Cleft Lip and Palate Surgery

About 1 in every 1000 live births has a cleft deformity (cleft lip and/or palate).

Face develops in the early weeks of fetal development by fusion of parts (processes) from different directions. A failure of such fusion would give rise to a cleft . But, why? Specific cause of each individual case is difficult to ascertain and this is avoided further to prevent increasing parental agony. However, the general causes are – genetic/hereditary tendency, maternal age at conception, maternal nutrition status, certain diseases and medications of mother in the early days of pregnancy. Some has also included x-ray exposure of early fetus as a cause.

CLP can be spotted in prenatal ultrasounds and even intrauterine surgical correction is now possible.

However, this has not yet become the accessible usual way of treatment and till then the following pattern of staged corrective management is what we follow:

  • At birth : Assessment by surgeon along with paediatrician and feeding advice; in very few cases, impression and modeling plate.
  • 3 to 4 months : Surgery to correct cleft lip deformity and primary rhinoplasty.
  • 9months : Surgery to correct cleft palate deformity.
  • Then onwards, the child is under regular guidance of an Orthodontist and a speech therapist.
  • 9years : Correction of residual alveolar defect (bone grafting) and fine tunings of the lip if needed.
  • 16 to 18 yrs : Orthognathic surgery to bring the upper jaw forward +/- push-back of the advancing lower jaw is often needed.
  • 18 years : Final rhinoplasty if needed.

Why us?

One surgeon performing all the surgeries and he himself is orthodontics trained. It helps if the surgeon knows what is possible by orthodontics and therefore, what to expect from the orthodontist and what the orthodontist expects from the surgeon. Moreover, primary rhinoplasty at 3 or 4 months age gives a very much better nose for the sensitive years before 18 (the time for final rhinoplasty).

Secondary Repairs

Sometimes we have to perform revision surgery for clefts, not so well repaired elsewhere

Fellowship Programs

    Fellowship programs started for
  • One year residential fellowship programme for MDS (OMS), MS (ENT) and MS (General Surgery). Details
  • Short postings as OBSERVER Details
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