Our Summary

This research paper reviews recent studies and trends in the area of orthognathic surgery (a type of jaw surgery) for patients with a cleft (a gap or split in the upper lip, roof of the mouth, or both). The paper discusses how changes specific to cleft patients after this surgery can impact the results. It examines why and how complications related to the cleft can occur during surgery, and suggests ways to prevent or reduce these complications. The paper suggests that a type of surgery involving both jaws (bimaxillary surgery) appears to be safe for cleft patients. It also suggests that a technique known as maxillary distraction, which can be total or segmental, could improve results. The paper discusses different techniques for cutting bone (osteotomies) and moving the upper jaw (maxillary mobilization) that could reduce negative outcomes. The paper concludes that cleft patients are more likely to experience complications due to their specific conditions before surgery. However, various surgical approaches and techniques can help to overcome these challenges, improve results, and enhance patient safety. The paper stresses the importance of good communication between the patient, their family, and the medical team treating the cleft.

FAQs

  1. What are some common complications in cleft orthognathic surgery?
  2. How can bimaxillary surgery benefit cleft patients?
  3. What are some alternative methods and techniques to improve outcomes in cleft orthognathic surgery?

Doctor’s Tip

One tip a doctor might tell a patient about cleft palate surgery is to follow all pre-operative and post-operative instructions provided by the surgical team. This includes avoiding certain foods or activities before surgery, taking prescribed medications as directed, and attending follow-up appointments for proper healing and monitoring of any complications. It is important to communicate any concerns or questions with the surgical team to ensure a successful outcome.

Suitable For

Patients with cleft palate are typically recommended cleft palate surgery in order to improve their ability to eat, speak, and breathe properly. Additionally, cleft palate surgery can help to improve the overall appearance of the face and reduce the risk of ear infections and dental problems. Cleft palate surgery is usually recommended for patients who are in good overall health and have realistic expectations about the potential outcomes of the surgery. It is important for patients to discuss their options with a qualified healthcare provider in order to determine the best course of treatment for their individual needs.

Timeline

Before cleft palate surgery:

  • Patient is diagnosed with cleft palate either prenatally or shortly after birth.
  • Patient undergoes evaluations and consultations with a cleft team, including surgeons, speech therapists, and other specialists.
  • Patient may undergo presurgical interventions, such as feeding therapy or speech therapy.
  • Surgical date is scheduled and preparations are made for the procedure.

After cleft palate surgery:

  • Patient undergoes the surgery to repair the cleft palate, typically between 6-18 months of age.
  • Patient is monitored closely in the hospital for any complications or issues.
  • Patient may experience swelling, discomfort, and difficulty eating or drinking in the days following surgery.
  • Patient continues to follow up with the cleft team for postoperative care, including speech therapy and monitoring of growth and development.
  • Over time, the cleft palate surgery results in improved speech, feeding, and overall quality of life for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cleft palate surgery may include:

  1. What specific complications are associated with cleft palate surgery?
  2. How can these complications be prevented or minimized?
  3. What alternative methods, such as maxillary distraction, may be considered for improving outcomes?
  4. What techniques will be used for osteotomies and maxillary mobilization during the surgery?
  5. How can I communicate effectively with my cleft team members to ensure the best possible outcome?
  6. What post-operative care will be necessary to reduce the risk of complications?
  7. What is the expected recovery time and what can I do to facilitate a smooth recovery process?
  8. Are there any long-term effects or risks associated with cleft palate surgery that I should be aware of?
  9. How often will follow-up appointments be necessary after the surgery?
  10. Are there any specific dietary or lifestyle changes I should make before or after the surgery to improve my outcome?

Reference

Authors: Ohrmann D, Hoyte-Williams PE, Chen PK. Journal: Curr Opin Otolaryngol Head Neck Surg. 2018 Aug;26(4):260-265. doi: 10.1097/MOO.0000000000000460. PMID: 29746304