Cleft Lip and Palate Surgery – Pediatric

File:Cleftpalate.jpeg

This surgery is performed to correct a cleft lip and palate. It involves creating an incision on the patient’s upper lip, repositioning the patient’s muscles and tissues comprising the roof of the patient’s mouth, and closing the incision with either removable or dissolvable stitches.

What is it?

Cleft lip (cheiloschisis) and cleft palate (palatoschisis) are common birth defects. These conditions are developmental defects that arise while the child is in the womb. Cleft means that either the lip or the roof of the mouth formed incompletely, and may occur separately or in conjunction, affecting one side of the face or both. Most clefts can be fixed with plastic surgery, restoring both functionality and appearance.

What should I do to prepare?

Ten days before the surgery, patients will need to stop taking most medications, especially blood thinners. The doctor will likely perform a blood test along with several physical examinations in the days/weeks before the surgery.  The patient should refrain from eating and drinking before the operation, only allowing for sips of water with some medications given by the doctor.  Additionally, make preparations for a delayed surgery if the child is not healthy or slightly underweight.

What happens during the process?

The surgical process will be unique to the particular defects of each child, but all will require general anesthesia. During a cleft lip repair, the plastic surgeon makes an incision on the side of the deformity spanning from the lip to the nostril. These two sides are sutured together, using tissue from the area to rearrange and close the lip as needed. Cleft lip repair restructures the muscle and connective tissue of the upper lip to provide the proper functionality of the mouth. If a first surgery is unsuccessful, a second surgery may be needed. Cleft palate surgery typically occurs when the child is a few months older. This surgery in children at an older age follows a similar procedure but is often more intensive.

What are the risks and potential complications?

Like all surgical procedures, cleft lip and palate surgeries carry risks and side effects. Risks and complications vary in severity depending on the age of the child, extent of cleft, and the lip/palate, but include irritation, pain, swelling, bruises, bleeding, and scarring.

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