Ganga Medical Centre & Hospitals Pvt Ltd

Coimbatore, India.

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Cleft Lip, Cleft Palate Surgery

Cleft lip and palate are a group of congenital deformities which can either arise sporadically or passed on hereditarily. The parents are anxious on getting a baby affected with this deformity. Fortunately these deformities can be corrected by surgery and the child can get a chance to lead a near normal life in the society.

What is cleft lip?

Cleft lip refers to a split in the upper lip which can be either complete reaching upto the nose or incomplete when it stops within the lip area. The children with cleft lip are taken up for surgery anywhere between three to six months of age when they are old enough to go through the surgery safely. If they are seen early enough i.e within days of birth they are advised to undergo nasoalveolar moulding which can improve the shape of nose and give better results with surgery. If not they are taken up for surgery.


Bilateral Cleft Lip


Pre OP


Post OP


Pre OP


Post OP


Unilateral Cleft Lip


Pre OP


Post OP


What is nasoalveolar moulding?

Nasoalveolar moulding refers to a process by which the alveolar processes which are a different levels are moulded to get into the same level. In case of bilateral cleft lip this can be used to bring the protruding part of the central lip to its normal position thus facilitating surgery. At the same time the nasal shape also can be moulded to achieve a better shape.



Before Nasoalveolar Moulding


After Nasoalveolar Moulding


What is cleft palate?

Cleft palate refers to the split in the palate which is the normal partition between the oral cavity and the nose. This can either occur along with the cleft lip or as a case of isolated cleft palate when the lip is normal. This can be either be complete when it extends throughout the length of the palate or incomplete when it involves the more posterior regions only.



Pre OP


Post OP


When and why should we repair a cleft palate?

The palate repair is usually done between nine to eighteen months of age. The children initially may have some difficulty in suckling or feeding which can be overcome by using the special feeding aids. This procedure is not only done for closure of the defect in the palate but also to help in the development of speech as the muscles are placed into their normal position during the repair. This will facilitate development of speech.


How can we get better speech in children with cleft palate?

Palatal repair is the first step toward getting a better speech in children with cleft palate. However they will need speech therapy to facilitate development of normal pronunciation and to correct faulty articulation. If in spite of these measures the children still have nasal speech they are investigated for velopharyngeal insufficiency at the age of 5-6 years. Additional surgical procedures for lengthening the palate or making it touch the posterior pharyngeal wall to get a better speech may be decided upon and performed at the time.



What is alveolar bone grafting?

The lip and palate repair will close the gap in the lip and the palate. However a small gap in the alveolus will remain. To close the gap in the alveolus to allow proper placement of teeth, alveolar bone graft needs to be done around the age of 7-8 years. Once the bone graft is placed the bone consolidates and then the orthodontist can move the teeth in the proper position to give a good smile.



Inadequate bone for canine to erupt


During bone
grafting


Canine brought into occlusion by orthodontics after bone grafting


When is rhinoplasty done in cleft patients?

Rhinoplasty or the nose correction is done as a part of the primary lip repair. But in spite of it some children can have minor change in the shape of the nose which may vary as the child grows. As the child enters adolescence and the facial growth is nearly complete a definitive rhinoplasty can be done to correct the shape of the nose.



Pre OP


Post OP


Pre OP


Post OP


Do all the children need all the above procedures?

All children may not need all the procedures mentioned above. They are assessed periodically and as per their needs decision on surgeries will be undertaken.


How much will these surgeries cost?

The normal cost of these surgeries will be around Rs. 60000/- But these surgeries have been performed through the Smile Train project at Ganga Hospital totally free of charge. Ganga Hospital has been a Smile Train partner since 2007 and has performed 892 procedures so far under this project. Anybody who opts to get surgeries under this scheme can get operated and there is no need for any income proof. For more detail please visit www.smiletrain.org


What about patients who have undergone surgery previously and still have some deformity?

Apart from the primary procedures we can improve the appearance or speech of the patients who have undergone surgery previously and have some residual deformity or problem. These secondary corrections are also performed free under this scheme.


Number of Operation Types per Year

 
Primary Lip Nose Unilateral
Primary Lip Nose Bilateral
Primary Cleft Palate
Lip Nose Revision
Secondary Cleft Palate
Fistula Repair
Alveolar Bone Graft
Years
M
F
M
F
M
F
M
F
M
F
M
F
M
F
2012 20 12 5 3 21 15 5 7 0 2 1 0 3 4
2013 18 9 5 1 33 15 4 2 0 2 2 2 5 2
2014 17 12 3 1 25 19 9 5 1 1 0 1 3 5


 

Unilateral cleft lip
Bilateral cleft lip
Primary palatoplasty
Palate rerepair/ fistula repair
Alveolar bone graft
Lip revision/ rhinoplasty
Total

2012

32

8

36

3

7

12

98

2013

27

6

48

6

7

6

100

2014

29

4

44

3

8

14

102



To Know More About the following Click on the Sub Heading

Cleft Lip & Palate

Cleft Orthognathic Surgeries

Cleft Orthodontics









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