SURGICAL PROCEDURES

Cleft Lip and Palate Repair

Overview

Cleft lip and palate repair is the surgical repair of an abnormal gap in the mouth’s ceiling and a slit in the lip. A divide in the lip and opening in the top part of the mouth is a common fetal abnormality during birth. When parts of the mouth and lip fail to form during pregnancy, a cleft lip and palate develops. In some instances, a syndrome (ectodermal dysplasia syndrome (CLPED)) may lead to the formation of a cleft. Environmental and genetic factors can cause this in newborn babies.

Fortunately, cleft lip and palate repair are procedures done to restore the aesthetics and function of the baby's lips and mouth. Restoration of the oral cavity helps the baby eat, hear, speak and breathe optimally. This procedure is beyond cosmetic appeal but is a necessity, particularly in the future when the child grows up and requires the ability to speak clearly to others in school and work.

Procedures

First, Dr Kleintjes aims to seal the divide in the lip. This is done to normalise the upper lip and restore function to the mouth. Next, he creates incisions along the sides of the cleft to develop tissue flaps and fringes of muscle and intraoral tissue. These components are gathered near the cleft to recreate and sculpt the lip and nose area.

Next, cleft palate repair completes restoration of the baby’s mouth. This surgery is an intricate procedure that requires careful repositioning of the cleft's muscles and tissues to create the mouth's top portion (ceiling). Similar to cleft lip repair, the surgeon makes incisions on the sides of the cleft and uses flap techniques to realign hard and soft palate tissues. Soft palate muscles that control speech are also manipulated. Finally, Dr Kleintjes seals the incisions from the middle of the mouth’s roof, giving the palate enough length for the baby’s growth.

Recovery

Bandages conceal the incisions outside the baby’s mouth. You will be given instructions on how to care for the surgical area as ordered by the doctor. You can apply or give your child prescription medicine the doctor instructed you to administer to prevent infection.

Feeding your baby can be quite different while you wait for your baby’s mouth to heal. So, it is best to utilise restrictions when necessary to encourage healing of the mouth’s tissues.

FAQ

1What can I do to stop my child from touching the stitches around their mouth after cleft lip and palate repair?
Exercise gentle restraint when necessary. This involves applying soft restraints to your baby’s hands to prevent them from touching their mouth. This may look strange but is required to safeguard your baby’s mouth. The doctor can help you with this if necessary.
2What should I watch out for after cleft palate repair?
Ear infections! There is a high risk of recurrent ear infections after cleft palate repair. Small ear tubes that help pump out excess fluid may be placed after cleft palate repair. However, the tubes need to be replaced often.
3Does my child need another surgery after cleft lip and palate repair?
Additional surgeries include using a bone graft which is a portion of bone to fix the gum’s cleft, as well as a rhinoplasty to enhance the nose shape. There is also an alternative procedure to redefine the jaw's shape.

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