Cleft lip and cleft palate are among the most common birth anomalies affecting children.
The incomplete formation of the upper lip (cleft lip and nasal deformity) or roof of the mouth (cleft palate) can occur individually, or both may occur together.
The conditions can vary in severity and may involve one or both sides of the face.
Surgery is required to repair both a cleft lip and nose and a cleft palate.
Alveolar Cleft Repair & Grafting
Alveolar cleft repair is a surgery that closes the gap between the mouth and the nose at the level of the gum line. It also grafts the bony defect, or area of bone that is missing. Grafting provides support for the base of the nose, which otherwise tends to sink in. Grafting provides bone in order for the adult teeth to descend and be able to survive. Typically, bone grafting is done when the canine tooth starts to descend, or come down. The timing for alveolar bone graft and cleft repair is done several years after the child’s first cleft lip and cleft palate repairs, typically between ages 7 to 9. If a lateral incisor tooth is present, then bone grafting may be done earlier to prepare the area for this tooth. Preparation for alveolar cleft repair and alveolar grafting involves a Pediatric Orthodontist, who will place a device to prepare your child for the graft procedure. Alveolar bone graft material can be autologous, which means that it comes from your child, or from an off the shelf product. Autologous graft material is typically bone taken from the hip. The procedure would be done in a hospital and your child would stay overnight.
Cleft Lip & Palate Repair
Cleft Lip and Nasal surgery repair the defect of the upper lip and nose. In patients with cleft lips, the nose is affected and needs to be addressed surgically.
Cleft Nasal Reconstruction, Cleft rhinoplasty is a nasal reshaping surgery for people with an abnormal appearance of their nose due to cleft lip and palate. Cleft rhinoplasty is far more complex than a typical rhinoplasty (“nose job”) which is why it is important to find a surgeon with experience performing cleft rhinoplasty.
Cleft Orthognathic Surgery, Cleft lip and palate patients often exhibit dentofacial deformities that necessitate orthognathic surgery. Orthognathic surgery in these patients generally includes not only maxillary advancement, but also sagittal, horizontal, and vertical movement of both jaws.
Facial Cleft Reconstruction, here are other, less common facial clefts that occur. These are often described according to the Tessier Classification of facial clefts. These clefts may involve the side or bottom center of the mouth, the nose, eyes, and forehead. The repair ranges from a single outpatient procedure to a more involved one. The more involved surgeries may involve bony repair or the tearing apparatus.
Secondary Speech Surgery, for people born with a cleft palate, a further operation may be needed if their speech is still sounding nasal and unclear after their initial palate repair. This is known as secondary speech surgery.