How to correct cleft lip and cleft palate?
Cleft lip and cleft palate 1 Ultrasound before birth. A prenatal ultrasound is a test that uses sound waves to create pictures... 2 Surgery. Surgery to correct cleft lip and palate is based on your child's particular situation. 3 Treatment for complications. Your doctor may recommend additional treatment for complications caused...
How are ear tubes used to treat cleft palate?
For children with cleft palate, ear tubes may be placed to reduce the risk of chronic ear fluid, which can lead to hearing loss. Ear tube surgery involves placing tiny bobbin-shaped tubes in the eardrum to create an opening to prevent fluid buildup. Surgery to reconstruct appearance.
What are the morphological alterations caused by the cleft palate?
The morphological alterations caused by the cleft are related to its severity and classification. A newborn with a unilateral CLP will present extraorally with the nasal alar cartilage on the side of the cleft displaced and flattened, and the tip of the nose deviated toward to the non-cleft side ( Fig. 1A ).
What is prosthodontic treatment for children with cleft palate?
Prosthodontic treatment involves providing an artificial plate which can be fitted to the teeth. This will be prepared by taking an impression of the palate and a plate which will be provided with the clasps (wires). If speech therapy is provided after prosthesis fitting, it may be showing some improvement in child’s speech.
What is the repair technique for a cleft palate?
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 the tissues of the hard and soft palate.
How do you care for a baby after cleft palate surgery?
Drinking and EatingGive soft, pureed or mashed foods for 3 weeks. ... Do not give foods that have chunks, lumps or pieces, such as seeds, grains, pulp or skin.Do not give hard, crunchy foods such as cold cereal, cookies, crackers or chips.Use only a spoon for feeding.Do not let your child feed themself.More items...
Which is the best time to surgical repair of cleft palate?
Palate repair surgery is usually done when your baby is 6 to 12 months old. The gap in the roof of the mouth is closed and the muscles and the lining of the palate are rearranged. The wound is closed with dissolvable stitches. The operation usually takes about 2 hours and is done using a general anaesthetic.
How long does it take for a cleft palate repair to heal?
Most children are back to their usual behaviour about a week after surgery. It usually takes about 3 to 4 weeks for the incision to heal. Your child may need to wear padded arm splints for 1 to 2 weeks after surgery to prevent rubbing the surgery area.
How does a baby eat with cleft palate?
They usually can breastfeed or use a regular bottle-feeding system. The only change needed might be positioning the nipple so the baby can latch. If you're breastfeeding your baby, try changing the feeding position so that your breast fills the cleft.
How do you clean a cleft lip?
Wash the area daily with plain, warm water, and pat it dry. Other cleaning products, such as hydrogen peroxide, can make the wound heal more slowly. Do not use antibiotic ointments on the incision unless your doctor has told you to. Keep the area clean and dry.
What is the rule of 10's in treating cleft deformity?
This is frequently referred to as the “Rule of 10s” (10 weeks old, weight of 10 pounds and 10 grams of hemoglobin). Repair before age 1 is generally thought to produce the least visible scar.
Can cleft palate babies speak?
Many children with cleft lip and/or palate develop normal speech with no need for help from the speech and language therapist. However, others may develop speech problems recognised by the speech and language therapist as being related to the cleft.
At what age is a cleft lip repaired?
The cleft lip usually is corrected early in a child's life, between 3 to 6 months of age, but sometimes later. Cleft lip surgery will correct the cleft and usually will leave minimal scarring. Virtually every child born with a cleft lip is able to lead a healthy, happy life once the cleft has been repaired.
Is cleft lip/palate a disability?
FACT: A cleft is not a 'disability'. It may affect a child in ways that mean they need extra help, but most children with a cleft are not affected by any other condition and are capable of doing just as well at school as any other child.
What are the complications after cleft palate repair?
Surgical repair of cleft palate is associated with three major long-term complications: palatal fistula, velopharyngeal insufficiency (VPI), and midface hypoplasia—which could be considered also as metrics and quality indicators [6, 7].
How do you feed a baby after cleft lip and palate repair?
Feeding will be not be easy for your baby for a few days after surgery. Her lip will be swollen, numb and uncomfortable so small feedings more often may help. Try comforting your baby by talking, singing, and rocking during feedings. You can bottle or breastfeed your baby.
How to repair a cleft palate?
Cleft palate repair. Various procedures may be used to close the separation and rebuild the roof of the mouth (hard and soft palate), depending on your child's situation. The surgeon makes incisions on both sides of the cleft and repositions the tissue and muscles. The repair is then stitched closed. Ear tube surgery.
What is the procedure for cleft palate?
Ear tube surgery. For children with cleft palate, ear tubes may be placed to reduce the risk of chronic ear fluid, which can lead to hearing loss. Ear tube surgery involves placing tiny bobbin-shaped tubes in the eardrum to create an opening to prevent fluid buildup. Surgery to reconstruct appearance.
How to close a lip separation?
To close the separation in the lip, the surgeon makes incisions on both sides of the cleft and creates flaps of tissue. The flaps are then stitched together, including the lip muscles. The repair should create a more normal lip appearance, structure and function.
What is the procedure to correct a cleft lip?
Surgery to correct cleft lip and palate is based on your child's particular situation. Following the initial cleft repair, your doctor may recommend follow-up surgeries to improve speech or improve the appearance of the lip and nose.
How does surgery help cleft lip?
Surgery to repair cleft lip creates a more normal lip appearance, structure and function. Surgery is done in a way to minimize the appearance of the scar. The scar will fade over time but will always be visible.
When is cleft lip surgery performed?
Surgeries typically are performed in this order: Cleft lip repair — within the first 3 to 6 months of age. Cleft palate repair — by the age of 12 months, or earlier if possible. Follow-up surgeries — between age 2 and late teen years. Cleft lip and palate surgery takes place in a hospital.
How can surgery improve your child's appearance?
Surgery to reconstruct appearance. Additional surgeries may be needed to improve the appearance of the mouth, lip and nose. Surgery can significantly improve your child's appearance, quality of life, and ability to eat, breathe and talk.
What are the complications of cleft palate surgery?
Any surgery has potential complications. The repair of a cleft palate is no different. The major potential problems following surgery include: 1 Breathing difficulty due to swelling in the mouth 2 Bleeding 3 Early or late separation of the repaired palate 4 Infection 5 Scarring
What is the goal of a palate repair?
The major goals of surgery are to: Close the gap or hole between the roof of the mouth and the nose. Reconnect the muscles that make the palate work. Lengthen the repaired palate so it can function properly. Surgeons use many different techniques to accomplish these goals.
What happens after a child's palate is fixed?
After the palate has been fixed, most children will immediately have an easier time swallowing food and liquids. But in about 1 out of every 5 children, a portion of the repair will split, causing a new hole to form between the nose and mouth.
How is the success of speech surgery judged?
Because of the importance of the palate in producing normal speech, success of the surgery is judged by how well the child develops speech patterns afterwards. The child should be assessed at yearly intervals by a trained speech and language pathologist.
What is a small hole in the nose called?
If large, it can cause significant eating problems and, most importantly, can affect how the child speaks. This hole is called a “fistula”, and may need further surgery to correct.
Can a cleft in the jaw grow in?
Teeth may not grow in properly or some may be missing altogether. Depending upon the severity of the cleft, some children will need orthodontic treatment to correctly line up their teeth, and some may need more surgery to replace the missing bone where the cleft splits the upper jaw bone.
What is cleft lip?
Introduction#N#Cleft lip and/or palate is one of the most common congenital anomalies affecting the craniofacial structures. 1,2 These anomalies are considered a relevant public health issue by the World Health Organization3 due to its effects on facial aesthetics, function and psychosocial challenges for the child as well as for the social and financial burden for the family. 1 The incidence of cleft lip and palate is not uniform and varies according to different ethnicities. The global average is approximately one in every 700 newborns. 1,4 Increased rates have been reported for Native American and Asian populations at 1 in 500 births. European-derived populations present intermediate prevalence rates at 1 in 1000 and the lowest rates were reported for African populations at 1 in 2500 births. 4,5
What is the orofacial cleft?
Orofacial clefts are a collection of conditions that includes: clefting of the upper lip, the maxillary alveolus (dental arch), and the hard or soft palate, in various combinations. The anatomic combinations include: Clefting of the lip and/or alveolus can occur either unilaterally (one-side) or bilaterally (both sides).
Where is the median portion of the lip located?
The median portion of the lip is isolated in the midline and remains attached to the premaxilla and to the columella. The premaxilla typically protrudes considerably forward of the facial profile and the nasal chambers are in direct communication with oral cavity.
Is the palatal segment on the side of the cleft tilted medially?
Intraorally there will be separation of the palatal shelves to various degrees, and the palatal segment on the side of the cleft is often tilted medially and superiorly. There is also a direct communication between the oral and nasal cavities on the affected side of the palate.
What are the problems with cleft lip and palate?
Children with cleft lip and palate exhibit multiple issues like feeding problems, delayed speech and language skills, misarticulation, dental problems, psychological problems, etc. Hence the testing and treatment of children with cleft lip and palate requires a team of professionals who are expert in the field. The multidisciplinary team includes:
How long does it take to get a cleft lip removed?
Information regarding timing of surgery will be provided by the plastic surgeon. Usually, surgery for cleft lip is recommended when the infant is around 3-6 months. The surgery takes around an hour. After the surgery, the child will be monitored under the supervision of doctors for a day. After the child’s condition is stable, the child will be discharged from the hospital. Sometimes, along with cleft lip, nasal problems are also seen which will be corrected during surgery of the cleft lip.
How to help a child with open mouth?
Always keep in mind to talk slowly and with open mouth. This will help the child to follow you and to talk slowly. If the child is making an attempt to talk slowly and with open mouth, appreciate the attempt and reinforce your child. This will improve the clarity of speech and others can understand child’s speech.
Can cleft palate cause speech problems?
Children with cleft lip and palate may also have associated dental problems like missing teeth, mal-alignment of teeth, malocclusion of upper and lower teeth, etc… This can be treated by an orthodontist. Sometimes the dental problems may lead to speech problems. The correction of dental anomalies positively influences speech.
Is it a parent's responsibility to make sure that the environment is apt for the child to develop speech
It is every parent’s responsibility to make sure that the environment is apt for the child to develop speech and language. The children should be provided with adequate speech and language stimulation at home. Parents should always keep in mind that the improvement in speech and language skills of the child will not be noticed immediately after the surgery. The surgery will just correct the structural defects and not the function (movement of the soft palate) of the structure.
