Generally about the treatment
During the early foetus stage, long before the child is born, the left and right sides of the lips grow together, along with the hard palate - under normal circumstances.
Despite this, 1 out of 800 children are born with the parts not meeting completely. A child born with a separation of the upper lip has got what is called cleft lip. A similar birth defect in the hard palate is called a cleft palate.
Seeing as the lips and palate develop individually, it makes it possible for a child to have cleft lip, cleft palate, or a variation of the two.
Cleft palate can make it difficult for the newborn to suck and swallow. Additionally, it can lead to significant speaking difficulties. If the cleft lip is not operated on, it will often cause great psychological suffering to the child, due to teasing and ridiculing later on. There is no immediate knowledge of the cause of these deformities, but there is a tendency for it to be hereditary. An operation is usually very successful, both for the appearance and the development of speech.
The procedure
A cleft lip can vary from being a small indentation to a line that goes all the way up into the nose. It can occur in one side or - in rare cases - in both sides.
The operation normally takes place, when the child is 2-3 months old. The surgeon will most commonly place a cut on each side of the line leading to the nostrils. Then he or she will pull the skin and muscle together in order to close the gap.
The muscle function and the mouth's normal "cupid's bow"-shaped appearance will become reconstructed. In some cases, the deformity of the nostrils will be improved with the same procedure. In other cases, another operation will be necessary.
A cleft palate can also vary in difficulty, from a small indention in the back part of the hard palate to being a long line, going from the far back to the front. As with cleft palate, it may occur in one or both sides. The operation of cleft palate is, however, a bit more extensive than the cleft lip, which is why the operation is postponed, until the child has reached the age of 1, so that he or she is able to tolerate this.
In order to correct a cleft palate, the surgeon will place a cut on both sides of the separation, in order to then pull the tissue together. This way the child will still be capable of eating and learning to speak after the surgery is over.
The treatment takes between 1-2 hours, depending on the extent.
Anaesthesia
Both operations are done under general anaesthesia, and with hospitalisation for about 24 hours.
Side-effects
Swelling, contusion (bruising), soreness, and pain. With the cleft lip operation, the patient will be left with a permanent scar. This will be hidden by the shade created by the nose and upper lip though.
Risk of complications
With a cleft lip operation, there is a risk of a less successful cosmetic result. Most commonly this is asymmetry, meaning that one side of the mouth and nose does not match the other completely. The purpose of the operation is to close the separation of the upper lip. If this is not carried out right the first time, a new operation will be necessary. With the cleft palate operation, there is a risk of poor healing or speech impairment, which will also require a second operation.
There is a risk of side effects from the anaesthetic used, along with bleeding, poor wound healing, a poor cosmetic result, and blood accumulation.
No form of surgery is risk free, although severe complications are very rare.
Healing and recovery
There will be restrictions as for the child's food, which the surgeon will explain in detail. Any bandages used will be removed after 1-2 days, and the stitches after about 5 days, if self-dissolving ones are not used. The child will often be restless and uneasy some weeks after the operation.
Duration of the result
The result of the surgery is permanent.