Cleft Lip and Palate Treatment

Lip formation generally occurs between the 4th and 7th weeks of pregnancy, while palate formation takes place around the 6th or 7th week. During the fetus’s development in the womb, the correct fusion may not occur in the upper lip, palate, and mouth areas. Problems in development during this process can lead to the formation of a gap in the relevant areas.

Appropriate treatment for this condition, resulting from the incomplete development of the baby’s lip and palate in the womb, is planned after birth. The cleft palate surgery initiates the repair process for the area, emphasizing significant aesthetic considerations. Performing the treatment in the early stages is crucial to prevent the formation of permanent scars.

The cause of cleft lip and palate disorder is generally based on hereditary factors. It can result from genetic transmission from close or distant relatives or the use of certain medications during pregnancy. During cleft lip repair, although research is conducted to identify the specific causes for each patient, it is challenging to make a definitive determination with 100% certainty.

Cleft lip and palate treatment is applied to correct a congenital disorder and restore the aesthetic appearance. Additionally, this condition makes daily functions such as eating and speaking more challenging.

A cleft in the patient’s lip or palate will hinder the mouth from fully performing its basic functions and effective use of teeth. Furthermore, during speech, there may be difficulty in producing sounds or letters accurately. As these issues significantly impact the patient’s quality of life, surgical correction of the lip/palate cleft is necessary to ensure individuals do not encounter any problems in their social and daily lives.

Cleft lip and palate treatment occurs with two main objectives and three distinct approaches. Firstly, efforts are made to address aesthetic structural issues. Subsequently, the focus is on the repair of functional impairments. The treatment process typically begins with palatoplasty, followed by orthodontic treatment and concludes with speech therapy.

Cleft lip and palate treatment definitively requires surgical intervention. In the repair of the affected areas, two different operations may be preferred. The details of these surgical interventions are outlined as follows:

• The most commonly preferred method in cleft lip surgery is flap surgery, aiming to achieve muscle repair by shifting tissues. In procedures performed by expert plastic surgeons, tissues are rotated from the non-cleft area, ensuring the transfer of healthy tissue. The operation typically takes around 1-2 hours.
• In cleft palate surgery, surgical procedures are employed to cover the area with healthy tissues. Initially, repair occurs in the nasal part, followed by the sections containing the palate muscles responsible for speech function and the areas providing the inner mouth mucosa.

Cleft lip and palate interventions are completed with the aforementioned operations, preventing a negative impact on the patient’s quality of life due to the health issue in later years. Orthodontic treatment for cleft lip and palate takes place after all these surgical processes.

After the surgical interventions for cleft lip and palate treatment, a comprehensive care process begins:

• It is crucial to preserve stitches and prevent them from being damaged as much as possible.
• Strict adherence to nutrition programs recommended by the specialized doctors who performed the procedure is essential.
• Breathing should be supported with steam applications.
• Regular adherence to follow-up programs at specified intervals is necessary.

These postoperative care measures contribute to the successful recovery and overall well-being of the patient after cleft lip and palate surgery.

Cleft lip and palate treatment progresses within a specific plan. The details of the planned treatment for the successful completion of the process are as follows:

The entire process of cleft lip and palate reconstruction progresses with the details mentioned in the table above until adulthood.

Multidisciplinary care for cleft lip and palate is one of the crucial aspects that need to be continued throughout the treatment. The patient should undergo various check-ups until adolescence or even adulthood. Initially, checks related to surgical operations are ensured. Especially, any aesthetic imperfections are monitored during the recovery process. Additionally, the results of the surgeries performed in the oral and palate areas are examined to observe the progress in development in that region.

Since cleft lip and palate treatment requires orthodontic intervention, after the surgery, the patient needs to pay attention to their dental and gum health. For this reason, a care program is initially established. Subsequently, the orthodontic plan created for the patient is also included in the care and recovery process. The successful completion of all these processes is crucial for achieving goals such as a good appearance, healthy nutrition, and proper speech for the patient.

Following the cleft lip and palate surgery, special care methods should be applied for 3-4 weeks to ensure the success of the surgical interventions. During this period, special attention must be given to the patient for positive outcomes from the surgeries. Especially within the first 24 hours, there might be bleeding in the mouth, swelling of the tongue, and difficulties in breathing. Parents should closely observe the patient during this period. The operated area should be kept clean constantly, and patients should consume plenty of water during the recovery period.

After overcoming the initial 24-hour period in the cleft lip and palate rehabilitation process, close observation can be slightly eased, but regular check-ups should not be neglected. With the onset of the third day after the operation, the consumption of liquid foods becomes possible. Solid foods can be gradually consumed based on the doctor’s recommendations, and after the fourth week, there are no more restrictions on nutrition.