Our Summary

This research paper is a detailed review of the current practices for repairing a unilateral cleft lip, which is a birth defect where one side of the upper lip doesn’t form completely. It discusses recent trends in surgical methods, including the use of precise, curved and mixed geometric designs for the repair. It also reviews new approaches for patient care before, during, and after surgery. These include protocols for faster patient recovery and shorter hospital stays, the ongoing use of a technique that helps shape the nose and gum area before surgery, and a tendency to prefer procedures that can be done in a day without a hospital stay.

The paper suggests there’s plenty of opportunity for further advancements, with promising new technologies on the horizon. These could make the surgery more aesthetically pleasing and functional, and improve the overall surgical experience.

FAQs

  1. What are the current trends in unilateral cleft lip repair surgeries?
  2. What are the benefits of using enhanced recovery after surgery (ERAS) protocols in cleft lip repair?
  3. What new technologies are being developed to improve cosmesis, functionality, and the operative experience in cleft lip repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cleft lip repair is to follow post-operative care instructions closely to ensure proper healing and optimal results. This may include keeping the surgical site clean, avoiding certain foods or activities that could disrupt the healing process, and attending follow-up appointments as scheduled. Additionally, it is important for patients to communicate any concerns or changes in their condition to their healthcare provider promptly. By following these guidelines, patients can help ensure a successful recovery and achieve the best possible outcome from their cleft lip repair surgery.

Suitable For

Patients who are typically recommended for cleft lip repair are those with a unilateral cleft lip deformity. This includes infants and children who are born with a visible separation or gap in the upper lip, which can extend into the nose. Cleft lip repair is usually recommended early in life, ideally within the first few months after birth, to improve both the cosmetic appearance and function of the lip and nose.

In addition, patients who may benefit from cleft lip repair include those with associated cleft palate deformities, as the two conditions often occur together. Individuals with cleft lip and palate may require a more comprehensive treatment plan that addresses both issues.

It is important for patients with cleft lip deformities to be evaluated by a multidisciplinary team of healthcare professionals, including plastic surgeons, oral and maxillofacial surgeons, otolaryngologists, speech therapists, and dental specialists. This team approach ensures that the patient receives comprehensive care and achieves the best possible outcomes from cleft lip repair surgery.

Timeline

Before cleft lip repair:

  • Prenatal diagnosis of cleft lip may occur during routine ultrasound screenings
  • Patient may undergo genetic counseling and receive information on the condition
  • Patient may be referred to a multidisciplinary cleft lip and palate team for evaluation and treatment planning
  • Nasoalveolar molding (NAM) may be recommended to reshape the gum and nasal structures before surgery
  • Patient and family may receive education and counseling on the surgical procedure and post-operative care

After cleft lip repair:

  • Patient undergoes cleft lip repair surgery, typically performed between 3-6 months of age
  • Patient is monitored in the recovery room and may stay in the hospital for a short period of time
  • Post-operative care includes pain management, wound care, and monitoring for complications
  • Patient may require follow-up appointments with the surgical team for assessment of healing and potential revisions
  • Long-term follow-up may include speech therapy, dental care, and additional surgeries as needed to address any residual issues or complications

What to Ask Your Doctor

  1. What are the different surgical techniques available for cleft lip repair, and which one 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 expected to be, and what can I do to facilitate a smooth recovery?

  4. Will there be any visible scarring after the surgery, and if so, how can it be minimized?

  5. How soon after the surgery will I be able to resume normal activities, such as eating and drinking?

  6. Will I need any additional procedures or treatments in the future to address any lingering issues related to my cleft lip repair?

  7. Are there any long-term effects or considerations I should be aware of following cleft lip repair surgery?

  8. How often will follow-up appointments be necessary after the surgery, and what will be checked during these appointments?

  9. Are there any lifestyle changes or precautions I should take to ensure the best possible outcome following cleft lip repair surgery?

  10. Can you provide me with any resources or support groups for individuals who have undergone cleft lip repair surgery?

Reference

Authors: Hughes EB, Tatum SA. Journal: Curr Opin Otolaryngol Head Neck Surg. 2023 Aug 1;31(4):286-292. doi: 10.1097/MOO.0000000000000897. Epub 2023 Apr 25. PMID: 37144507