CLEFT LIP REPAIR
The term, cleft lip and palate, refers to a spectrum of congenital conditions that occur in the oral & nasal area. The most common presentation of this condition is involvement of both the lip and palate (technically cleft lip-alveolus-nose-palate) but it can also occur as an isolated cleft lip or an isolated cleft palate.
These common orofacial clefts occur in about 1 per 800 births but the frequency changes based on race. Interestingly cleft lip occurs more frequently in males while the isolated cleft palate is more common in females.
Cleft lip repair of a baby- Before and after surgery
The comprehensive management of cleft lip and palate continues until the child becomes a young adult. The various procedures are done for cleft lip and palate patients are
Primary cleft lip repair @ when 5kg body wt. is attained by the baby.
Primary cleft palate repair @ 10 months of age.
Speech evaluation at 3years of age and speech therapy might be started if needed.
Speech surgeries were done at an appropriate age for correction of nasal speech based on speech evaluation and speech therapy.
Secondary alveolar bone grafting will be done @ 8-9 yrs of age for the facilitation of eruption of permanent canine and lateral incisors.
Orthognathic surgeries for correction of cleft maxillary hypoplasia at a young adult stage.
A 4-month-old baby who was born with a right cleft lip and palate deformity came to our hospital (Richardson’s dental and craniofacial hospital). This baby also had the cleft of the alveolus on the right side and cleft involving the palate from the junction of hard and soft palate extending into the uvula. There was no prior history of facial clefts on either side of the parents. There was the history of consanguineous marriage.
Right cleft lip repair was done by Dr.Sunil Richardson and his team after the patient attained 5 kgs of body weight. Cleft lip and nose repair were done using a rotation-advancement technique under general anaesthesia. Continuity of the orbicularis muscle was established as well as rotating the medial lip element down and advancing into alignment the lateral lip element.
The foundation of the surgical treatment of cleft lip and palate is the initial cleft lip repair. It sets the tone for how the eventual facial result can look but a lot of facial and oral development, as well as other surgeries, will take place before the ‘course’ is completed.