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Bid for Surgery: Cleft Lip and Palate Surgery
Cleft Lip and Palate
Surgery
| Procedure: |
In the early weeks of development, long
before a child is born, the right and left sides of the lip and the roof of the mouth
normally grow together. Occasionally, however, in about one of every 800 babies, those
sections don't quite meet. A child born with a separation in the upper lip is said to have
a cleft lip. A similar birth defect in the roof of the mouth, or palate, is called a cleft
palate.
Since the lip and the palate develop separately, it is possible for a child to have a
cleft lip, a cleft palate, or variations of both. |
| Risk Factor: |
When surgery is done by a qualified plastic
surgeon with experience in repairing cleft lip or palate, the results can be quite
positive. Nevertheless, as with any operation, there are risks associated with surgery and
specific complications associated with this procedure.
In cleft lip surgery, the most common problem is asymmetry, when one side of the mouth and
nose
does not match the other side. The goal of cleft lip surgery is to close the separation in
the first operation. Occasionally, a second operation may be needed. |
| Side Effects: |
In cleft palate surgery, the goal is to
close the opening in the roof of the mouth so the child can eat and learn to speak
properly. Occasionally, poor healing in the palate or poor speech may require a second
operation. |
| Length: |
2 to 5 hrs |
| Anesthesia: |
Local with sedation, or general. |
| In/Out: |
Either depending on individual
circumstances and extent of surgery |
| Recovery: |
If dressings have been used, they'll be
removed within a day or two, and the stitches will either dissolve or be removed within
five days. Your doctor will advise you on how to feed your child during the first few
weeks after surgery. |
| Duration: |
Permanent. |
| The Procedure |
In the early weeks of development, long before a
child is born, the right and left sides of the lip and the roof of the mouth normally grow
together. Occasionally, however, in about one of every 800 babies, those sections don't
quite meet. A child born with a separation in the upper lip is said to have a cleft lip. A
similar birth defect in the roof of the mouth, or palate, is called a cleft palate.
Since the lip and the palate develop separately, it is possible for a child to have a
cleft lip, a cleft palate, or variations of both.
If your child was born with either or both of these conditions, your doctor will probably
recommend surgery to repair it. Medical professionals have made great advances in treating
children with clefts and can do a lot to help your child lead a normal, healthy, happy
life. |
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| The best candidates for this surgery |
Children born with a cleft lip or palate may
need the skills of several medical professionals to correct the problems associated with
the cleft. In addition to needing plastic surgery to repair the opening, these children
may have problems with their feeding and their teeth, their hearing, their speech, and
their psychological development as they grow up.
For that reason, parents should seek the help of a Cleft Lip and Palate Team as early as
possible. Medical professionals with special experience in the problems of cleft lip and
palate have formed such teams all over the country to help parents plan for their child's
care from birth, or even before.
Typically, a Cleft Team might include a plastic surgeon, a pediatrician, a dentist, a
speech and language specialist, a social worker, a hearing specialist, an ear-nose-throat
specialist, a psychologist, a nurse, and a genetic counselor.
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| Types of anesthesia |
Surgeons prefer to use general anesthesia; in
that case, you'll sleep through the operation. |
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| The surgery |
Cleft lip surgery
A cleft lip can range in severity from a slight notch in the red part of the upper lip to
a complete
separation of the lip extending into the nose. Clefts can occur on one or both sides of
the upper lip.
Surgery is generally done when the child is about 10 weeks old.
A cleft lip is a separation of the upper
lip that can extend into the nose.
To repair a cleft lip, the surgeon will
first make an incision on each side of
the cleft from the lip to the nostril.
To repair a cleft lip, the surgeon will make an incision on either side
of the cleft from the mouth into the nostril. He or she will then turn the dark pink outer
portion of the cleft down and pull the muscle and the skin of the lip together to close
the separation. Muscle function and the normal "cupid's bow" shape of the mouth
are restored. The nostril deformity often associated with cleft lip may also be improved
at the time of lip repair or in a later surgery.
The cleft lip is then drawn together and
stitched to create a normal "cupid's bow"
shape to the upper lip.
The scar left after surgery will gradually
fade with time.
Cleft palate surgery
In some children, a cleft palate may involve only a tiny portion at the back of the roof
of the mouth; for others, it can mean a complete separation that extends from front to
back. Just as in cleft lip, cleft palate may appear on one or both sides of the upper
mouth. However, repairing a cleft palate involves more extensive surgery and is usually
done when the child is nine to 18 months old, so the baby is bigger and better able to
tolerate surgery.
When the roof of the mouth doesn't
grow together properly, the condition
is called a cleft palate. To repair it,
the surgeon will make an incision
along both sides of the cleft.
To repair a cleft palate, the surgeon will make an incision on both sides
of the separation, moving tissue from each side of the cleft to the center or midline of
the roof of the mouth. This rebuilds the palate, joining muscle together and providing
enough length in the palate so the child can eat and learn to speak properly.
Tissue is drawn together from both
sides of the cleft to rebuild the roof
of the mouth. |
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| Does my child have to stay in a
hospital after the surgery? |
If dressings have been used, they'll be removed
within a day or two, and the stitches will either dissolve or be removed within five days.
Your doctor will advise you on how to feed your child during the first few weeks after
surgery. |
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| Risk factors, complications, side effects?
|
In cleft lip surgery, the most common problem is
asymmetry, when one side of the mouth and nose does not match the other side. The goal of
cleft lip surgery is to close the separation in the first operation. Occasionally, a
second operation may be needed.
In cleft palate surgery, the goal is to close the opening in the roof of the mouth so the
child can eat and learn to speak properly. Occasionally, poor healing in the palate or
poor speech may require a second operation. |
|
| How long would recovery take? |
If dressings have been used, they'll be removed
within a day or two, and the stitches will either dissolve or be removed within five days.
Your doctor will advise you on how to feed your child during the first few weeks after
surgery.
It's normal for the surgical scar to appear to get bigger and redder for a few weeks after
surgery. This will gradually fade, although the scar will never totally disappear. In many
children, however, it's barely noticeable because of the shadows formed by the nose and
upper lip. |
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Cost of this procedure varies with region from a low of
$3,124
to a high of $6,236. This cost includes surgeon's fee,
anesthesia, and facility costs. |
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