Cleft Lip and Cleft Palate

Cleft Lip and Cleft Palate

CLEFT LIP:

Cleft lip is a physical split or separation of two sides of the upper lip and appears as a narrow opening or gap in the skin of upper lip. This separation often extends beyond the base of the nose and includes the bones of upper jaw or upper gum.

CLEFT PALATE:

Cleft palate is a split or opening in the roof of mouth. Cleft palate can involve the hard palate (the bony front portion of the roof of the mouth) and the soft palate (the soft back portion of the roof of the mouth).

Cleft Lip and Cleft Palate - Overview

CLEFT LIP:

Cleft lip is a physical split or separation of two sides of the upper lip and appears as a narrow opening or gap in the skin of upper lip. This separation often extends beyond the base of the nose and includes the bones of upper jaw or upper gum.

CLEFT PALATE:

Cleft palate is a split or opening in the roof of mouth. Cleft palate can involve the hard palate (the bony front portion of the roof of the mouth) and the soft palate (the soft back portion of the roof of the mouth).

Cleft lip and cleft palate can occur on one or both sides of the mouth, because the lip and the palate develop separately. It is possible to have a cleft lip without cleft palate and a cleft palate without cleft lip, or both together.

Cleft Lip and Cleft Palate - Symptoms

  • Cleft lip or cleft palate occurs mostly in new born babies, it develops at the time of pregnancy (early stage of pregnancy) when formation of features of the baby starts.
  • Cleft lip or cleft palate can be confirmed after a child’s birth, by physical examination of the mouth, nose and palate.
  • Main symptom of cleft lip and cleft palate is opening in the mouth.
  • Opening leads to many difficulties, like:
  • Difficulty with feeding
  • Difficulty in swallowing
  • Nasal speaking voice
  • Chronic ear infections

Cleft Lip and Cleft Palate - Pre-Procedure

  • Best time suggested by doctors for surgery of cleft lift is 3-6 months of age and for cleft palate is 12-18 months of age.
  • Before the surgery child should free from cold and cough, chicken pox and other viral infections.
  • In some cases child may need to undergo surgery again, when cleft palate splits again during the healing process.
  • Surgical technique for cleft lip or cleft palate will be decided according to cleft of the patient at the time of consultation with the doctor.

 

Cleft Lip and Cleft Palate - During Procedure

  • Surgery will be performed under general anaesthesia.
  • Stay in hospital depends on the surgery, generally it is 2-4 days.
  • Duration of the surgery to close cleft lip or cleft palate can take between 2-3 hours, depends on the type of cleft, one sided cleft (unilateral) or two sided cleft (bilateral), or whether the nose is also affected or not.
  • Surgery will be performed by using local tissues from either side of the mouth to rebuild the palate. There will be no skin grafting.
  • Initial stage of the surgery is to create a functional palate, which reduces the chances of fluid developed in middle ears, and helps to develop teeth and facial bones properly.
  • Incisions will be made on either side of the cleft to create flap of skin, muscle and intraoral tissue that will be drawn together and stitched to close the cleft and recreate typical lip and nose anatomy.
  • The repair of cleft lip or cleft palate requires careful repositioning of tissues and muscles to close the cleft and rebuild the roof of the mouth.
  • After repairing cleft lip or cleft palate, incisions will be closed with removable or absorbable sutures.

Cleft Lip and Cleft Palate - Post-Procedure

  • Child may be irritable after the surgery.
  • Stitches will either dissolve or will be removed after 5-7 days of surgery.
  • Scar will gradually fade but will never disappear completely.
  • Swelling, bruises and bleeding near the stitches is normal.
  • Child should not use straw or pacifier for few days after surgery.
  • Child should not play with mouth toys or engage in rough play for 1-2 weeks after surgery.
  • Do not touch surgical area for at least 3 weeks after the surgery.
  • Within first week of surgery, only give liquid food to the baby, in second week give soft diet that contains of food that melt in the mouth like, pudding, custard, and in third week normal food can be given.

Cleft Lip and Cleft Palate - Risk & Complications

  • Difficulty in feeding for long period after the surgery.
  • Ear infections and hearing loss.
  • Bleeding
  • Poor healing of incisions
  • Irregular healing of scars including shortening, thickening or overgrowth.
  • Asymmetries in the lip or nose.
  • Respiratory problems after surgery
  • Damage to deeper structures, such as nerves, blood vessels, muscles and auditory canal can occur and may be temporary or permanent.
  • Possibility of revision surgery.

Cleft Lip and Cleft Palate - Doctors

Dr. Amitabh Singh
Dr. Manik Sharma

Cleft Lip and Cleft Palate - Hospitals

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