Cleft lip and palate are major birth deformities with worldwide prevalence, associated with definite clinical and psychosocial impact on the society. Cleft lip and cleft palate are openings or split in the upper lip, the roof of the mouth (palate) or both. They result when facial structures that are developing in an unborn baby don’t close completely. This deformity directly or indirectly affects the lip, palate, teeth, jaws, ear, nose and even majority of the face in severe cases. The human face has its own growth phase like the rest of the body and this is affected by the cleft condition, creating functional and esthetic challenges. The sequelae of the cleft can cause limitation in vital aspects like airway, sucking, feeding, speech, etc which are detrimental to the child’s social well-being. Thus, cleft surgeries are required at certain stages in accordance with the growth of the child and its needs.
What is the need for a cleft craniofacial team in cleft surgeries?
Because of the multi-faceted nature of this condition, expert team care required. A general cleft- craniofacial team consists of craniofacial surgeons, pediatricians, anesthesiologists, maxillofacial surgeons, ENT surgeons, speech therapists, audiologists, dentists, orthodontists. In this way issues with child care, general health, surgical anesthetic preparation and safety, cleft defects of the lip or palate or nose, bone grafting, hearing, speech, psychological and emotional status, dental problems and even teeth alignment are addressed as a whole.
The cleft craniofacial team for cleft surgeries:
Cleft Craniofacial Surgeon: In charge of planning, performing the majority of the surgeries which the patient may need. The surgeries performed include lip repair, palate repair, pharyngeal flap, alveolar bone grafting, nasal reconstruction, lip revision, orthognathic surgeries, and distraction osteogenesis.
Oral-Maxillofacial Surgeon: Treat defects and deformities of the jaws along with the cleft surgeon in procedures like bone grafting to the alveolar ridge (tooth supporting portion of the upper jaw) and orthognathic surgeries.
Pediatric Anesthetist: Specialized in pediatric anesthesiology. Provides definitive child safe anesthetic protocol for surgeries requiring general anesthesia.
Pediatrician: Child specialist, concerned with overall medical health of the child, fitness for surgery, development and growth needs.
ENT Surgeon: Few patients may have limitations in hearing, blockage of Eustachian tubes, recurrent ear infections which would require the expertise of an ENT surgeon.
Orthodontist: The orthodontist explains how the cleft affects growth and development of the face and teeth from birth to adulthood. Helps to diagnose and provide treatment for malaligned teeth.
Nurse: The nurse’s role is related to monitoring and taking care of the infant or the child in the pre and post-operative period. Awareness regarding feeding techniques and wound care.
Speech Pathologist: The speech pathologist evaluates speech, articulation, and language. Has a major role in speech evaluation and development before and after surgery.
Pediatric Dentist: Pediatric dentist provides comprehensive dental care to infants, children, adolescents, and young adults throughout their growth and development.
The best treatment of modality is a combined team effort.
It is essential that every cleft child is subjected to this complete range of facilities available to give the most favorable outcome. Each member of the team is involved in a coordinated treatment protocol for cleft patients. Here at Richardsons dental and craniofacial Hospital, we have a craniofacial team with experienced members, working tirelessly over the years with one believe that these kids should be no different than kids without clefts and so it’s our goal and aims to give them the same life which every non – the cleft individual has.