How Do They Repair Cleft Lip

Children with a cleft lip or palate will need several treatments and assessments equally they grow upwardly.

A cleft is commonly treated with surgery. Other treatments, such every bit voice communication therapy and dental care, may also exist needed.

Your child will exist cared for by a specialist cleft team at an NHS cleft middle.

Your child's care programme

Children with clefts will have a care plan tailored to meet their individual needs. A typical care plan timetable for scissure lip and palate is:

birth to 6 weeks – feeding assistance, back up for parents, hearing tests and paediatric assessment
3 to 6 months – surgery to repair a cleft lip
6 to 12 months – surgery to repair a fissure palate
18 months – speech cess
3 years – spoken language assessment
5 years – spoken communication assessment
viii to 12 years – bone graft to repair a cleft in the gum area
12 to fifteen years – orthodontic treatment and monitoring jaw growth

Your child will also need to nourish regular outpatient appointments at a cleft eye and so their condition can be monitored closely and whatsoever issues tin can be dealt with.

These will unremarkably exist recommended until they're around 21 years of age, when they're likely to have stopped growing.

Surgery

Lip repair surgery

Lip repair surgery is ordinarily washed when your baby is effectually three months onetime.

Your baby will be given a general anaesthetic (where they're unconscious) and the cleft lip will exist repaired and closed with stitches.

The operation usually takes i to 2 hours.

Most babies are in hospital for 1 to 2 days. Arrangements may be made for you to stay with them during this fourth dimension.

The stitches will exist removed afterward a few days, or may dissolve on their ain.

Your child will have a slight scar, but the surgeon volition try to line upwards the scar with the natural lines of the lip, to make it less noticeable. It should fade and become less obvious over time.

Palate repair surgery

Palate repair surgery is usually done when your babe is 6 to 12 months sometime.

The gap in the roof of the oral fissure is closed and the muscles and the lining of the palate are rearranged. The wound is airtight with dissolvable stitches.

The functioning usually takes about two hours and is washed using a general anaesthetic. Most children are in hospital for 1 to 3 days, and over again arrangements may be made for yous to stay with them.

The scar from palate repair volition be inside the mouth.

Additional surgery

In some cases, additional surgery may be needed at a later stage to:

repair a crevice in the glue using a slice of bone (a bone graft) – usually done at around eight to 12 years of historic period
better the appearance and part of the lips and palate – this may be necessary if the original surgery did not heal well or in that location are ongoing speech problems
meliorate the shape of the nose (rhinoplasty)
ameliorate the appearance of the jaw – some children born with a crevice lip or palate may have a small or "set-dorsum" lower jaw

Feeding help and advice

Many babies with a cleft palate have problems breastfeeding because of the gap in the roof of their mouth.

They may struggle to class a seal with their oral fissure – and then they may take in a lot of air and milk may come out of their olfactory organ. They may also struggle to put on weight during their get-go few months.

A specialist cleft nurse tin can advise on positioning, alternative feeding methods and weaning if necessary.

If breastfeeding is not possible, they may advise expressing your breast milk into a flexible bottle that is designed for babies with a crack palate.

Very occasionally, it may be necessary for your baby to be fed through a tube placed into their olfactory organ until surgery is carried out.

Treating hearing problems

Children with a scissure palate are more than probable to develop a condition called mucilage ear, where fluid builds up in the ear.

This is because the muscles in the palate are connected to the middle ear. If the muscles are non working properly because of the crevice, sticky secretions may build up within the centre ear and may reduce hearing.

Your child will have regular hearing tests to check for any issues.

Hearing problems may improve after cleft palate repair and, if necessary, can be treated by inserting tiny plastic tubes chosen grommets into the eardrums. These allow the fluid to drain from the ear.

Sometimes, hearing aids may be recommended.

Dental care

If a cleft involves the gum area, it'south common for teeth on either side of the crevice to exist tilted or out of position. Oft a tooth may be missing, or there may be an extra tooth.

A paediatric dentist will monitor the wellness of your kid's teeth and recommend treatment when necessary. It's also of import that you annals your kid with a family dentist.

Orthodontic treatment, which helps better the alignment and appearance of teeth, may also exist required. This tin include braces or other dental appliances to help straighten the teeth.

Brace treatment usually starts after all the baby teeth have been lost, but may be necessary before a os graft to repair the fissure in the gum.

Children with a cleft are more vulnerable to tooth decay, so it'due south important to encourage them to do expert oral hygiene and to visit their dentist regularly.

Speech and linguistic communication therapy

Repairing a cleft palate will significantly reduce the chance of speech problems, but in some cases, children with a repaired cleft palate still need speech therapy.

A spoken language and language therapist (SLT) will assess of your child's spoken language several times every bit they get older.

If there are any problems, they may recommend further cess of how the palate is working and/or work with y'all to assist your child develop clear speech. They may refer yous to customs SLT services almost your home.

The SLT will continue to monitor your child'southward speech until they are fully grown and they will work with your child for every bit long as they need assistance.

Further cosmetic surgery may sometimes be required for a small number of children who have increased airflow through their nose when they're speaking, resulting in nasal-sounding speech.

Specialist United kingdom of great britain and northern ireland cleft lip and palate centres

England

Royal Victoria Infirmary, Newcastle-upon-Tyne
Leeds General Infirmary
Royal Manchester Children's Hospital
Alder Hey Children's Hospital, Liverpool
Nottingham Children's Hospital
Birmingham Children'southward Hospital
Addenbrooke's Infirmary, Cambridge
Dandy Ormond Street Infirmary, London
Broomfield Infirmary, Chelmsford
John Radcliffe Hospital, Oxford
Salisbury District Infirmary
Bristol Royal Hospital for Children
Guy'south and St Thomas' Infirmary, London

Wales

Morriston Hospital, Swansea

Scotland

Royal Hospital for Sick Children, Edinburgh
Royal Hospital for Sick Children, Glasgow

Northern Republic of ireland

Children's Hospital, Belfast

Page last reviewed: 13 August 2022
Next review due: 13 August 2022

Source: https://www.nhs.uk/conditions/cleft-lip-and-palate/treatment/

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