Cleft lip and palate are one of the most common congenital disorders in children. One in 700 children is affected at birth. These conditions occur in various combinations like one side lip alone, both sides lips alone, palate defects alone, or lip defects combined with palatal defects. Lip defects are often associated with nasal defects also.
Various causes like nutritional deficiency during pregnancy, genetics, marriage between close relatives can be attributed to these defects. However, with new technologies, these defects are often diagnosed before birth and can be effectively tackled once the child is born.
Isolated lip defects with or without nasal deformity are cosmetic deformity with minimal functional deficits. Speech defects are minimal but can be present when palate defects are also there. These defects are repaired usually at 3 months of age when the child attains suitable weight to tolerate the procedure. NAM (nasal-alveolar molding) is used from the time of birth till the surgery to help with the procedure. We use Millard and Tenison techniques to repair the lip for the best aesthetic results.
Cleft palate on the other hand has functional deficits like difficulty in feeding and speech defects. Since the child is not able to make proper seal breastfeeding becomes difficult. Special techniques are taught to parents so that children can be fed properly. Once the child is 6-9 months of age palate is repaired.
Late repair of the palate is associated with permanent speech defects which are very difficult to correct later. Children often need speech therapy after the repairs. Older patients may undergo endoscopic evaluation of oral and windpipes to see the defects creating speech distortions.
We use Bardach two flap techniques, VWK pushback palatoplasty and Furlows repair for repairing palates. Procedure is decided according to the needs of the patient.