19 December 2020 Saturday / Published in Plastic Surgery

Cleft Lip and Palate Repair

dudak damak yarığı tedavisi, Lippen- und Gaumenspalte

What is Cleft Lip and Palate Anomaly?

The defective union of the structures of the baby’s face area for various reasons during the development of the baby in the womb is called cleft lip and palate anomaly in the medical language.

How Does Cleft Lip and Palate Anomaly Occur?

Union of the cells that form the structure of the lip when the baby is in the mother’s womb starts at the 4^th or 5^th week and the union of the cells forming the palate structure is completed on the 8^th or 9^th week. The union of the lip and palate structure is completed by the 12^th week of the baby’s development, but for the reason that is thought to be hereditary or environmental, a normal combination of a lip and palate cannot occur in about 1 in 1,000 babies and a surgical intervention is required to treat a child born with this deformity.

How Does Cleft Lip and Palate Occur in Babies?

Genetic (hereditary) and environmental factors are thought to cause the formation of cleft lip and palate in babies.
If the cleft lip and palate occurred in family members before, there is a possibility that new babies will also have this anomaly. However, even if the condition was not seen in any of the family members before, this can also manifest with syndromes such as Trisomy D and Trisomy E or with mutated genes.
It should be regarded that rubella infection that the mother had in the first trimester of pregnancy, oligohydramnios (inadequate or complete deficiency of amniotic fluid in the womb), vitamin B deficiency, drug use such as steroid anticonvulsant, etc. can cause this anomaly.

How Cleft Lip and Palate (Harelip) is Treated?

Children born with cleft lip and palate need the help of different specialisations due to various comorbid problems. Right along with the cleft repair to be performed by plastic surgery, other treatments should be continued. Because as the patient gets older, various problems may arise regarding nutrition, dental health, hearing, speaking and psychological development. For this reason, the family must apply to the centres where they can get team support. Generally, in addition to a plastic surgeon, this type of team includes paediatrist, otorhinolaryngologist, speaking and hearing specialists, psychologist, genetic counsellor, dietitian, nurse and social counsellor. When to consult to which specialist is coordinated by the plastic surgeon.

Cleft Lip and Palate Frequently Asked Questions

It is against the law in Turkey for the healthcare organisations including private practices to indicate prices online for procedures, treatments or consultations. Please contact us by calling or texting ?+90 541 334 3484 (WhatsApp available) or ☏ +90 212 257 1515 for the average cost of the procedure or any other enquiries related to the procedure. You need to send some photos to the Patient Care Coordinator to be examined by Professor Yazar to get the exact all-inclusive price.

If the cleft lip and palate surgery are performed by an experienced plastic surgeon, it is possible to achieve a good result. However, risks and complications can be encountered, as with any operation. The most common problem observed after cleft lip repair is the failure to provide symmetry on both sides of the lip. The primary purpose of cleft lip repair is to close the cleft in a single surgery. However, a second intervention may be required in some cases.

The main purpose of cleft palate repair is to close the orifice in the palate and ensure that the child is fed and speaks appropriately. In these surgeries, various recovery problems and speaking disorders sometimes require a second attempt.

The cleft lips can be of different structures, from a small notch on the upper lip to a full cleft that extends to the base of the nose. The cleft can be one-sided or on both sides of the rim. Surgical intervention is usually performed when the child is 6-12 weeks old. Muscle repair is performed in surgery, following the incision to be made on both sides of the cleft. The cleft will be closed after the oral mucosa and skin repair is completed. This means, the muscle will gain its function and standard lip shape will be created. A deformity that occurred in the nose also benefits from this intervention.

The baby may have an uneasy period after surgery. Various drugs are recommended by the surgeon to get over this period. To keep the child’s hands away from the surgery area, it is necessary to use bandages that prevent the elbows from bending for a while. Bandages are removed after 1-2 days; skin sutures are removed after five days or they fall off themselves depending on the material used. The surgeon gives recommendations regarding the nutrition of the child for the first few weeks. The surgery scar will become redder and wider in the first few weeks. This appearance will decrease over time; however, the scar will never disappear completely. This scar becomes hardly visible in many children, due to shadows in the nose and lips area.

Cleft palates vary in shapes extending to the lip area in the form of a small notch that affects the uvula. Cleft palate repair can be performed between 10-12 months, depending on the condition of the patient and the decision of the plastic surgeon. During the surgical repair, the tissues on edge are brought closer to the midline through an incision made on both sides of the palate and palate integrity is provided. During this repair, the soft palate muscles are also repaired and the necessary base is provided for the correct speaking and nutrition of the child.

In the first postoperative 1-2 days, there may be complaints of restlessness and pain that can be easily controlled with medications. During this period, although the child is started to be fed orally, IV fluid is given through the vein and necessary support is provided since the child cannot be fed in average amounts. Bandages are used to prevent the elbow from bending to prevent the child from bringing hands to mouth in the early days. The surgeon gives necessary recommendations for the nutrition of the child in the first few weeks after the surgeon. Following these recommendations, the palate will heal without any problems.

Consultant Plastic, Reconstructive and Aesthetic Surgeon Professor Yazar is available in his private practice based in Nisantasi, Istanbul for appointments to provide detailed and tailored information on the procedure.

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