Our Summary

This research paper discusses a study on children who have undergone surgery for cleft lip and/or palate, a common birth defect affecting the mouth and nose. The researchers looked at 752 patients who had these surgeries at “S. Chiara” Hospital between 2009 and 2015. They collected data on the patients’ backgrounds, the type of cleft they had, any known risk factors, details of their surgeries, and their follow-up visits.

They also recorded any complications that occurred. The researchers found that complications were reported in about 14% of the patients.

To gauge how satisfied the patients’ caregivers were with the results of the surgeries, the researchers gave them a survey. The survey asked about satisfaction with several features related to the cleft, such as the appearance of the lip, nose, teeth, and profile, and the child’s ability to breathe. The average scores on these questions were quite high, indicating a high level of satisfaction.

Additionally, the researchers asked four assessors to rate the aesthetic (appearance-related) satisfaction using a visual scale. These ratings were also high, showing that the surgeries were generally successful in improving the patients’ appearance.

The researchers concluded that the team-based approach to treating children with clefts led to good results in terms of satisfaction and aesthetic appearance. They also noted that two specific surgical techniques - periosteoplasty and lip-adhesion - were particularly important in their approach.

FAQs

  1. What was the rate of complications reported in the study of children who underwent cleft lip and/or palate surgeries?
  2. How did the researchers measure the satisfaction of the caregivers after the surgery?
  3. What were the two specific surgical techniques that the researchers noted as particularly important in their approach?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft lip repair is to follow all post-operative instructions carefully to ensure proper healing and minimize the risk of complications. This may include keeping the surgical site clean, avoiding certain foods or activities that could cause strain on the repair, and attending follow-up appointments as scheduled. It’s also important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended cleft lip repair include infants and children born with cleft lip and/or palate. Cleft lip repair is usually recommended when the child is around 3 to 6 months old, while cleft palate repair is typically done between 9 to 12 months of age.

In some cases, older children and adults with untreated cleft lip and palate may also be recommended for surgery to correct their condition. Patients with associated complications such as feeding difficulties, speech problems, dental issues, and hearing loss may also benefit from cleft lip repair surgery.

Overall, patients recommended for cleft lip repair are those who would benefit from improving their appearance, speech, feeding abilities, and overall quality of life. Each patient’s case is unique, and the decision to undergo cleft lip repair surgery is typically made in consultation with a multidisciplinary team of healthcare professionals, including plastic surgeons, oral and maxillofacial surgeons, speech therapists, and other specialists.

Timeline

Before cleft lip repair:

  1. Prenatal diagnosis or identification of cleft lip during ultrasound.
  2. Birth of the baby with cleft lip.
  3. Consultation with a pediatric surgeon and other specialists to discuss treatment options.
  4. Preparation for surgery, which may include feeding strategies, dental evaluation, and counseling for the family.

After cleft lip repair:

  1. Surgery to repair the cleft lip, typically performed when the baby is around 3-6 months old.
  2. Post-operative care and monitoring for complications.
  3. Follow-up visits with the surgical team to assess healing and adjust treatment as needed.
  4. Long-term care to address any additional surgeries or treatments that may be required as the child grows.
  5. Assessment of satisfaction with the surgical results through caregiver surveys and aesthetic ratings.

What to Ask Your Doctor

Questions a patient should ask their doctor about cleft lip repair:

  1. What type of cleft lip repair surgery do you recommend for my specific case?
  2. What are the potential risks and complications associated with cleft lip repair surgery?
  3. How long is the recovery process after cleft lip repair surgery?
  4. Will there be any visible scarring after the surgery, and if so, how can it be minimized?
  5. What can I expect in terms of follow-up care and appointments after the surgery?
  6. How will cleft lip repair surgery impact my child’s ability to eat, speak, and breathe?
  7. Are there any specific dietary or lifestyle restrictions my child should follow after the surgery?
  8. How successful are cleft lip repair surgeries in improving the appearance of the lip, nose, teeth, and profile?
  9. Are there any specific techniques or approaches that you recommend for achieving optimal aesthetic results?
  10. How important is a team-based approach in the overall success of cleft lip repair surgery, and what role will each member of the team play in my child’s care?

Reference

Authors: Gatti GL, Freda N, Giacomina A, Montemagni M, Sisti A. Journal: J Craniofac Surg. 2017 Nov;28(8):1918-1924. doi: 10.1097/SCS.0000000000003820. PMID: 29088690