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Treating Cleft Lip and Palate

Cleft lip and palate are developmental defects that happen in the early stages of pregnancy, when the fetus is developing. This congenital malformation of the upper lip and roof of the mouth can affect the child’s health as well as social interaction by way of speech abnormality, impaired hearing and psychological trauma. Cleft palate repair at a professional plastic surgery practice can improve the hearing, breathing, eating and speaking abilities of the child.

What Causes Cleft Lip and Palate?

Though there is no specific reason as to why this condition occurs, experts believe that it may be caused by a combination of environmental and genetic factors. Researchers hold that this genetic defect could occur due to the following factors:

  • Inherited genes
  • Environmental factors
  • Lack of folic acid during pregnancy
  • Smoking
  • Consumption of alcohol
  • Nutrition and obesity
  • Medications consumed during pregnancy
  • Viral illness
  • Exposure of the fetus to chemicals

Cleft Palate Repair

When the child is between six weeks to twelve months of age, surgery is performed to close the cleft lip. In addition to cleft lip surgery, the course of treatment may also include speech rehabilitation, surgery to improve cosmetic appearance, and dental correction.

Some children may require orthodontic treatment such as nasal alveolar molding or NAM before surgery to guide the growth of the mouth in the right direction. This lengthy process mainly involves the realignment of the upper jaw’s cleft segments. To allow precise cleft repair and correction of nose deformities, the edges of the cleft lip edges are brought closer.

Using a specific dental impression material, the plastic surgeon makes an upper jaw mold with an acrylic plate, which is then fitted to child’s mouth. Based on the growth of the bone, the acrylic plate is adjusted to promote a more anatomic alignment. The jaw alignment is followed by significant lip alignment improvement, after which nasal correction is initiated.

The next stage is nasal correction which involves placing a separate stent from the plate extending to nostril to improve the lining of the nose and to elevate the nasal tip. Finally, the lining of nose is stretched to bring about more accurate and aesthetic nasal repair. The duration of nasal alveolar molding depends on the child and the severity of the condition. In cases where the cleft involves the gum line, bone grafting and orthodontic care may be recommended at a later stage.

A board-certified plastic surgeon with vast experience and skill in reconstructive procedures can provide effective treatment for cleft lip and palate with less scarring, discomfort and surgical trauma. To optimize functional and aesthetic outcomes, such surgeons work with a team of specialists comprising an orthodontist, a pediatric plastic surgery nurse, a speech pathologist, an otolaryngologist (ENT), a dietician, an audiologist, and an oral surgeon.

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