FIX CLEFT LIP CLEFT PALATE

How Do You Fix Cleft Lip & Cleft Palate?

Diagnosis

Most cases of a cleft lip and cleft palate are detected immediately at birth and do not require special tests in order to diagnose. In many cases, cases of a cleft lip and cleft palate are found on an ultrasound prior to the birth of the baby.

Ultrasound

A prenatal ultrasound is a test which uses sound waves in order to create images of the developing fetus. When the doctor is analyzing the pictures, they may detect an abnormality in the facial structures.

Cleft lip can be detected using a prenatal ultrasound as early as the 13th week of pregnancy. As the fetus continues to develop, it may be easier to diagnose a cleft lip. Cleft palate, when it occurs alone, can be more challenging to see using ultrasound.

When the prenatal ultrasound shows a cleft, your doctor may offer a procedure which takes a sample of the amniotic fluid from your uterus. The fluid test can help determine if the fetus has inherited a genetic syndrome which can result in additional birth defects. In most cases, however, the cause of a cleft lip and cleft palate is unknown.

The goals in treating a cleft lip and cleft palate are to improve the child’s ability to eat, speak and hear normally. The treatment also works to achieve a normal facial appearance. Treatment for children with cleft lip and cleft palate often includes a comprehensive team of doctors and experts. This team can include the following specialists:

• Surgeons with a specialty in cleft repair (plastic surgeons or ENTs)
• Oral surgeons
• Ear, nose and throat doctors
• Pediatricians
• Pediatric dentists
• Orthodontists
• Nurses
• Auditory or hearing specialists
• Speech therapists
• Genetic counselors
• Social workers
• Psychologists

Treatment for cleft lip and cleft palate typically involves surgery to repair the defect and therapy to treat any related conditions.

Surgery

A cleft palate is usually repaired using a surgery called palatoplasty. This surgery typically takes place when the baby is 10–12 months old. The goals of palatoplasty include:

• Closing the opening between the nose and mouth.
• Create a palate which effectively works for speech.
• Prevent food and liquid from leaking out the nose.

In this surgery, a plastic surgeon will complete the following:

• Close the cleft in layers.
• Rearrange and repair the muscles of the soft palate. This allows them to work better during speech.
• Make two incisions on each side of the palate behind the gums. This helps to ease tension on the palate repair.

This surgery requires general anesthesia and usually takes about two to three hours to complete. Most babies are able to go home after a day or two in the hospital. The stitches will dissolve on their own. Your child will also need to be on a liquid diet for a week or two. They can then progress to eating soft foods for a few more weeks before returning to a regular diet. Parents may be asked to put their baby in special sleeves which prevent the elbows from bending. This ensures the baby can’t put any fingers or hard objects into the mouth and helps the healing process.

Cleft palate surgery has made significant advances in recent years. It is highly successful and effective treatment. As with any surgery, there are possible risks. Call the doctor if any of the following occur:

• The child has a fever above 101.4°F (38.5°C)
• Prolonged pain or discomfort
• Heavy bleeding from the mouth or nose area
• Refusal of drinking fluids
• Doesn’t make wet diapers

Most kids with cleft palate are successfully treated and do not have lasting problems. An experienced team can help create a treatment plan which is tailored for your child’s specific case.

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