Cleft Lip-Palate is one of the congenital anomalies that occur during the development of the fetus in the mother's womb. In the 4th and 6th weeks of the pregnancy process, the structure forming the lip is expected to unite. If this structure does not join, cleft lip is observed.
In the 8th-12th weeks of the pregnancy process, the structure forming the palate must come together. Cleft palate develops if this structure does not unite. In some people, both Cleft Lip and Cleft Palate problem may occur at the same time.
Cleft Palate and Cleft Lip; Problems of non-union of the palate and the structure that make up the lip may occur in different ways.
•Unilateral Cleft Lip - Complete (complete)
• Unilateral Cleft Lip - Incomplete (incomplete)
p>• Bilateral Cleft Lip - Complete (complete)
• Bilateral Cleft Lip - Incomplete (incomplete)
• Unilateral Cleft Palate - Complete (complete)
• Bilateral Cleft Palate - Incomplete (incomplete)
Lip Halves can be in the form of a slight notch, as well as Cleft Lips extending to the lip, nose and even the palate. observable. Cleft lip and palate may occur due to genetic factors, or in some cases, as a part of a pregnancy-related syndrome or due to other pregnancy anomalies.
When is Lip-Palate Cleft Surgery Performed?
Cleft Lip surgery in the early period (after the baby is older than 2-3 months); Cleft palate surgery is ideal to be planned in the future (after the baby is 6 months old). In both surgeries, the important criteria are that the blood values, weight and development of the baby have reached a level that will not pose a risk in terms of surgery, and that there are no factors that may cause problems in receiving anesthesia. Alveolar cleft operation is performed at approximately 11-12 years of age.
Cleft Lip - Palate requires a new planning regarding the feeding of the baby. In the feeding process, since the sucking function will be insufficient in babies diagnosed with cleft lip and / or cleft palate; baby lap It should be fed with a spoon or special bottles.
In the feeding of babies with cleft palate, feeding can be provided by using an intraoral obturator.
The negative effects of cleft palate on speech functions can be provided. It is important to correct it before the speech starts (at least 18 months) due to its effect.
How is Lip-Palate Cleft Surgery Performed?
Lip - Palate Cleft surgery is performed under general anesthesia, in a hospital environment, in a multidisciplinary procedure. It is performed by the team.
It takes 2-3 hours on average, depending on the duration of the surgery, the size of the cleft and the scope of the surgery to be performed.
In Cleft Lip Surgery;
• The area where the cleft lip occurs, the muscles in the area, the skin and the lip mucosa are repaired.
• If there are spaces in the inner part of the lip extending into the nose,
• The opening at the base of the nose is closed,
• If there are clefts in areas such as teeth, gums and dental beds, these areas are also repaired during surgery.
Cleft lip surgery begins with an incision extending from both sides of the cleft to the nostril. The dark pink part that forms the slit is turned inside through these incisions. The cleft is repaired by closing the muscle, skin and lip mucosa respectively. Since the preferred sutures are usually self-dissolving sutures, there is no suture removal. The lip area is closed with the help of sterile strips and dressing is done. If necessary, small tampons can be placed inside the nose.
In Cleft Palate surgery;
• Cleft Palate surgery is performed using a special mouth opener. .
Cleft palate surgery begins with an incision on both sides of the cleft on the midline on the roof of the mouth. The palate is closed with the tissue brought over the cleft area, and the muscle in the soft palate is repaired.
A palate long enough for proper speech and swallowing is formed. Since the preferred sutures are usually self-dissolving sutures, there is no suture removal. Control bleeding in the palate with a cellulose dressing pad� �r.
After Cleft Lip-Palate Surgery
After Cleft Lip-Palate Surgery a one or two night hospital stay is given. In this process, the baby is supported by intravenous nutrition.
After the surgery, the suture and suture area should be kept hygienic, and fingers should not be inserted into the operation areas and mouth. For this reason, the baby will need to wear gloves and use special armbands that prevent bending of the elbows after the surgery.
After cleft palate surgery, the baby should be fed on the lap and with a spoon. Care should be taken to keep the oral wound area clean by drinking water after each meal. Liquid nutrition is foreseen for an average of 2-6 weeks. After cleft lip surgery, liquid nutrition can start at the end of 1-2 days following surgery. Before the transition to liquid nutrition, which is foreseen in both surgeries, a clear diet is applied.
The risk of scarring after cleft lip-palate surgery is high. Especially after cleft lip, scarring is inevitable. The aesthetic and plastic surgeon will plan your treatment and follow-up process in a way that will provide the optimum result in this regard.
Nasal deformation after cleft lip and palate surgery is also one of the complications that are often observed.
Read: 0
