What is a cleft lip and palate ?
During gestation, the left and right portions of a foetus'' lip and roof of the mouth usually unite under normal development. Sometimes, this does not happen and the reason for this abnormality is not fully understood yet though it has been found that smoking during pregnancy can double the risk.
A baby born with a separation in the upper lip is said to have a cleft lip. A similar separation in the roof of the mouth is called a cleft palate.
What happens during surgery ?
A cleft lip can range in severity from a slight notch in the red portion of the upper lip to a completion of the lip extending into the nose.
Surgery is usually performed when the child is 10-12 weeks old. The surgeon will make an incision on either side of the cleft from the mouth into the nostril. The outer portion of the cleft will be turned down while the muscle and skin of the lip will be pulled together and stitched up to close the separation. The fold of the upper lip and normal muscle function will be restored in the process. As for the nose defect, it may be corrected during the same surgery or in another procedure.
The cleft palate is normally repaired when the baby is 9 months old. During the surgery, an incision will be made on both sides of the cleft. Tissue will then be shifted from each side to the center of the palate and muscle will be joined together.
What are the risks and complications ?
The most common problem is asymmetry in the upper lip or nose. The repaired cleft lip in an adult becomes an uneven upper lip. There will also be a scar that extends from the upper lip to the nose. A second operation may be necessary to improve the appearance.
In the cleft palate surgery, poor healing and a nasal quality in speech after surgery may call for another procedure.
What happens after surgery ?
For young children, elbow restraints will be used for a few weeks to prevent them from scratching the stitched area. Stitches in the mouth will dissolve on their own and those on the skin will be removed in 5 days.
Any soreness or pain experienced can be effectively controlled by the medications prescribed. Solid food will have to be substituted by a liquid diet for a few weeks and intravenous fluids will be given to maintain body fluid levels.
The child will need long term speech and dental therapy treatments as he or she grows up.