Cleft lip and palate is a congenital cleft in the lip and palate that is clinically observable due to a defect in the development of the tissues of the human lip, dental bed and palate resulting in the absence of a normal tissue structure.
Although cleft lip and palate is one of the most common congenital malformations, it can be remedied with love through the efforts and contributions of many people. The treatment of cleft lip and palate is not only a matter of surgical closure of the cleft present, but also a comprehensive sequence of treatment for cleft lip and palate patients by medical teams from different disciplines. Zhou Zhibo, Department of Maxillofacial Surgery, Peking University Oral Hospital
The sequence of sequential treatment for cleft lip and palate according to its developmental growth from newborn to adult is as follows.
l Pre-birth counseling and explanation of treatment for children with cleft lip and palate.
l Post-birth registration of children with cleft lip and palate, guidance on parental feeding methods and psychological counseling
l 3 months: repair of unilateral cleft lip
Depending on the child’s condition, the need for simultaneous repair of the nasal deformity is decided, as well as the need for preoperative orthodontic correction of misaligned jaw deformities.
3-6 months: Repair of bilateral cleft lip
Generally, it is not necessary to repair the nasal deformity at the same time, and to consider the need for preoperative orthodontic correction of the anterior jaw deformity.
l 6-18 months: repair of cleft palate and examination of middle ear function
Repair of cleft soft palate and/or hard palate, ENT examination of middle ear to rule out otitis media
l 3-9 years: other surgical and other treatments that may be needed
Depending on the joint involvement of the parents, the child and the doctor of the child with cleft lip and palate, the decision will be made to
1. revision of secondary deformities of the nose and lip
2. palatal fistula repair DD possible fistula in the palate after cleft palate repair
3. pharyngoplasty DD to improve the child’s articulation
If possible, the above three procedures can be performed under a single anesthetic.
4. orthodontics DD to determine the timing of orthodontic correction of misaligned teeth according to the specific situation of the child with cleft lip and palate
5. Speech training DD to improve the pronunciation of children with cleft lip and palate.
l 9-11 years old: alveolar ridge implantation DD before the eruption of cuspids
The purpose is to close the oronasal fistulae that exist in the bony fissures of the dental bed, to make the maxillary alveolar bone a whole, to elevate the supporting nasal floor, and to lay the foundation for orthodontic alignment of the misaligned dental bed.
l 11-16 years old.
Depending on the involvement of the parents, the child and the doctor of the adolescent with cleft lip and palate, it is decided that
1. revision of secondary deformities of the nose and lip
2. pharyngoplasty
3. Orthodontics
After the age of 16: after the cessation of orthognathic surgery DD development
1. orthognathic surgery to correct mid-facial developmental defects and improve dental occlusion and joint problems
2. Correction of secondary deformities of the nose and lips.
3. Phonological evaluation.