Treatment of Cleft lip in Children
Best children's hospitals and doctors for cleft lip treatment abroad
Leading hospitals
Cost for treatment
Content
- Overview
- Causes of cleft lip and palate
- Features of cleft lip
- Treatment of cleft lip
- Rehabilitation period
- Where can I undergo treatment of cleft lip?
- The cost of cleft lip treatment abroad
- How can I undergo treatment of cleft lip?
A congenital cleft palate is a developmental defect that implies a serious deformation of the tissues of the soft and hard palate. Often, this defect goes along with a cleft of the lip and other structural pathologies of the facial skeleton.
Overview
The most common congenital malformations of the skull and face are cleft lip and cleft palate.
A cleft lip is a division of the upper lip, usually just below the nose. A cleft palate is a deformation of the palate implying an abnormal structural connection with the nasal cavity. Cleft lip and cleft palate are often revealed together.
The formation of a cleft lip and cleft palate can be influenced by both environmental and genetic factors. In women who use tobacco, alcohol, or other substances during pregnancy the risk of having a baby with a cleft lip or cleft palate may increase. Having one baby with a cleft lip or cleft palate increases the risk of having a second baby with this defect.
Cleft lip and cleft palate can be improved with surgery. The timing of such plastic surgery depends on the deformity and the health condition. To improve a cleft palate, a two-step procedure is often done. Reconstruction of the cleft lip, nose, and soft palate (the smooth, softback of the palate) is performed between 3 and 6 months of age. Then, at the age of 15 to 18 months, the hard palate can also be restored. At an older age, the child may need dental, orthodontic, and speech therapy.
Causes of cleft lip and palate
The formation of the maxillofacial apparatus in the fetus occurs in the first eight weeks of pregnancy. Deformation is caused by the influence of certain factors on the fetus during the pregnancy.
The development of pathology is facilitated by a number of factors that include:
- Consuming alcohol, drugs, or smoking before and during pregnancy
- The use of certain medications in the first trimester of pregnancy
- Obesity of the second or third degree
- Exposure to certain chemicals
- Unfavorable environmental conditions
- Lack of folic acid
- Age over 35
- Severe toxicosis
- Genetic predisposition
- Severe emotional stress and physical trauma
Features of cleft lip
Sometimes it is possible to identify a defect in the 14th-16th week of the prenatal period during an ultrasound examination of the fetus. With a small defect, it can only be detected by visual examination of the child after birth.
The final diagnosis is made immediately after the birth of the child since the defect is detected during the initial examination of the newborn.
Such children have difficulty breathing. Inhaled air does not warm up enough and is not humidified enough, which makes children susceptible to the development of respiratory diseases. Such children cannot suckle their mother's breast, so they have to be fed with the help of special devices.
The junction of the mouth and nose interferes with the normal breastfeeding process because the baby is not able to create the vacuum in the mouth needed to get milk from the mammary glands or a bottle. Because of the possible ingestion of food into the respiratory organs, the integrity of the structures of the upper respiratory system is disrupted, and complications of the middle ear develop.
As a child grows up, he or she develops maxillofacial changes that contribute to the incorrect formation of speech. Fluid built-up in the middle ear can cause otitis and hearing loss. In children with a cleft palate, deformation of the teeth is observed: the teeth can move, protrude, go over each other; quite often, children with such diagnosis have extra teeth and malocclusion.
In more mature age, the presence of a severe functional defect prevents the correct development of speech, which, together with a severe cosmetic imperfection (in the presence of a cleft lip), leads to impaired social adaptation and severe psychological problems.
The mental and physical development of children is age-appropriate, but they can feel severe discomfort from their anomaly.
Treatment of cleft lip
Cleft lip repair is exclusively surgical and includes a complex of reconstructive and cosmetic plastic surgery. Used techniques are aimed at lengthening the soft palate, connecting the palatine muscles, and narrowing the middle part of the pharynx to restore the normal anatomy of the oral cavity. During the operation, the surgeon restores the integrity of the upper lip, alveolar ridge, and performs plastic surgery of the upper palate.
Treatment of young patients is aimed at the restoring of natural functions: food intake, speech, and hearing. It is important to create conditions for the development of these functions on time. In the future, follow-up therapy in specialized centers is possible to promote the development of speech, hearing, or oral health.
Two ages are considered optimal for surgery: 2-12 days and 3-6 months after birth. Surgeries performed in the first 2-12 days reduce the possibility of mental trauma in parents. However, children of this age have increased sensitivity to blood loss, small anatomical areas of the upper lip, imperfection of some physiological functions, which worsens the conditions for healing and, accordingly, the results of the surgery do not always satisfy both surgeons and the parents of the little patient.
At 3-6 months, the child stabilizes the rate of bone structures development in the mid-face region, and the risk of damage to the growth zones and cartilage of the nose is reduced. At this age, with normal development, the child's condition allows performing the necessary surgical procedures in full.
Cleft lip repair specifically should be aimed at restoring the anatomical integrity of the upper lip, eliminating congenital deformities of the nose, facial defects, and creating favorable conditions for the correct growth and formation of the middle face area throughout childhood. Depending on the type of congenital defect of the upper lip, the degree of nose deformity, the degree of underdevelopment of the alveolar ridge and palate, cheiloplasty, or rhinocheiloplasty are performed.
Cleft lip and cleft palate occur in various forms, each of those requires an individual medical repair regimen. The following ones are the main methods of the repair of cleft lip and palate that depend on the location of the defect:
- Isolated cleft lip treatment.
As a rule, with an isolated cleft lip, one surgery is quite sufficient. Between the 4th and 5th months of life, plastic surgeons repair cleft lip by completely closing it, and as part of the same operation, the tip of the nose is lifted and the nasal septum is lengthened. A cleft lip has no functional implications though.
- Isolated cleft palate treatment.
If there is a cleft in the hard and soft palate, a special individual palatine plate is made. If only the soft palate is affected, the plate is not necessary.
At the age of 3-4 months, or when the child reaches a weight of 5 kg, the soft palate is closed and the condition of its muscles is normalized. Thereafter, it is no longer necessary to wear the palatal plate for a soft palate, although the hard palate remains cleft.
Plastic surgeons repair cleft hard palate at about 9 months of age. It is also possible to close the soft and hard palate simultaneously at the age of 7 months. Because children with a cleft palate often have hearing problems, plastic surgeons also perform an otomicroscopy during the repair.
- Cleft lip and jaw treatment.
The procedure depends on the width of the cleft jaw. If the jaw segments are far apart, surgeons first connect the halves of the lips at the age of 3 months as part of a small operation. After this, the segments of the jaw begin to gradually approach each other. Ideally, they repair. This greatly facilitates the subsequent operation – as a rule, after 3 months it is possible to carry out a final lip repair and, if necessary, a jaw plastic surgery.
- Unilateral cleft lip, jaw, and palate treatment.
As in the case of a cleft palate, an individual palatal plate is made after the baby is born. At the beginning of the 4th month of life, superficial closure of the soft palate and lips is performed. Eating is greatly simplified after the first surgery.
After 4 or 6 months, the hard palate is closed, after which it becomes possible to eat solid food also. Before the active phase of speech development, the palate is completely closed and all conditions for normal speech are created. The last operation is performed at the age of 12-16 months: final lip closure with shape correction, alignment of the affected wing of the nose and, if necessary, lengthening of the nasal septum are carried out.
- Bilateral cleft lip, jaw, and palate treatment.
Surgical treatment of bilateral clefts is more difficult because the intermaxillary bone with such clefts often extends far beyond the normal jaw arch, the wings of the nose are very distant from each other, and the nasal septum is too short. Depending on the deformation of the jaw segments, before the surgery repair, additional treatment may be required with the use of various plates: palate plates, nasoalveolar molding, Latham apparatus.
Rehabilitation period
The need for possible future corrections cannot be predicted. It can arise during the recovery process. Therefore, specialized centers for the treatment of clefts of the lip, jaw, and palate recommend staying under the supervision of the doctor at least until the end of the transitional age.
The period of hospitalization after the operation depends on the type of the procedure, the age of the patient and his condition and, as a rule, does not exceed several days. Several operations to eliminate minor defects can be carried out in one day.
A unique complex of rehabilitation procedures can help quickly return to a normal lifestyle, restore swallowing functions, prevent the development of speech disorders, and correct a cosmetic lip defect.
After plastic surgery for the cleft lip and palate repair, patients or their parents receive a detailed follow-up plan from nutritionists, speech rehabilitation specialists, and pediatric psychologists.
Where can I undergo treatment of cleft lip?
Medical tourism becomes more and more popular these days, as treatment abroad ensures a much better quality of cleft lip repair.
The best success rates in cleft lip and palate repair demonstrate:
- University Hospital Rechts der Isar Munich, Germany
- University Hospital Frankfurt am Main, Germany
- University Hospital Hamburg-Eppendorf, Germany
- University Hospital Carl Gustav Carus Dresden, Germany
- University Hospital Erlangen, Germany
You can check out the full list of hospitals on the Booking Health website.
The cost of cleft lip treatment abroad
The prices in hospitals listed on the Booking Health website are relatively low. With Booking Health, you can undergo treatment abroad in the best hospitals in the world at an affordable price.
The cost of plastic reconstruction of cleft lip varies, as the prices depend on hospitals, the chosen type of treatment, and its complexity.
The cost of cleft lip treatment in Germany is from 3,357 EUR to 15,619 EUR.
The cost of cleft lip treatment in Israel is approximately 7,900 EUR.
The cost of cleft lip treatment in Turkey is approximately 5,900 EUR.
You also need to consider the cost of additional corrective procedures and follow-up care. Therefore, the ultimate cost of plastic reconstruction of the cleft lip may differ from the initial price.
To make sure that the cost of plastic reconstruction of cleft lip is suitable for you, contact us by leaving the request on Booking Health website.
How can I undergo treatment of cleft lip?
It is not easy to self-organize any treatment abroad. It requires certain knowledge and experience in medical tourism. Thus, it is safer, easier, and less stressful to shift some responsibility onto a medical tourism agency.
As the largest and most transparent medical tourism agency in the world, Booking Health has up-to-date information on cleft lip repair in the best hospitals in the world. Booking Health will help you select a hospital, taking into account your wishes for treatment. It is vital to have accurate information on the success rates of the specific hospital in cleft lip repair. Our goal is to find the best medical facility for you, where your child can safely undergo the treatment of cleft lip.
We want to help you and take on all the troubles. You can be free of unnecessary stress, while Booking Health takes care of all organizational issues.
Medical tourism can be easy! All you need to do is to leave a request on the Booking Health website, and our manager will contact you shortly.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed
