How to treat cleft lip and palate
How to treat cleft lip and palate
Children with cleft lip or palate may need several treatments. They are treated during the growing season. Cleft lip and palate are usually treated with surgery, but other treatments such as speech therapy and dental and orthodontic treatment may also be needed to relieve the symptoms.
Lip repair surgery
Lip augmentation surgery is usually performed around three months of age. In this surgery, general anesthesia is used and then the cleft lip is carefully closed with repair sutures.
To repair the cleft lip, the surgeon makes an incision on one side of the cleft from the mouth to the nostril. The purpose of lip restoration is to create a structure that has a natural function and shape.
Normal anatomical features such as the upper middle lip, lip line, nostril floor, and annular muscles around the lip are also restored. The muscle in the central part of the upper lip in the bilateral lip cleft must move properly, and this is very important.
The surgeon then lowers the dark pink outer part of the cleft and pulls on the muscle and lip skin to close the cleft. Muscle function and the arch shape of the mouth are also restored. Perforation of the nostrils is also often seen in patients with cleft lip and palate, which must be corrected as the lip is repaired.
Surgery may take an hour or two. Most children stay in the hospital for a day or two. If absorbable sutures are not used, the sutures will be removed after a few days.
A small scar may remain on the upper lip, but the surgeon tries to hide the scar in the natural folds of the lip. Over time, the effect will fade and become less obvious.
Com restoration surgery
Surgery to repair the palate is usually scheduled at 6 to 12 months of age. In this operation, the empty space in the roof of the child's mouth is closed and the muscles and the covering layer of the roof of the mouth and on it are covered, and then the wound is closed with absorbable sutures.
The cleft palate may extend completely from the front to the back of the mouth.
In this cleft, like the cleft lip, one or both sides of the roof of the mouth may be open. Soft palate may be operated on at the same time as lip repair.
Hard palate is operated on when the child is older and the teeth are protruding, as this prevents the growth of teeth and maxillary growth.
To repair the cleft palate, the surgeon makes an incision on both sides of the cleft and draws the tissues on both sides along the midline of the roof of the mouth and on the cleft.
In this way, the palate is regenerated and the muscles on both sides are joined. So from now on the child can talk and eat normally.
The palate repair surgery usually takes two hours and is performed under general anesthesia. Most children stay in the hospital for one to three days. The scar is inside the mouth and cannot be seen.
Alveolar bone graft (jaw)
Children with cleft lip and palate, which also includes the alveolar arch cleft, should have a bone graft to maintain their arch and allow teeth to grow in this area.
The timing of this surgery varies, but it is done around the age of six or eight. An X-ray is first taken of the mouth to determine the growth status of the permanent teeth.
After the dental team aligns the dental tissue or closes the cleft lip, the canine bone sponge is placed in the jawbone.
The child usually stays in the hospital overnight to make sure he or she is getting enough fluids and is in stable condition. Uncomfortable thigh pain and unwillingness to walk are common in these conditions.
A soft diet and restriction of strenuous activity for up to 10 days are recommended.
Other surgeries required
Gingival repair using bone grafts is usually done around the age of eight to twelve.
Improving the shape and function of the lips and palate may be considered if the initial surgery site is not well healed or if there are speech problems.
Improve the shape of the nose with rhinoplasty
Improving the shape of the jaw (some babies born with cleft lip and palate may also have problems with the lower jaw)
Solve nutritional problems in children with cleft lip and palate
Many children with this condition can not breastfeed easily because the gap in the roof of their mouth prevents them from sucking enough into their mouth, so a lot of air and milk gets into their nose.
These children have difficulty gaining weight in the first few months of life.
The specialist can teach parents alternative ways to feed the baby. If breastfeeding is not possible, it may be advisable to pour breast milk into a flexible bottle designed specifically for cleft palate children and give it to the baby.
In rare cases, the baby may need to be fed through a tube inserted into the nose until reconstructive surgery is performed.
Solve hearing problems in children with cleft lip and palate
In these children, fluid is more likely to accumulate inside the ear. This is because the muscles of the roof of the mouth are attached to the middle ear, and if they do not work properly due to the cleft palate, the sticky secretions of the ear can accumulate inside it and make hearing difficult. A hearing tests should be performed regularly to check for any hearing problems.
Hearing problems may improve after cleft palate repair. If necessary, a small plastic tube can be inserted into the tympanic membrane to help drain the fluid and eliminate this problem. Sometimes hearing aids may be recommended.
If the cleft palate also involves the gums, the teeth are usually crooked on one side of the cleft and protrude out of place. Often one tooth does not protrude or extra teeth may grow.
The pediatric dentist monitors the health of the child's teeth and, if necessary, performs the necessary treatments.
Orthodontic treatment may be needed to help improve the alignment and shape of the teeth.
In this case, orthodontic brackets or other devices may be used to straighten and align the teeth. Orthodontic bracket treatment usually begins after all of your baby teeth have fallen out, but may be needed to repair the cleft palate before the bone graft.
Children with cleft lip and palate are prone to tooth decay, so it is important to strengthen their health habits and have dental checkups done twice a year.
Cleft palate repair significantly reduces the risk of speech problems in the future, but in some cases, children with cleft palate who have undergone reconstructive surgery may also need some form of speech therapy.
The speech therapist monitors and monitors the child's speech status. If there are any problems, the necessary steps will be taken to make the child speak clearly. Monitoring a child's speech continues into adulthood until help is needed.
Corrective surgery may be necessary for a small number of children who have a large stream of air passing through their nose when talking, leading to nasal congestion.