Cleft Palate

Cleft Palate

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Birth defects are important causes of infant and childhood disability. These, may have significant impact on individuals, families, healthcare, systems and society.

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What is Cleft Palate?

These are defects like gap or cut in the roof of mouth. It is one of the orofacial clefts. It is more common in boys. It occurs when roof of mouth does not completely close during fetal development, leaving an opening that can extend into nasal cavity.

How is the severity of Cleft Palate?

Severity can vary between involvement of only part of Palate to entire hard & soft Palate and sometimes can be combined with Cleft lip. It can be either one sided (unilateral), both sided (bilateral) or membranous (Sub mucous).

When Cleft Palate is treated?

Cleft Palate is treated between 9 months to 12 months of age.

What are the complications if Cleft Palate is not treated?

Feeding difficulty, Speech and language delay, ear infection and hearing loss, Teeth growth deformity, Cosmetic deformity, Psychosocial issues.

FAQ's

Child having Cleft Palate between 9 to 12 months of age with following:

  • Haemoglobin > 10gm/dl
  • No signs of any active infection

Surgery is performed under General Anaesthesia.

Depending upon severity of Cleft Palate, the duration of surgery varies between 2 hours to 4 hours.

Child is usually kept nil by mouth/fasting for atleast 6 hours post-surgery. During this period hydration is maintained with intravenous fluids. After 6 hours liquid/ formula feed can be given with sterile spoon. Oral hygiene needs to be maintained after each feed.  Child will be given Antibiotics, Analgesics and Multivitamin syrup for atleast 3 days post-surgery. Plaster cast will be applied to both the elbows to avoid bending of elbows, so that child’s hands do not reach the mouth.Plaster casts are generally removed after post operative day 10 once the stitches are completely healed. Speech therapy is started after formal assessment by speech therapist.

Depending upon child’s general condition and complexity of Cleft palate, there may be chances of Delay in healing of stitches, Palatal Fistula, need of revision surgery.

Genetics (commonly associated with syndrome like Down’s syndrome, etc.), Pesticides, Radiations, Vitamin deficiency in mother, maternal infections, consanguineous marriage; Tobacco, smoking & Alcohol addiction in mother, late 1st pregnancy (greater than 35 years), etc.

  • Avoid late pregnancy (> 35 years)
  • Discourage marriage in blood relation
  • Prevention of Malnutrition
  • Prevention of infection like Varicella, HIV, Toxoplasmosis, Herpes, Syphilis
  • Protection against mutagen (X-ray, Alcohol, Drugs, Smoking)
  • Prevention maternal Folate insufficiency, Diabetes, Obesity
  • Increase in awareness about risk factors and etiological factors

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