Cleft lip surgery is a surgical procedure performed to treat a cleft lip. Cleft lip is a congenital abnormality that occurs in infants marked by cleft lip and palate. Gap the formed due to imperfect union between the two sides of the lip and palate mouth.
Cleft lip surgery can generally be performed on babies aged 3-12 months. If the cleft lip that occurs affects the shape of the nose, the doctor who performs the cleft lip surgery will also correct the shape of the patient's nose. This nose shape correction surgery is known as rhinoplasty. For the purposes of surgery, the doctor may take tissue from another part of the body (graft). Patients with cleft lip can undergo several operations to close the cleft completely.
Indications for Cleft Lip Surgery
Cleft lip surgery is performed on children if they suffer from cleft lip, cleft palate, or a combination of the two. Cleft lip and palate are often discovered by doctors after the birth of the baby during a postnatal examination. However, in some cases, the cleft lip can be detected during a prenatal examination through a pregnancy ultrasound, although the cleft palate should still be examined after the baby is born.
This operation should be performed on children with cleft lip because it can interfere with the process of eating, breastfeeding, and speaking. In addition, they can also experience hearing loss and ear infections due to fluid buildup in the ear. Children with cleft lip and palate are also more prone to tooth decay due to imperfect tooth development.
Cleft Lip Surgery Warning
So far, it is not known that there are special conditions that cause a child to not have cleft lip surgery at all. However, in some children who have allergies to the anesthetic that will be used, cleft lip surgery can still be carried out with special treatment or supervision.
Cleft Lip Surgery Preparation
Preparation for surgery can be started since the newborn and diagnosed with a cleft lip by a doctor. After that, the doctor together with other health workers will plan with the child's parents regarding the stages of treatment. In general, the planned stages of cleft lip treatment that the patient will undergo for several years are:
- Unuts 0-6 weeks. The doctor will provide temporary treatment regarding the condition of the child's cleft lip, to relieve complaints and difficulties that may be experienced. In addition, the doctor will also ensure that the child's eating and drinking process is not disturbed, as well as conduct a hearing test on the child.
- Unuts 3-6 months. The plastic surgeon will perform surgery to repair the cleft lip in children.
- Umyrrh 6-12 months. Doctors will perform surgery to repair the cleft palate in children.
- Unuts 18 months. The doctor will carry out an examination of the speech ability of children who have undergone lip and cleft palate surgery for the first time.
- Unuts 3 years. The doctor will carry out a second examination of the child's speaking ability.
- Unut 5 years. The doctor will carry out a child's speech test for the third and final time.
- Unuts 8-12 years. The doctor will perform an operation to repair the cleft gum by means of a bone graft in the gum area. This is only done if the child also suffers from cleft gums.
- Age 13-15 years. The doctor will carry out additional treatment and examinations to monitor and improve the condition of the teeth and gums of children who have undergone lip and cleft palate surgery. The doctor will also monitor the growth and development of the child's jawbone to make sure there are no abnormalities.
Before the child reaches the age sufficient to undergo cleft lip surgery, the doctor will ask the parents to maintain nutritional intake, so that the child remains healthy until he reaches the age suitable for surgery. During this period, parents will be assisted by health workers other than doctors who aim to train parents to feed their children. After they are old enough to undergo surgery, the doctor will check the child's health condition before undergoing surgery. This examination is in the form of a general health examination of the child and supporting tests to ensure the child's condition, for example a blood test.
A few days before surgery, the doctor will ask parents to stop taking drugs that risk causing bleeding, such as aspirin or ibuprofen. The doctor will also ask for information from parents regarding the drugs and supplements that the child is taking. A few hours before the operation, the parents will be asked by the doctor not to feed and drink the child. Health workers will also make sure the child is healthy enough to have the surgery a few hours earlier. If the child is not well enough to have surgery, the surgery can be delayed for a few days until the child is well enough.
Cleft Lip Surgery Procedure
Cleft lip surgery is performed with the child unconscious after being given general anesthesia. When the child is unconscious, the doctor will immediately repair the cleft lip by joining the two separated lips together. If the cleft is too wide for suturing, the doctor will perform a special procedure using a lip adhesive (adhesive) or lip joining device. The lips are then joined using sewing thread, either with sewing threads that can be attached to the lips or those that cannot. If the child's lips are sutured with sutures that do not fuse with the lips, the child will undergo a suture removal procedure once they are fully healed and the lips are properly fused.
The surgery will generally leave a scar on the lip at the bottom of the nose. However, to maintain the appearance of the child, the doctor will arrange and make the surgical scar as natural as possible. The surgical scar will fade by itself as the child grows. If needed, the doctor will also adjust the shape of the nose to match the shape of the lips that have undergone cleft lip surgery. Cleft lip surgery generally lasts about 2 hours.
Operation Procedure Palate Chippy
Cleft palate surgery is generally performed when the child is 6-12 months old, either in children who also have a cleft lip or who only have a cleft palate. Children who undergo cleft palate surgery will first be given general anesthesia, so they will not be conscious during the surgical procedure. The doctor will then close the cleft palate in the roof of the mouth. In addition, the doctor will also adjust the position and shape of the muscles found on the roof of the mouth. After the muscles are positioned properly, the doctor will then join the cleft palate using sutures that are attached to the palate muscles.
Cleft palate surgery will generally last about 2 hours. This operation will result in a scar on the inside of the mouth, and will not be visible from the outside. The voice of a child with a cleft palate will usually hum while speaking, and sometimes the buzzing persists even after the child has had surgery. In addition, in some cases, the buzzing sound appears only a few months after the child has had cleft palate surgery.
Additional Operation
As the child grows, the shape of the child's lips and face can change. This condition sometimes causes the child to undergo additional surgery. Examples of additional surgeries that can be performed are pharyngoplasty to correct the shape of the throat to improve speech quality, and cleft gum surgery if there is a gap between the gums that forms along with the cleft lip. Cleft gum surgery will involve a bone graft as a material to join the separated gums.
After Cleft Lip Surgery
After the operation, the child will be taken to the treatment room to undergo postoperative recovery. Generally, children will be hospitalized for about 1-3 days or as needed. During hospitalization, children may be accompanied by their parents.
Parents will be given instructions by the doctor to keep the surgical wound clean and free from infection. In addition, the surgical wound should not be stretched or compressed during the recovery period, which is about 3-4 weeks. To clean the surgical wound, parents can use special soap and smear the wound with ointment to keep the wound and skin in the operating area from drying out. The child should be kept hands so as not to touch and interfere with the surgical suture, so that recovery can take place optimally.
During the recovery period, the child is only allowed to be given liquid food. If the child's condition does not allow his mother to breastfeed, the doctor will give a bottle specially designed for children who suffer from cleft lips and palates. Breast milk can be expressed and put into the bottle to be given to the child. If absolutely necessary, the child will be fitted with a special tube in the nose as a substitute for food entry through the mouth.
Recovery after cleft lip and palate surgery generally goes without any serious problems or complications. In addition, after completing cleft lip surgery, the child will undergo a hearing examination which can be affected by postoperative oral conditions. This hearing test can be repeated at certain times several years after the operation. Children can also experience speech disorders due to changes in the shape of the oral muscles after surgery. To help this condition, children can undergo speech therapy guided by special officers.
Cleft Lip Surgery Risks
Cleft lip and palate surgery is safe to undergo. However, like other surgical procedures, cleft lip and palate surgery can still cause complications, including:
- Bleeding.
- Infection.
- Respiratory disorders.
- Allergic reaction to the drugs given.
- Abnormal growth of facial bones, including the part of the face between the nose and lips.
