Speciality of Hand Surgery | Replantation | Dos & Donts | First Aid | Tendon Injuries | Nerve Injuries | Common Hand Conditions | Rheumatoid Arthritis | Fused Fingers | Radial Club Hand | Brachial Plexus Injuries | Post cancer reconstruction | Vascularised bone graft | Spastic | Soft tissue reconstruction  | Cleft Lip & Palate | Fellowship Training Programme | Micro Surgery Training Institute |




 Cleft Lip and Palate
One in 800 children born have a birth defect called Cleft Lip and Palate. In this condition the upper lip, a part of the jaw with the teeth(Alveolus) and palate have a gap.  All the three components may exist together or some may be born with cleft of either the lip or the palate alone.  Cleft lip is cosmetically unacceptable and cleft of the palate causes nasal regurgitation while eating and difficulty in speaking. 

Cause
Though many factors are known to cause this problem, in an individual patient it may be dificult to pin point the cause.  Clefts can run in families and be associated with other problems. Some drugs taken during pregnancy are known to cause clefts. Clefts are more common in certain ethnic groups. In most cases, however, there is no identifiable cause or risk factor. 

Associated Problems?

Most children with clefts do not have other birth defects. Most are normal in intelligence and abilities. Children with clefts do have a higher incidence  of  middle ear infection.     If untreated, frequent ear infections and even hearing loss can result. Many children with clefts have abnormalities of the  teeth.  This can range from crooked teeth to extra or missing teeth.

Treatment 

Children with clefts benefit from specialized team care.  Usually repair of  cleft lip is done  when the baby is  10-12 weeks old and  cleft palate repair is done between 9 to 12 months of age. The exact age for repair will depend on the size and health of the child.

Some children with cleft palate will require a second operation on the palate to help get better speech (pharyngoplasty). This happens in about 20% of cases, and cannot be predicted at the time of the original palate surgery.

Many children with clefts involving the  gum  line will benefit from an operation to put extra bone in the gum. This is called an alveolar bone graft. This allows the permanent teeth to come in better. This operation is done between the ages of 8-10 years, depending on how fast the permanent teeth are developing.

Children with clefts of the lip may need or want touch up operations to improve the appearance of the scars. As teenagers, some need nasal surgery to improve breathing or appearance. In some children with clefts, the jaws are not in good alignment. In these cases, surgery can be done to align the bite.

Surgery for cleft lip and palate requires special anaesthetic skills.  In Ganga Hospital there is a well experienced team to take care of such children.