Cleft Lip or Cleft Palate refers to the openings caused by the mutual unification of the structures during the development of the baby in the mother’s womb during the development of the facial part and the mouth and the related problems in the lip , nose , gums and palate. It is sometimes difficult to notice cleft palate. They can be seen together or separately. There are many different shapes of palate lip clefts.
In this type, there is a small notch on the lip.
These slits form slits where the base of the nose is not fully included.
These are slits that also cover the base of the nose.
Conditions in which the soft and hard palate are affected together.
Clefts in which only the soft palate is affected.
The condition of having clefts on both sides of the structure called the vomer.
When viewed from the outside, there is no cleft, but the muscles do not join.
With a good examination at birth, the diagnosis can be made definite. However, it may be possible to catch lip clefts with ultrasound during pregnancy. Sometimes it can be difficult to diagnose in the very posterior cleft or hidden cleft of the soft palate. In this type of baby, nourishment comes from the nose while feeding, difficulty in sucking or not being able to suck at all is observed.
Cleft has no specific cause. A cause cannot be found in more than half of babies. In a small group, it can be seen together with other organs and structures. These are inherited. Also, a group of babies had a close distant family relative history. Consanguineous marriage can be a cause. Serious diseases in the first 1-2 months of pregnancy and some medications can be considered among the causes.
While lip clefts cause cosmetic, lip and nose problems; The most important problem that can be experienced in cleft palate is speech disorder. Immediately after birth, the most important issue is nutrition. Following and treatment of the middle ear and teeth after the operations becomes important. There may be tooth-jaw-face development problems. Problems are less with only cleft lip or only cleft palate, but differ.
Neither cleft lip nor cleft palate spontaneously pass or close. Only after birth may be narrowing of the cleft within months as the age progresses.
Both can be treated. The treatment is long-termed and the purpose is evaluated in 2 separate stages. First stage; It is the correction of visual problems and speech disorders, if any, before the child starts primary school. Second stage; In adulthood, the development of teeth, jaw and face is within natural limits and, if affected, both appearance and respiratory problems of the inside and outside of the nose are solved. These treatments are briefly grouped under 3 main headings: plastic surgery, orthodontic treatment and speech therapy.
Lip clefts are operated on the baby’s health and development status between 2.5 months and 5 months. In this session, the cleft on the lip is closed and the nose is corrected. The gingival cleft is not touched in most cases. Palate clefts are often closed between 6 months and 9 months. Rarely, surgery is delayed to 1 year.
Being late is mentioned in babies who are not operated before the age of 1 at the specified times after birth. As each year is delayed, surgeries become more difficult and success begins to decline. In addition, it becomes very difficult to correct the negative results of late and incomplete surgeries with subsequent surgeries.
If the slits are closed with a suitable technique, the scar will be extremely less obvious. There may be very slight irregularities in the cleft line on the lip , and also a little asymmetry in the cleft side nose , wings and holes. A perfect result is often not possible. Revision or retouching operations may be required at later ages.
Before the cleft palate surgery to be performed, the most important point for parents; their babies are entrusted to teams of experts who constantly perform these surgeries and follow these babies with every problem. Each team must have a scientifically approved protocol. According to these applications, every point to be considered before and after cleft palate surgery is clear and explained in detail to the patient’s relatives.
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