How do cleft lip and palates develop?
Cleft lip andpalates developduring the early period of development in mother’s womb. Both sides of the lips and palate are normally formed together. However, in one child born out of 800, these parts of the body do not combine. If the combination does not happen in the upper lift, it is called as “Cleft Lip”and if it happens in the palate, it is called as “Cleft Palate.”
In what kind of forms cleft lip can be seen?
The non-combination of lip and palate arches can be seen in different forms. These are:
- Complete cleft lip one sided
- Complete cleft lip double sided
- Incomplete cleft lift one sided
- Incomplete cleft lip double sided.
These forms can be seen as one sided and double sided.
In what forms cleft palate can be seen?
- Incomplete cleft palate
- Complete cleft palate
In what situations cleft lip and cleft palate can be seen together?
Lip clefts and palate clefts can happen separately, but most of the time, the two happen together. Complete or incomplete palate and lip clefts can be seen as one sided or double sided.
When are the cleft lip and cleft palate surgeries performed?
Cleft lip and cleft palate surgeries do not have a time limitation. Doctors can decide on the surgery time according to the severity of the cleft, treatments that may help before the surgery, baby’s blood chart and weight. When all these parameters are taken into consideration, the best time for the surgery is the first three months and as soon as possible, while the palate surgery is between the first 10 and 18 months before the infant start to talk, which is a suitable period for the child.
How should the surgery be planned?
In your first appointment with your plastic surgeon, your surgeon will give detailed information about the surgical method that will be applied. Information about the place where the surgery will be made, the type of anesthesia that will be used, probable risks and complications will be given. Moreover your plastic surgeon will answer the questions about how you can feed your baby before and after the surgery.
How is the cleft lip surgery done?
Cleft lip anomaly can happen in different modes from a little crenation in the red part of the upper lip to a cleft on the upper lift going towards inside of the nose. Cleft can be on one or double side of the lips. During the cleft lip surgery, the surgeon will make a cut in the both sides of the clefts towards the nostril. The surgeon will turn the dark pink part inside and via closing the muscle and skin layers, the surgeon will fix the cleft. Thanks to this, the embowed shape of the lip and the muscle functions will be provided. The problems in the nostrils can be fixed in the first surgery or in another surgery. However, creating the symmetry may need more than one surgery.
How is the recovery period after the cleft lip surgery?
After the surgery your child may feel uneasy, but your surgeon will give the proper medicines for that. You may have your child worn gloves so that she or he does not play with the stiches and elbow holders can also be necessary. If the sore is closed with medical dressing, this will be opened in one or two days. The stiches will be taken off on the seventh day. The surgeon will tell you how to feed your baby in the earlier weeks. In a few weeks just after the surgery, the swelling and the reddish structure of the scar are normal. After a while, it will decrease but it will not disappear completely. However, in most of the children it will not show off between the shadow of nose and the lip.
How is the cleft palate surgery done?
Cleft palate anomaly can happen in some children as thinness behind the palate, while in others a whole cleft through the palate can be seen. As it happens in the cleft lip, the cleft palate can be one sided or double sided. The fixation of the cleft palate needs a more complicate surgery and it is done between 10-18 months after the birth, which is the suitable time to tolerate the surgery. Doing the surgery before the infant starts talking is better. It will help the infant speak easily.
During the surgery, the surgeon will cut along both sides of the cleft. The surgeon will bring tissue from both sides on the palate to the cleft in the middle. This process will close the palate, fix the muscle on the soft palate and will create a suitable palate to speak and swallow properly.
How is the recovery period after palate surgery?
Your child may have some pain which can be resolved by drugs easily within first two days after the surgery. She/he may not desire to eat or drink something, therefore, intravenous supportive fluid treatment would be applied. You may need to make your child wear gloves and elbow holders to prevent your child to touch the sutures. Your surgeon tells you how to feed your child during first weeks. The important issue is that you should follow instructions of your surgeon strictly to prevent recovery problem in the palate.
Do the children with cleft palate suffer from ear problems?
Children with cleft palate are susceptible for ear infections because the cleft affects the middle ear. Ear-nose-throat specialist in the team may suggest placement of special plastic tubes into the ear drum to provide drainage and aeration required.
What are late term treatments for the children with cleft palate and cleft lip?
Children with cleft lip and palate may need to have additional operations until 18-20 years of age to normalize lip and palate structures and tooth arcs as much as possible after their first surgery to close the cleft. Such children have a surgery to direct their nose cartilages during 3 to 5 years of age and bone grafting during 8 to 10 years of age if problems occur on tooth arches and a final nose aesthetics about 18 years of age.