Complications and treatment of cleft lip and cleft palate

What are complications of a cleft lip and cleft palate?

There are a number of complications that may affect infants and children with cleft lip and palate. These include the following:

1. Feeding problems: Because of the anatomical defects, it may be very difficult for newborn infants to breast feed successfully. The abnormal separation of the upper lip makes it very difficult for the newborn to obtain a good seal that is necessary for a successful nursing experience. Routine nipples for bottle-feeding present the same problem; however, specialized bottles and nipple systems exist that facilitate effective nutrition. Those children with a cleft palate are commonly fitted with a removable artificial palate very early in life. This device limits the possibility of passage of liquids through the defect into the nostrils as well as also facilitating the ability to efficiently suck on the specialized nipple.
2. Ear infections and hearing loss: Children with cleft palate are more likely to have recurrent ear infections and associated fluid accumulation in the inside of the eardrum. In order to limit these issues, most children with cleft palate have PETs  placed through the eardrum during their early months.
3. Speech problems: As would be expected, the malformations associated with cleft palate and lip may impact articulation. The most common issue tends to be a nasal quality to their voice. Corrective surgery may lessen these speech issues but most children with cleft lip and/or palate benefit from formal speech therapy.
4. Dental problems: Children with cleft lip and/or palate commonly have issues with missing and malformed teeth and commonly require orthodontic treatments and occasionally oral surgery if the upper jawbone (maxilla) has impaired function (such as improper placement and abnormal positioning of permanent teeth).
   

What is the treatment for a cleft lip and cleft palate?

Successfully treating an infant or child with cleft lip and/or palate requires patience by both the parents and ultimately the patient. Several years of multiple surgical procedures are generally necessary to provide a satisfactory outcome. The repair of a cleft lip is usually addressed at approximately 3 months of age. One or two surgical procedures may be necessary to achieve both effective lip function and cosmetic repair. Cleft palate repair is a multistep series of surgical procedures starting at about 6 to 12 months of age and finalized in the later teen years. The first procedure is typically repair of the defect in the palate, which allows better feeding and weight gain and reduces the frequency of hearing loss and recurrent ear infections. Repair of the palate defect also encourages appropriate development of the upper jaw (maxilla) and other facial bones. At approximately 8 years of age, a bone graft is performed to further support the upper jaw structure and aid in speech articulation. Braces are generally required to straighten permanent teeth and plastic surgical scar revision (removal) is done after the majority of adolescent growth has occurred.

What is the prognosis for a cleft lip and cleft palate?

While the effective treatment for cleft lip and cleft palate requires many surgical procedures, speech therapy, and consultation with many medical specialists, it should be anticipated that an excellent outcome regarding appearance and function can be achieved. In order to maximize the medical management as well as coordination with multiple health-care professionals and parents, a cleft palate team is generally the preferred approach to coordination of care. Such teams are commonly found at pediatric teaching hospitals in major cities. The members of the medical team will commonly consist of

1. plastic surgeon,
2. otolaryngologist (ear, nose and throat doctor [ENT]),
3. oral surgeon,
4. prosthodontist (makes dental appliances),
5. dentist and orthodontist,
6. speech pathologist/therapist,
7. audiologist (hearing specialist),
8. social worker/psychologist,
9. geneticist,
10. nurse coordinator.

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Milan Tomic

Hi. I’m Designer of Blog Magic. I’m CEO/Founder of ThemeXpose. I’m Creative Art Director, Web Designer, UI/UX Designer, Interaction Designer, Industrial Designer, Web Developer, Business Enthusiast, StartUp Enthusiast, Speaker, Writer and Photographer. Inspired to make things looks better.

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