Cleft palate

Cleft lip

Unilateral cleft lip: This form of cleft affects only one side of the upper lip and may extend to the upper part of the gums.

Bilateral cleft lip: This form of cleft affects both sides of the upper lip and can extend to the upper part of the gums.

Cleft palate

Cleft palate: This condition involves a split in the soft part of the palate, which is closer to the throat. This cleft can affect the ability to breastfeed and speak.

Cleft hard palate: This condition involves a split in the hard part of the palate, which is located closer to the front of the mouth. A cleft hard palate can affect the shape of the face and the structure of the oral cavity.

Complete cleft palate: This form includes a cleft in both the hard and soft palate, which can significantly affect function and aesthetics.

Cleft lip and palate

This form involves a cleft in the upper lip along with a cleft in the soft and/or hard palate. This complex form can have a greater impact on nutrition, speech, and health aspects.

Consultations

Before surgery, the patient and family undergo a detailed consultation with a plastic surgeon and, possibly, a team of specialists (speech therapist, dentist) who will work together on a treatment plan.

Searches and preparations

In preparation for surgery, certain tests may be needed to ensure that the child is physically ready for the procedure. This may include blood tests and an assessment of the child's general health.

Surgical procedure

The surgeon will make incisions inside the oral cavity and, if necessary, on the outside of the nose, depending on the type of cleft.

The surgeon will close the cleft by connecting the surrounding tissue, cartilage, and muscles. In the case of a cleft palate, the surgeon will carefully join the edges of the soft and/or hard palate together to achieve normal function and appearance. This stage requires precision to ensure proper speech and swallowing function.

Sometimes grafts (transplants) from other parts of the body can be used to further strengthen the structures of the nose or improve the functionality of the palate.

Once all necessary corrections have been made, the surgeon will carefully close the incisions. The stitches may be removed after a few days, depending on the type of stitches used.

Recovery monitoring

After surgery, the child usually remains in the hospital for observation for several hours or days, depending on the complexity of the procedure and the child's general condition.

Medical staff will monitor vital signs, such as pulse, blood pressure, and breathing, to ensure that the child is recovering properly from anesthesia.

Painkillers

After surgery, your child will likely be prescribed painkillers to manage pain. It is important to monitor your child's response to the medication and notify the doctor if the pain becomes unbearable.

Nutrition

Postoperative diet: After the procedure, the child may need to start on a liquid diet and later be switched to soft foods. It is important to avoid hard, hot or spicy foods until full recovery is achieved.

Hydration: Ensure adequate hydration, especially if the child is on a liquid diet.

Wound care

Parents should carefully monitor the area around the incision and the stitches. It is necessary to ensure that the wound remains clean and dry. Instructions on washing and caring for the wound will be given by the surgeon.

Parents should be aware of signs of infection, such as redness, swelling, pus, or fever, and notify the doctor immediately if they notice these symptoms.

Activities

It is important to give your child enough rest so that their body can recover. Avoid intense physical activity and blows to the nose area.

Parents should make sure that their child does not touch or rub their nose, and avoid situations that could lead to nose injury.

Regular check-ups

After surgery, the child will need to have regular check-ups with the surgeon to assess recovery and determine any additional treatments or therapies (e.g., speech therapy) needed.

Problems with breastfeeding and feeding

Newborns with a cleft palate may have difficulty breastfeeding or bottle-feeding. The cleft can make it difficult to create the vacuum needed for successful feeding, which can result in reduced food and fluid intake.

Possible swallowing difficulties

People with a cleft palate may experience difficulty swallowing food, especially if other problems with the structural development of the oral cavity or pharynx are also present.

Speech development

A cleft palate can significantly affect speech development. Problems may occur with the pronunciation of sounds, especially those that require normal soft palate function (e.g., the sounds "k," "g," "h," "n").

Sound patterns

Children with cleft palates may have unique speech sound patterns, such as nasality, which occurs when air passes through the nose instead of the mouth when making certain sounds. This problem may require speech therapy interventions to improve articulation and clarity of speech.

Speech therapy

Most children with cleft palates use speech therapy to improve their speech skills. These therapies may include exercises to strengthen the muscles of the mouth and improve airflow control.