1.Prenatal: ultrasound at delivery to determine fetal cleft lip or combined cleft palate – psychological counseling.
2.First interview: 14 days to 1 month after birth to determine the defect, feeding instructions, and preoperative orthodontic specialist to complete orthodontic treatment.
3.Pre-operative evaluation: 3-4 months re-visit to assess the development to decide the time of surgery and make an appointment for surgery.
4.Phase I surgery time: 6-9 months old, weight over 7 kg, cleft lip, cleft palate phase I revision, soft tissue closure of the alveolar process cleft at the same time, parallel nasal deformity phase I revision. The nasal mold should be worn after the operation.
5.First postoperative follow-up: 3-4 weeks after surgery, remove the nasal mold, and instruct the lip massage to soften the scar and use the appropriate postoperative scar removal drugs. Post-operative nasal brace is recommended to be worn for more than one year.
6.6 months postoperative follow-up: observe the softening of the lip scar, adjust the scar removing medication, and generally assess the facial development and psychomotor development. Ear, nose and throat specialist will complete hearing assessment.
7.2 years old follow-up: assess the child’s speech development; correct bad habits; assess the mid-facial development and give functional orthopedic advice if there is maxillary dysplasia (geodysostosis); early speech intervention; assess the upper lip and nasal development and consider second-stage cleft lip revision if necessary.
8. 4-4.5 years follow-up: very important to complete speech assessment of palatopharyngeal closure function and decide whether to end treatment of cleft palate completely; also re-evaluate the appearance of upper lip and nasal deformity and perform cleft lip stage II, nasal deformity correction and cleft palate stage II revision if necessary at the same time.
9, 7-9 years old: After the upper orthodontic incisors erupted, the orthodontic treatment will be carried out again to evaluate the defect of cleft alveolar process. Continue orthodontic treatment after surgery.
10.16-18 years old: After the whole body bone development is completed at the age of 16-18 years old, nasal cartilage scaffold implantation will be decided according to the shape of the nose.