Simultaneous Unilateral Cleft Lip and Palate Repair

Baby boy from Assam

This baby boy from Assam was born with a cleft. He is about one year of age. The incidence of cleft lip and palate in newborns is comparatively higher in Assam. The baby had a split upper lip. He also had a hole in the roof of his mouth which affected his feeding. An ultrasound test during development in the womb revealed that the developing baby had a cleft.

There is a history of clefts running through the family. Even though the parents were aware of the right time to perform the surgery, they were hesitant and brought the baby only at about one year of age. They, however, requested for simultaneous cleft lip and palate correction.

Unilateral cleft lip and palate

Unilateral cleft lip is a congenital split in the upper lip on one side. It is often associated with cleft palate. The cleft palate refers to a hole in the roof of the mouth. It usually involves the soft palate and hard palate. Babies with cleft lip and palate have difficulty in feeding. They have nasal regurgitation. Cleft babies may develop various problems as they continue to grow.

They develop dental problems which require corrective treatments. The dental problems may require surgical and non-surgical intervention. They also have an increased risk of middle ear infections which may lead to hearing problems. Babies born with clefts may have speech problems. Thereby requiring a speech therapist opinion.

Types of clefting

There are various types of clefting which may involve oral and nasal cavities. They are

  • Incomplete
  • Unilateral and
  • Bilateral

Cleft lip and palate surgery in India

The parents were very depressed with their baby’s condition. They were very concerned about her future. They were searching through the internet for the best cleft lip surgeon in India. They were referred to our hospital by a local physician. Dr.S.M.Balaji one of the leading cleft lip and palate surgeon in India examined the patient.

He agreed to correct the cleft lip and palate simultaneously. The oral and nasal cavities had to be closed also.

Cleft palate repair

Cleft palate repair was to be done first. The abnormal palatal musculature was to be corrected during the surgery. The cleft palate repair was done using Veau Wardill Kilner’s technique.

Primary cleft lip repair

Corrective lip repair was also of utmost importance. Cleft lip and palate surgeon Dr. S.M. Balaji also performed cleft palate repair at one year of age. Unilateral cleft lip repair is done using Modified Millard’s technique. The upper lip musculature was also corrected during the surgery.

Surgery outcome:

The result of the surgery was as expected. He looked normal unlike any other child of his age with minimal to no scar. The parents were pleased with the outcome of the surgery.

Future surgical corrections:

Bone grafting is to be done at 3 and a half to 4 months of age thereby promoting bone growth. Speech correction / Pharyngoplasty may be necessary at 3-4 years of age. Further surgical corrections will be carried out at later date.

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