeth and these children are more prone to ear infections as well which can lead to partial or total hearing loss.
How is a cleft lip and cleft palate diagnosed ?
A cleft lip and a cleft palate is usually obvious or evident at birth or during the later stages of embryonic development by advance ultrasonography. If you have a family history of cleft lip and cleft palate it is advised to go for a genetic counselling before you conceive or plan a baby. If you are pregnant and have the fear of your child being born with a cleft condition, advanced ultrasonography and tests of the amniotic fluid can be done to identify the defect. It is very difficult to control the defect if already present when the child is developing in the womb, but can be corrected with a safe timeline after the child is born to improve the overall quality of life of the child.
What is the time when cleft lip and palate can be repaired ?
Cleft lip and cleft palate are either diagnosed before birth or after birth, hence immediate treatment planning, counselling of the parents is very essential to help the child in leading a normal life, as these anomalies affect the day to day activities and overall development of the child. In most of the conditions a cleft lip repair is done between one year of the age when the child is born and a cleft palate repair is done between one year and sex months or earlier. The more the treatment is delayed the more the complications. Apart from the cleft repair surgery your child might also require follow up surgeries (plastic surgery to improve aesthetic appearance) or hospital visits to correct any speech problems, hearing problems if any.
Who performs a cleft lip and cleft palate repair ?
Cleft lip and cleft palate repair are complex procedures which require close monitoring by a team of your gynaecologist and obstetrician, oral surgeon, a pediatric dentist (a pedodontist), an orthodontist (one who specialises in correction of the way our teeth and jaws function), a prosthodontist ( a specialist who specialises in giving your child retainers to help in feeding and swallowing) and a plastic surgeon to help in improving the appearance of your child once the functional issues are corrected.
Is the cleft lip and cleft palate repair surgery performed under anesthesia ?
Yes, the cleft repair surgeries are major surgical procedures and are performed under general anaesthesia and sedation if required. Ask your treating surgeon about the details on the type of anaesthesia which will be suitable for your child.
What happens during a cleft lip and cleft palate surgery ?
After the administration of anaesthesia the cleft lip repair is performed by giving an incision and closing the bridge between the two ends of the lips which failed to fuse with stitches. Sometimes soft tissue flaps may be used if the gap is very large. During a cleft palate repair several techniques are used to correct the bony defect to close the roof of the mouth and cover it with a soft tissue flap. Cleft palate repair is a more complex procedure and the type of procedural technique used depends on the type and the extent of the defect. It is essential to ask your surgeon about the type of procedural technique which will be used for your child. Sometimes nasal repair and ear surgeries are also performed along with the cleft repair to improve the overall functionality. The duration of the procedure again depends on the gravity of the defect and the type of technique used.
What happens after the cleft lip and cleft palate surgery ?
After the surgery is completed, your child will be kept under observation for at least a week to ten days. The doctor will give you strict instructions which need to be followed at home related to activity and diet to aid in faster recovery. Routine follow up visits are highly recommended to see the outcome of the surgical repair and manage any complications. Also if any further therapy or surgery is required, counselling might be done for the same.
What are the risks and complications associated with a cleft lip and cleft palate repair surgery ?
Like any other surgery, complications may be related to the anaesthesia, such as breathlessness, gastric upset, headache and vomiting sensation. Complications related to the surgical procedure as such include bleeding, infection at the surgical site or need for a second surgery if the second surgery was not successful in completely correcting the cleft. Occasionally the surgery might affect the normal development of teeth and jaws leading to severe dental problems.
What is the outcome of a cleft lip and cleft palate surgery ?
A child born with a cleft lip and cleft palate is of major concern for the parents and the family. It is very essential to seek the right counselling and plan the right treatment for your child at the earliest. This developmental anomaly usually disheartens and saddens many parents, but it is a treatable condition and hence it is very important for the parents to be understanding and open about any procedural discussion with the treating doctors. As mentioned earlier the surgeries are successful when the treatment is well planned and is done is at the right time.
How to find plastic surgeons for cleft lip surgery ?
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Find and choose a plastic surgeon for cleft lip surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
