Our Summary

This research paper discusses orofacial clefts, which are common birth defects that can affect the mouth and face. These conditions can cause difficulties with feeding and often require the use of specialized feeding equipment. The paper discusses early interventions such as lip taping and nasoalveolar molding, which can be used before surgery to improve the outcome of the surgical repair. There are several techniques available for the surgical repair of orofacial clefts, and the choice of technique depends on the severity of the cleft and the surgeon’s preference. After the surgery, children with orofacial clefts continue to be at risk for certain health issues, such as middle ear disease, velopharyngeal dysfunction (problems with the throat and soft palate), and malocclusion (misalignment of the teeth). These children need ongoing care from a team of different health professionals.

FAQs

  1. What are some early interventions that can be used to preoperatively modify cleft defects?
  2. What factors determine the choice of technique for the repair of orofacial clefts?
  3. What are the potential risks or complications after definitive repair of orofacial clefts?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cleft lip repair is to follow post-operative care instructions carefully to ensure proper healing and minimize scarring. This may include keeping the surgical site clean, avoiding certain foods or activities that could disrupt healing, and attending follow-up appointments as recommended. It is also important to communicate any concerns or changes in symptoms to the healthcare team promptly.

Suitable For

Patients with cleft lip and/or cleft palate are typically recommended for cleft lip repair. These patients may also have other craniofacial malformations that require surgical intervention. In the perinatal period, these patients may have challenges with feeding and nutrition, requiring specialized feeders. Lip taping and nasoalveolar molding may be used as early interventions to modify the cleft defects before surgical repair.

After the initial cleft lip repair, patients may require ongoing follow-up with a multidisciplinary team to address potential complications such as middle ear disease, velopharyngeal dysfunction, and malocclusion. The choice of surgical technique for cleft lip repair depends on the extent of the cleft and the preference of the surgeon. Overall, patients with cleft lip and/or cleft palate require comprehensive care from a team of specialists to address their unique needs and ensure optimal outcomes.

Timeline

Before cleft lip repair:

  • Prenatal diagnosis of cleft lip
  • Feeding challenges and need for specialized feeders in the perinatal period
  • Lip taping and nasoalveolar molding to modify cleft defects preoperatively
  • Consultation with a multidisciplinary team including surgeons, speech therapists, and orthodontists

After cleft lip repair:

  • Surgical repair of cleft lip
  • Follow-up appointments with the surgical team to monitor healing and address any complications
  • Continued monitoring for middle ear disease, velopharyngeal dysfunction, and malocclusion
  • Long-term follow-up with a multidisciplinary team to address any ongoing issues and ensure optimal outcomes

What to Ask Your Doctor

  1. What is the best age for cleft lip repair surgery?

  2. What are the potential risks and complications of cleft lip repair surgery?

  3. How long is the recovery process after cleft lip repair surgery?

  4. Will my child require additional surgeries or treatments in the future?

  5. What type of follow-up care will be needed after cleft lip repair surgery?

  6. How will cleft lip repair surgery affect my child’s speech development?

  7. Are there any long-term effects or limitations associated with cleft lip repair surgery?

  8. What can I do to help support my child’s healing and development after cleft lip repair surgery?

  9. Are there any specific feeding or nutrition considerations I should be aware of for my child with a cleft lip?

  10. Can you recommend any resources or support groups for families of children with cleft lip?

Reference

Authors: Worley ML, Patel KG, Kilpatrick LA. Journal: Clin Perinatol. 2018 Dec;45(4):661-678. doi: 10.1016/j.clp.2018.07.006. Epub 2018 Sep 18. PMID: 30396411