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A cleft is a split or gap in the upper lip, the roof of the mouth (palate), or both. A cleft lip may just occur on one side of the lip or both sides. It is one of the most common birth defects that affect children worldwide. It occurs when facial structures that are developing in an unborn baby do not close completely or join together correctly.
Cleft lip repair and cleft palate repair are the surgical procedures that can be used to correct this abnormal development. The procedures are intended to close the cleft defect, creating a more normal appearance, as well as to improve the child’s ability to speak, eat, breathe, and hear.
Cleft repair is based on your child’s particular situation. The repair plan can be tailored to meet the child’s individual needs. The repairs are typically carried out in the following order:
Cleft lip repair is performed within the first 3 to 6 months of age, depending on your child’s health status.
Cleft palate repair is performed in a separate surgery when the child is 12 months of age or earlier if possible.
During cleft lip or palate repair surgery, your child will be given a general anesthetic, so they will not be awake or feel any pain. Several different surgical techniques can be used to repair cleft lip and palate, reconstruct the areas, and treat or prevent related complications. In general, the procedures may include:
Cleft lip repair – to start the procedure, the surgeon creates incisions on both sides of the cleft and makes flaps of tissue. Then the surgeon stitches the flaps together, including the lip muscles. This will close the separation of the lip and create a more normal lip appearance. The surgery performed to close cleft lip repair is known as cheiloplasty. If your child needs nasal repair, the procedure can be carried out at the same time.
Cleft palate repair – surgery to repair cleft palate is called palatoplasty. During the surgery, the surgeon makes an incision on both sides of the cleft to reposition the muscles and tissue. Then, the repair is closed with stitches.
Most children need to stay in the hospital for 1 to 3 days after surgery; you can arrange to stay in the hospital with them during this time. Plan to stay in Buri Ram for at least 7 days, because the surgeon will schedule a follow-up checkup. During the checkup, your child’s healing will be monitored and the stitches will be removed.
It may take around a week after surgery for your child to get back to their usual behavior. However, the full recovery time after the incisions heals usually takes around 3 to 4 weeks. During the recovery period, your child may need to wear a lip guard and arm splints to protect the incisions while they heal.
Here are some ways you can care for your child at home:
Ensure your child gets enough sleep at night and rest as much as possible. However, allow them to gradually become more active.
Put your child to sleep on their back.
Do not use a pacifier or let your child put toys, hands, or other objects in their mouth.
The surgeon will give instructions for feeding your child. Make sure to follow it. You may need to use a special bottle to give your child breast milk and formula. You also need to give your child plenty of fluids.
Wash the area around the incision with clean water. Ensure to keep it clean and dry.
In some cases, your child may need additional surgery to improve the appearance of the lip, nose, and mouth, as well as to reduce the risk of chronic ear fluid. Your child may also need speech and language therapy. Make sure to discuss these additional surgeries with your child’s doctor.
Cleft lip and cleft palate repair are safe procedures with high success rates. However, there are some possible risks you need to be aware of. These include:
Irregular healing of scars
Asymmetries or residual irregularities in the lip or nose
Allergic reaction to general anesthesia
Damage to deeper structures, such as blood vessels, nerves, muscles, and auditory canal, which may be temporary or permanent.
There is currently no alternative to cleft lip or palate repair. These procedures are important for the development and quality of life of your child. You may have heard that nasoalveolar molding (NAM) is a non-surgical way to repair cleft lip or palate. The truth is, your child may still need to undergo surgery after using NAM as the device is meant to make the cleft less severe, decreasing the number of surgeries your child needs.
Before cleft lip or palate repair, your child may have hearing problems, dental problems, and speech problems. It may also be hard for them to feed on a normal bottle. After cleft lip or palate repair, these problems should improve. The procedures can enhance your child’s appearance, quality of life, and the ability to talk, eat, and breathe.
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