Cleft lip treatment in Germany

Content

1. Overview
2. Causes
3. Types
4. Diagnostics
5. Treatment
6. Rehabilitation period
7. Where can I undergo cleft lip treatment in Germany?
8. The cost of cleft lip treatment in Germany
9. How can I undergo treatment of cleft lip?

Cleft lip and cleft palate are common, but at the same time are one of the most severe malformations of the maxillofacial region.

Overview

A cleft lip is a severe malformation of the maxillofacial region, manifested by a disruption in the integrity of the upper lip and accompanied by significant functional disorders. Difficulties in restoring disturbed vital functions of nutrition, breathing and speech, anatomical restoration of the upper lip, nose and upper jaw in a child without treatment are the reason for the disability of children with cleft lip and palate.

With this malformation of the face, specific signs can be detected even in the prenatal period. After birth, disruptions of the following vital functions are observed:

1. Impaired nutritional function. Normal sucking during feeding is in most cases impossible due to the lack of separation of the nasal and oral cavities. Subsequently, the disruption of chewing is associated with an anomaly of the dentition.
2. Speech. With cleft lip, it is difficult to form correct speech (speech is slurred, voice is snuffling). This may be the cause of delayed speech development.
3. Hearing. Cleavage and improper attachment of the palatine muscles cause dysfunction in hearing.
4. Nasal breathing. Deformation of the parts of the nose leads to a change in the airflow, disrupts adequate breathing, and contributes to the development of various concomitant pathologies of the organs of the respiratory system.

When parents find out about a cosmetic defect in the form of a violation of the anatomy of the upper lip and deformity of the nose already at birth, it naturally causes a negative reaction. Nevertheless, you need to know that a cleft lip can be treated.

Harmonious development of a child with a cleft lip is difficult without the proper treatment due to the cosmetic defect and functional impairment.

Causes

A cleft lip has a multifactorial origin. For the development of a cleft lip, it is necessary to have either a genetic predisposition or the impact of unfavorable environmental factors.

Internal factors include:

• Biological defects of germ cells
• Older age of parents
• Genetic predisposition

External factors include:

• Physical: mechanical effects on the fetus, uterine malformations, multiple pregnancies
• Chemical: malnutrition, hypo- or hypervitaminosis, hormonal imbalance, smoking, alcohol consumption, drug use
• Biological: infectious diseases (influenza, rubella, herpes), excess of adrenal hormones in the blood

Types

A hidden cleft lip is characterized by the absence of violation of the integrity of the skin of the lip. On the side, there is a vertical deformation of the skin, under which the splitting of the circular muscle of the mouth is determined. This type of cleft lip is especially noticeable during physical activities.

An incomplete cleft lip is characterized by a cleft lip that does not reach the lower part of the nostrils. The lip does not grow together only in its lower parts, while at the base of the nose there is a properly developed tissue. With this type of cleft lip, there may be a deformation of the nose.

With a complete or isolated cleft lip, splitting of the tissues of the upper lip is observed along the entire area of the lips. In this case, there is always a deformation of the skin-cartilaginous part of the nose.

With a unilateral cleft lip, there is a flattening and stretching of the wing of the nose. The tip of the nose is displaced to the side, the nostril is wide on the sides, and the nasal septum is curved.

With a bilateral complete cleft lip, there’s split to the right and left. The middle part of the lip is shortened. The septum is short and due to this, the tip of the nose is flattened and pulled up to the upper lip. Both wings of the nose are stretched and flattened.

Diagnostics

A medical diagnosis of cleft lip in the prenatal period is based on the ultrasound examination at the 14-16 weeks of pregnancy. Mandatory medical information at this point is obtained with:

• Differential diagnostic studies
• Collecting anamnesis
• Ultrasound examination of the fetus
• Medical genetic counseling

With the medical diagnosis of cleft lip in the postnatal period it is recommended to find out the following information:

• The presence of a hereditary pattern of congenital medical conditions of the maxillofacial region

Necessary differential diagnostic studies include:

• Collecting anamnesis
• Assessment of the physiological and neurological condition of the baby
• Ultrasound examination
• Medical genetic counseling
• Information of the state of ENT organs
• Examination by audiologist
• Orthodontic examination; according to indications, early orthodontic treatment

Treatment

There is a certain standard in medical treatments of cleft lip. Usually, methods of surgery in the treatments of the cleft lip can be of several types. The main ones are cleft palate repair surgery and cleft lip repair surgery. Their combination is also possible because these two pathologies often develop together.

Plastic surgery for cleft palate naturally allows eliminating a palatal cleft. Treatment is carried out in several stages. Experts recommend performing a plastic surgery for cleft palate from six months of age to one year.

Plastic surgery for cleft lip is performed to eliminate the cleft lip area. During the surgery, external defects are removed, the lip and the functionality of the oral muscles are restored. The surgery is carried out starting from the age of three months.

In general, depending on the complexity of the specific medical case and the individual peculiarities of patients, up to six operations may be required.

Surgical treatment of children with a cleft lip is carried out depending on the severity of the pathology and the severity of anatomical and functional disorders. Early cleft lip plastic surgery can be performed in maternity hospitals extremely rarely, in 1-3 days in extreme cases. In the case of bilateral cleft lip, surgery for cleft lip (cheiloplasty) can be performed in one or two stages with an interval of two months.

Cheiloplasty is performed under general anesthesia. The pediatrician prepares the child for the surgery with the participation of the dentist and anesthesiologist.

The goal of plastic surgery for cleft lip treatment is to restore the correct anatomical shape of the upper lip and nose, which will contribute to the normalization of functions and the elimination of cosmetic defects in the future.

Currently, when performing cheiloplasty, a combination of different techniques is usually used. With certain forms of cleft lip and palate, even before cheiloplasty, early orthodontic treatment is indicated to reduce the width of the cleft lip. This is necessary to obtain good aesthetic results, prevent postoperative complications, and facilitate the surgery itself.

Modern methods of cleft lip surgery allow obtaining good anatomical results of the operation. However, with age, 70-80% of patients begin to notice various postoperative signs on the lip and nose. Corrective treatments in the area of ​​the upper lip and the oral cavity give good results when they are carried out starting from the age of 4-6 years.

Plastic surgery to eliminate the deformity of the nose for aesthetic reasons is performed at the age of 12-14 years, and sometimes even later when the intensive growth of the bones of the facial skeleton ends.

Cleft lip operations are performed at various periods: from 1 to 3 years old; from 3 to 5 years old; at the age of 7-8 years and older. However, it should be remembered that the age of a child is not the only criterion for plastic surgery. Some maxillofacial surgeons consider it most appropriate to operate on children with a cleft lip and palate in the preschool period (up to 4-5 years old). During this period, as a rule, plastic surgeries on the lips, soft and hard palates are performed simultaneously.

It is necessary to take into account the severity of the cleft lip, the general physical and mental development of the child, the presence of concomitant pathologies, the possibility of orthodontic treatments and speech therapy training for the child.

Rehabilitation period

One of the main problems in the treatment of patients with cleft lip and palate is the organization of feeding. Special devices are used to ensure adequate feeding. Unnatural feeding suppresses the innate reflex of swallowing, aggravates the underdevelopment of the upper and lower jaw, and muscles of the soft palate. This type of feeding should be used according to strict indications: for children with severe concomitant pathologies, mainly newborns. The primary task is to teach parents how to feed the baby properly, and prevent aspiration of food into the respiratory tract. Weight control in the first weeks of life is carried out daily.

Surgical treatments of patients with cleft lip and palate is essential, but only comprehensive, timely and systematic specialized care for patients with congenital malformations of the face and jaw can ensure the optimal anatomical and functional effect of treatment and complete rehabilitation.

Rehabilitation of patients with this pathology is one of the difficult tasks of medicine. Since the prevention of this medical condition is currently impossible, surgical and orthodontic treatments come to the fore, allowing to eliminate the defect and functional disorders.

Full social adaptation of the child is possible only if the surgery is carried out in due time and at its full potential. The rehabilitation of such a child should be considered as a long-term complex process, which starts from birth and continues until adolescence, requiring the participation of various specialists: a neonatologist, maxillofacial surgeon, geneticist, pediatrician, orthodontist, speech therapist, otolaryngologist, and psychologist.

Where can I undergo cleft lip treatment in Germany?

Medical tourism is becoming more and more popular these days, as, for instance, the treatment in Germany ensures excellent quality of cleft lip repair.

The best success rates in cleft lip repair in Germany demonstrate:

1. University Hospital Rechts der Isar Munich
2. University Hospital Frankfurt am Main
3. University Hospital Hamburg-Eppendorf
4. University Hospital Carl Gustav Carus Dresden
5. University Hospital Erlangen

You can check out the full list of clinics in Germany on the Booking Health website.

The cost of cleft lip treatment in Germany

The prices in hospitals listed on the Booking Health website are relatively low. With Booking Health, you can undergo treatment in Germany in the best hospitals at an affordable price.

The cost of cleft lip treatment in Germany varies, as the prices depend on the hospital, the chosen type of treatment, and its complexity.

The cost of cleft lip treatment in Germany is about 11,000-14,000 EUR.

You also need to know about the cost of additional corrective procedures and follow-up care. Therefore, the ultimate cost of cleft lip treatment in Germany may differ from the initial prices.

To get the information about the cost of cleft lip treatment in Germany, contact us by leaving the request on the 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 about cleft lip repair in Germany.

Booking Health will help you select a hospital, taking into account your wishes for treatment. We will provide you with information about the most suitable of German clinics, and you can choose the right one for you.

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. We will make sure that you or your child safely undergo the cleft lip treatment in Germany.

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