Overview
Cleft Lip
Cleft Lip or Hare Lip is a birth defect where the upper lip is split or separated either in the middle, on one side or on both the sides.
Causes
Doctors don't know exactly why a baby develops cleft lip or cleft palate, but believe it may be a combination of genetic (inherited) and environmental factors (such as certain drugs, illnesses, and the use of alcohol or tobacco while a woman is pregnant).The risk may be higher for kids whose sibling or parents have a cleft or who have a history of clefting in their families. Both mothers and fathers can pass on a gene or genes that can contribute to the development of cleft palate or cleft lip.
What Are The Types Of Cleft Lip?
Cleft Lip can be
- Unilateral Cleft Lip - On one side of the nose
- Bilateral Cleft Lip - On both the sides of the nose.
Cleft Lip can either be
- Complete Cleft Lip - When the split extends right up and into the nose
- Incomplete Cleft Lip - When the split in the upper lip does not extend up to the nose.
What Are The Problems Associated With Cleft Lip?
Feeding Problems
- Cannot suck effectively
- Milk gets into the nasal cavity and may result in choking or aspiration
Teething Problems
- Missing teeth
- Increased number of cavities
- Malocclusion of teeth - When teeth are bunched together or on top of each other.
Speech Problems
- Nasal voice
- May develop nodules on the vocal cord due to vocal abuse
- Delayed speech and language development
- Difficulty with articulation and proper pronunciation of words
Ear Infections
- Most children with Cleft Lip are prone to middle ear infection
- Hearing Loss
- May be associated with repeated ear infection
Psychological Problems
- To pay the price for looking and sounding different.
- Social Problems
- Suffer isolation and alienation
Preparing For Surgery
Prior to surgery, your plastic surgeon will discuss with you : -
- Pre-surgical considerations, diagnostic testing and medications
- Day-of-surgery instructions and medications
- Specific information related to the use of anesthesia
- Postoperative care and follow-up
Your plastic surgeon will also discuss where your child’s procedure will be performed. Cleft repair is generally performed in a hospital setting.
Treatment
Thanks to medical advancements, reconstructive surgery can repair cleft lips and palates and, in severe cases, plastic surgery can address specific appearance-related concerns.A child with oral clefting will see a variety of specialists who will work as a team to treat the condition. Treatment usually begins in the first few months of life, depending on the health of the infant and the extent of the cleft.
Members of the cleft lip and palate treatment team usually include : -
- a geneticist
- a plastic surgeon
- an ear, nose, and throat physician (otolaryngologist)
- an oral surgeon
- an orthodontist
- a dentist
- a speech pathologist (often called a speech therapist)
- an audiologist
- a nurse coordinator
- a social worker and/or psychologist
The specialists will evaluate your child's progress regularly, and monitor hearing, speech, nutrition, teeth, and emotional state. They'll share their recommendations with you, and can forward their evaluation to your child's school and any speech therapists that your child may be working with.
What Is The Recovery Period Like After Cleft Lip Surgery?
Your child will feel some pain and soreness following the Cleft Lip surgery. He / she will be irritable and may require some medication to calm down and relieve the pain and soreness which commonly occurs following the operation to repair Cleft Lip. Your surgeon might prescribe antibiotics to minimize the chances of infection while in the hospital. He / she will provide you with instructions on feeding and general care of the baby during the crucial couple of days after surgery for Cleft Lip. Your child may have to be put in restraints to make sure he / she does not rub the area of the face that has stitches. Your child will be hospitalized for about 4 - 5 days, the stitches need not be opened as they dissolve on it's own after a few days.
Benefits Of Surgical Repair Of Cleft Lip
The team approach to correcting Cleft Lip and other problems associated with it has several fold benefits. Symmetry or balance of facial features is restored to a great extent but not completely. The surgeons have mastered sophisticated techniques that have improved the success rate of surgery for Cleft Lip many fold. If the surgery to repair Cleft Lip is performed in the first year of life, chances are that ability to feed properly; talk, facial growth and development of social skills will be less problematic in the years to come.Risks Of Surgical Repair Of Cleft Lip
- Asymmetry of your child's upper lip - This is a common problem when one side of your mouth and nose do not match the other side. In such a case, a revision surgery is performed to try and match both the sides of the face as closely as possible.
- Incomplete closure of the cleft - A small hole may be apparent in the upper lip after the operation for Cleft Lip has healed. A second operation may be required to completely repair the Cleft Lip.
- Bleeding, swelling, bruising and delayed healing - It is normal to have some bruising and oozing of bloody discharge around the mouth and nose which will subside in a week or so.
- Infection of the incision site
- Allergic reaction to anesthesia
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