Cleft lip and palate Surgery

Cleft Lip and Palate

Cleft lip and cleft palate are birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy. Affecting approximately one in 700 babies. Cleft lip and palate, are not only cosmetic deformities but also have significant functional morbidities for the new-born.

Cleft Lip: A cleft lip is a physical separation of the two sides of the upper lip, and appears as a narrow or wide opening or gap in all layers of the upper lip. This separation can include the gum line or the palate.

Cleft Palate: A cleft palate is a split or opening in the roof of the mouth. A cleft palate can involve the hard palate (the bony front portion of the roof of the mouth) and/or the soft palate (the soft back portion of the roof of the mouth) and can be associated with a cleft lip.

Prenatal diagnosis of Cleft deformity

Ultrasonography at 11 to 13 weeks/ 18 weeks of pregnancy

Comprehensive care begins even before the child is born. During periodic scans during pregnancy (Ultrasonography), sonologist can identify cleft lip and palate at the foetal developmental stage, as early as 11-13 weeks, thus, ensuring early intervention.

Secondary Cleft surgeries

Palatal Fistula Closure

An oronasal fistula is an abnormal communication between the oral cavity and the nose that occurs after surgical repair of a cleft palate.

Oronasal fistula (ONF) is the commonest complication associated with cleft palate surgery. The rate of ONF varies from 4-35%.

Alveolar Bone Grafting

Clefts of the alveolus are usually left open after the initial cleft lip and cleft palate repairs. Bone grafting helps to support the adult teeth in the cleft area, closes any remaining gaps in the cleft site and provides support for the base of the nose. This cleft in the bone and gums prevents teeth from grow properly and the floor of the nose from develop normally. Alveolar grafting is usually done between 8 and 10 years of age, depending on the child’s dental development.

Lip Revision

This procedure improves lip symmetry and fullness as well as the thin appearance of lip. It also reduces visibility of scarring. It can also correct whistle deformity which is a notch in the middle of the upper lip due to inadequate vermilion bulk.

Speech Corrective Surgery/ Velopharyngeal insufficiency

Following cleft palate repair, speech assessment is important step for cleft babies. To have errorless speech, the children should undergo timely speech and language assessment.

The aim is to have good quality, intelligible (understandable) speech by age 5-6 years so that they can enter school and able to participate fully in class and communicate with their peers.

Velopharyngeal insufficiency (VPI)

Velopharyngeal insufficiency (VPI) occurs when the seal between your oral and nasal cavities does not close completely. With VPI, air escapes through your nose during speech, causing a nasal sound and other speech issues. The assessment of VPI is performed through perceptual speech analysis by a speech-language pathologist (SLP). Instrumental diagnosis can be achieved through video nasopharyngeal endoscopy, multi view speech videofluoroscopy, or both. By optimizing the use of these modalities, treatment can be customized individually (surgical/non-surgical), and speech outcomes can be improved significantly.

Cleft Rhinoplasty

Cleft rhinoplasty is a nasal reshaping surgery for patients with an abnormal appearance of their nose due to cleft lip and palate.

Cleft Osteotomies

Correction of the cleft jaw deformity is planned when the permanent dentition is fully erupted, the arches have been orthodontically levelled and aligned, and jaw growth is complete.

Smile Train
Providing Life-Changing Cleft Treatment to Children in Need Across the Globe

Dr. Sarwpriya Sharma is a cleft specialist who has partnered with Smile Train, an international children’s charity that provides cleft lip and palate surgery for children in need.

Through her association with Smile Train, Dr. Sharma has helped transform the lives of countless children by providing them with access to life-changing surgeries and comprehensive cleft care.

Smile Train is a global children’s charity that has provided over one million cleft surgeries in more than 90 countries.

They work with local doctors and hospitals to provide free, safe, and quality cleft treatment to children from underserved communities.

Smile Train also provides comprehensive cleft care, including speech therapy, dental care, and orthodontic treatment, to ensure that children receive the support they need to thrive.