Cleft lip and palate are among the most common facial deformities that children suffer from. Therefore, they require attention, care, and support from their families and surroundings to help them overcome this injury, which affects their psychological aspects significantly. Cleft lip and palate are considered deformities that affect the child's upper lip, the palate, or both.

 

1. Genetic factors related to a family member.

2. Environmental factors that can affect the shape of the fetus during pregnancy.

3. Maternal use of prohibited medications during pregnancy, such as medicines for migraine headaches, epilepsy, chemotherapy, or some cancer medicines.

4. Smoking by the father or mother.

5. Alcohol consumption.

6. Folic acid deficiency during pregnancy.

 

The condition can occur at the beginning of pregnancy when the fetus is in the mother's womb, specifically in the first trimester, and when the fetus's lips are forming. 

1. Unilateral cleft lip: It is a split in the upper lip that either extends to the nose or does not reach it.

2. Bilateral cleft lip: It is characterized by two splits on both sides of the lip, either extending to the nose or not.

Statistics have shown that one case every seven hundred births is born with this congenital condition every year. These statistics also indicate that cleft lip ranks fourth among the most prevalent deformities among newborns. The incidence of cleft lip deformity is higher in males than females, while cleft palate deformity in females is higher than in males.

 

After birth, the baby can be examined visually, and no further tests are needed. However, before birth, the condition can be diagnosed using a 4D ultrasound, preferably in the thirteenth week of pregnancy, and it becomes clearer as the pregnancy progresses.

 

1. Difficulty in feeding leads to nutritional deficiencies regardless of breastfeeding or bottle-feeding.

2. Ear and chronic infections may result in hearing loss due to fluid buildup in the ear.

3. Speech difficulties and the inability to pronounce correctly due to changes in the articulatory organs. The palate plays an important role in pronouncing words correctly.

4. Tooth decay and jaw problems if the cleft passes through the upper gum.

5. Respiratory issues.

 

It is necessary for patients, who are usually children, to undergo plastic surgical procedures. As a result, the child may undergo one or more surgeries, depending on the severity of his condition.

 

To ensure optimal results, the medical team treating this condition should consist of more than one doctor, each representing a different field of medicine, due to the nature of the condition and the potential overlapping damages to the patient. Dr. Wael Ghanem, a consultant in plastic surgery and corrective congenital defects, has made sure to provide a comprehensive service to children with cleft lips. The following are some of the medical specialties that intersect in this surgery:

• Plastic surgeon.

• ENT doctor.

• Dentist.

• Speech therapist.

• Oral and maxillofacial surgeon.

• Pediatrician.

The surgical procedures required for each patient with a cleft lip differ depending on the type and severity of the deformity. Timing and treatment will be determined based on each patient's overall medical needs, but treatment typically includes a combination of procedures described here:

The child undergoes cleft lip repair surgery between the first and third months. This procedure is the first that he must perform to restore the lip to its natural state, whether it is a unilateral or bilateral cleft. The natural continuity and thickness of the lips are maintained to achieve a natural aesthetic appearance by closing the skin layers and connecting the muscles. In the case of a unilateral cleft lip, the goal is to modify the shape of the gums. In the other case, the goal is to correct the jaws and ensure their normal growth, which involves the role of a dentist in monitoring the natural teeth growth and assessing the need for intervention.

 

This surgery is the second one performed on a child with a bilateral cleft when he is six months old. This procedure aims to reduce fluid accumulation in the middle ear and to allow healthy natural growth of teeth and the face in general.

This is done to ensure that no blockage in the ear canal may affect hearing or require the insertion of tubes to drain any fluids if they are present.

If there is a problem with the palate, speech therapy sessions begin. Some tests, such as endoscopy and X-rays, may be conducted to evaluate the movement of the palate. Some children may need tightening or lengthening of the muscles in the soft part of the palate.

After completing the previous surgeries, children need to see a dentist for dental orthodontics, bone grafting, or dental implants to ensure teeth natural and proper growth. Some cases may require surgical intervention or jaw correction when they reach the age of five.

The child may need a cosmetic intervention for the nose, which may be done in one stage at the age of six or seven years, and he may need a second stage at the age of sixteen.

 

In the case of a child with a cleft lip in the family, parents may be concerned about the possibility of having another child with the condition. While it is difficult to completely prevent it, some measures can be taken to reduce the likelihood of its occurrence. These include the following steps:

• The mother should take the necessary vitamins during pregnancy.

• Avoid smoking, both active and passive, and avoid alcohol.

• The parents should undergo genetic testing to determine the likelihood of the condition in their offspring.

After cleft lip surgery, Prof. Dr. Wael Ghanem recommends using a dropper or syringe for feeding from the side of the mouth for two weeks while adhering to daily care instructions.

You can enjoy the joy of parenthood with Prof. Dr. Wael Ghanem, a plastic surgeon and congenital defect repair consultant.