Cleft Lip and Palate | Dr Kevin Adams

What is a cleft lip and palate?

Cleft lip (cheiloschisis) and cleft palate (palatoschisis) are among the most common birth defects affecting children in North America. The incomplete formation of the upper lip (cleft lip) or roof of the mouth (cleft palate) can occur individually, or both defects may occur together. The conditions can vary in severity and may involve one or both sides of the face.

A cleft, or separation of the upper lip and/or the roof of the mouth, occurs very early in the development of your unborn child. During foetal development, certain components of the upper lip and roof of the mouth fail to form normally. Cleft lip and cleft palate repair is a type of plastic surgery to correct this abnormal development both to restore function and to restore a more normal appearance.

Most clefts can be repaired through specialized plastic surgery techniques, improving your child’s ability to eat, speak, hear and breathe, and to restore a more normal appearance and function.

What you need to know about cleft lip and palate surgery

Early intervention by a team of specialists to evaluate your child is essential in cleft lip and/or cleft palate repair. The team can work together to deﬁne a course of treatment, including surgical repair of the cleft, speech rehabilitation and dental restoration.

These specialists may include a:

· Plastic surgeon
· Paediatrician
· Paediatric dentist
· Otolaryngologist (ear, nose, and throat specialist)
· Auditory or hearing specialist
· Speech pathologist
· Genetic counsellor
· Social worker

Be prepared to discuss:

· Your concerns and an evaluation of your child’s condition
· Options available for cleft lip and/or cleft palate repair
· Likely outcomes of surgery and the potential risks and complications associated with the procedure
· A recommended course of treatment

Be candid about your concerns for your child and your plastic surgeon’s ability to meet his or her special needs.

The success of your child’s procedure, safety and overall satisfaction requires that you:

· Honestly share your concerns
· Fully disclose your child’s health history including current medications, vitamins, and herbal supplements
· Commit to precisely following all of your plastic surgeon’s instructions

Important facts about the safety and risk of this procedure

The decision to have cleft surgery is extremely personal and your plastic surgeon will explain the beneﬁts, goals and potential risks or complications. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure, the alternatives and the most likely risks or potential complications.

The risks include:

· Bleeding (hematoma)
· Infection
· Poor healing of incisions
· Irregular healing of scars including contracture (puckering or pulling together of tissues)
· Residual irregularities and asymmetries
· Anaesthesia risks
· Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
· Damage to deeper structures — such as nerves, blood vessels, muscles, and lungs — can occur and may be temporary or permanent
· Possibility of revision surgery

Be sure to ask questions:

It’s natural to feel some anxiety, whether excitement for the anticipated outcomes for your child or preoperative stress. Please discuss these feelings with your plastic surgeon