Types of Cleft Lip and Palate Surgeries
Cleft lip and palate repair involves multiple surgeries that are often carried out in stages, depending on the child’s needs. These surgeries include:
1. Cleft Lip Repair (Cheiloplasty)
- Usually performed between 3 to 6 months of age.
- The surgery closes the gap in the upper lip, reshaping the lip and improving facial symmetry.
2. Cleft Palate Repair (Palatoplasty)
- Generally done between 9 to 18 months of age.
- This procedure closes the gap in the roof of the mouth, helping to restore normal eating and speech functions.
3. Alveolar Bone Grafting
- Performed around ages 8 to 12, when adult teeth begin to erupt.
- This surgery helps stabilise the upper jaw and support the growth of permanent teeth.
4. Additional Surgeries for Function and Appearance
- Secondary surgeries to improve appearance, speech, or alignment may be done during adolescence or adulthood.
- These could include nasal reconstruction, lip revision, or jaw alignment.
How Cleft Lip and Palate Surgery Works
Cleft lip and palate surgeries are specialised procedures conducted by a team of plastic surgeons, ENT specialists, and paediatricians. Here’s a brief overview of how each type of surgery typically works:
1. Cleft Lip Repair
- In cleft lip surgery, the surgeon carefully brings together the tissues on each side of the lip gap, creating a closed, continuous line that forms the upper lip.
- Muscle layers are stitched together, ensuring a natural look and function. The nose may also be reshaped for symmetry if affected.
2. Cleft Palate Repair
- In cleft palate surgery, the surgeon closes the gap in the palate by reconnecting tissue and muscle layers, which restores functionality to the roof of the mouth.
- This helps the child develop normal speech patterns and reduces the risk of ear infections.
3. Alveolar Bone Grafting
- Bone grafting involves taking a small piece of bone, often from the child’s own hip, and placing it in the cleft area of the gums.
- This provides stability for the teeth and upper jaw, aiding proper tooth alignment.
4. Additional Surgical Corrections
- Additional procedures, such as jaw surgery, rhinoplasty, or orthodontic work, may be considered later to refine appearance and ensure normal function.
Recovery and Aftercare
The recovery process varies based on the type of cleft surgery performed and the child’s age. Here’s what to expect after surgery:
1. Post-Surgery Care
- The surgical area is typically bandaged, and special instructions will be provided to ensure a safe healing process.
- Pain management is usually necessary for the first few days, and caregivers are advised to keep the surgical area clean.
2. Dietary Restrictions
- Soft or liquid foods may be recommended initially to avoid placing strain on the surgical site, especially for cleft palate repair.
- Parents should follow the surgeon’s recommendations to ensure optimal healing.
3. Speech and Hearing Follow-Up
- Since cleft palate affects speech and hearing, speech therapy may be recommended. Regular ear check-ups are also essential as children with cleft palate are at higher risk for ear infections.
4. Long-Term Follow-Up
- Follow-up appointments help monitor growth and ensure proper facial and dental development. Additional surgeries or orthodontic treatment may be part of a comprehensive cleft care plan.
