CLEFT LIP SURGERY

Cleft lip is a congenital problem that requires specific treatment, including surgery and special care with feeding, dentition, hearing, language and speech of the baby or child…

This is a super specialization that very few surgeons have access to. By training I have been fortunate to collaborate with the best surgeons in this superspeciality as are the Dr. Tresserras, Dr. Ortiz-Monastery, Dr. Triaca.

Surgery in the neonatal period, as in adulthood if a case was poorly resolved in childhood, is one of the most demanding challenges for the surgeon. Improving speech in patients with cleft palate, normalizing lip and nose or normalizing the facial structure and smile require deep knowledge of the face and dentition, which is the basis of the specialty of maxillofacial surgery.

Other specialties cannot address the problem in its whole. If you carry a cleft lip and palate stigmas, ask for a consult and we will tell you if we can improve it.

 

Despite the early correction, patients born with cleft lip and/or palate present throughout their growth stigmas of their deformity, which can be corrected.

These are: Speech problems: mainly nasal voice, which we can improve and correct by means of surgery and phoniatry specialists. Alvaolar ridge deformities: They are bone defects at the same level as the canine fossa of the upper jaw, which causes the nose base to sink a bit more on that side. They might be linked to not erupt the canine, leaving a flaw in the dentition.

They can be corrected by surgery. Upper lip defect: In those cases where primary repair was not very successful or satisfactory, both the function and the aesthetics of the lip are affected. Upper jaw growth deficit: Patients who experience a cleft palate surgery end up with a scar that prevents the normal development of the upper jaw, leaving a very projected jaw-like face and a short upper lip sensation.

Correction is possible after proper planning and subsequent surgery. Nasal growth fault: these patients, as they grow, have an alteration in the shape of the nose, caused by an altered growth. Correcting it is one of the hardest challenges, and it requires a special knowledge and technique of this malformation.

Currently we address the problem by reopening all structures and replace them in the position they should be in, normalizing nose and lip in a single session. If the phonation is inadequate, we remake at the same time the palate, giving the patient a good phonation and avoiding the nasal voice. The idea is to limit the number of interventions getting the best possible result.  

 

What does it mean to have a cleft lip and what can be done?

 

Cleft lip is a congenital malformation, what does this mean? When perioral structures are being created in fetuses, there are times that these structures don’t close properly, and then children are born with a malformation specially in the upper lip, in which the lip is incomplete. This is associated with alterations in the nose formation, and in many cases, it is also associated in dental alveoli, or on the palate, causing what is called cleft palate.

  • In certain races there is an inbreeding topic, a genetic one, however, in our society the cause is unknown nowadays. We know that one out of twenty thousand pregnancies can give this alteration. Unfortunately, many women have an abortion because of this issue, thinking that this malformation can’t be solved. Currently, with eh techniques we have, they are kids that, with very few interventions, can have a normal appearance and function.
  • Mainly the cleft lip is exhibited in an upper lip that has like a window, this is caused by a muscle, which in theory should surround the oral cavity that doesn’t close properly. At the same time this window also alters the nostril formation. If the lip is also associated with an alveolar deformity, seeing the child’s mouth we will observe how the alveoli is not attached, and in the case of being associated with alterations in the palate, both hard and soft, we will see how the whole palate is directly linked with the nostrils.
  • There is a minimum percentage of children born with cleft lip, which may be associated with sindroúnicas alterations or with other types of manifestations, but these are the minority. Most children who have this alteration are completely normal children, the problem is that there is no feasible solution for the the lip so early in life, and in case there is a solution for the cleft palate, at first the kids have problems with feeding, they can’t breastfeed properly. That’s why usually a small gadget or teats to feed are put until the first correction interventions being. Subsequently, once these first problems are corrected, the child will develop correctly but always following the different therapeutic steps.
  • Cleft lip surgery depends mainly on when it has been practiced. Surgeries in the past operated incorrectly the correction of the lip, so these patients were left with some sequels, and they are the ones we treat right now. The cases revolve around the sequelae of both nasal and plasty defects that have been performed in an incomplete way in the tip. Currently, kids are treated in a proper way and the plata labial is associated with a rhinoplasty, a technique which is also known as Macuns, so the kid gets out with his nose and lip fully reconstructed.
  • Cleft palate is associated with cleft lip. In this case two interventions must be made:
    • Onf of soft palate before the child begins to speak, and
    • Later, before 3 or 4 years, we close the hard palate, allowing a normal growth of the maxilla.

 

 

 

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