Cleft lip surgery is the surgical process to make a normal appearance and function of lips. The surgery is performed on children who have a cleft hole in the roof of the mouth or who are born with abnormal openings of lips. Cleft lip surgery is usually performed in the first three to four months after birth. The cleft lip surgery can be performed in a single procedure if the cleft is not so extensive but sometimes, it requires two different medical procedures to treat the cleft lip when the cleft is extensive and involves a wide area of lips and nose. The children born with cleft lip also need the additional treatment of speech therapy and dental care. They also need help in the feeding process. The children with cleft lip also have hearing problems so the hearing tests are performed at regular intervals. There can be risks and complications during the surgical procedure of cleft lip. So proper management and prevention are needed to avoid any delay in the recovery process. The recovery time can vary for each child. But normally, it takes 3-4 weeks for the incision to heal. Cleft lip surgery may leave a scar that usually fades away after some time.
Types of Cleft Lip Surgery Treatment India
Some types of cleft lip surgery according to the technique are as follows:
- Millard Technique (Rotation-Advancement Technique)
- Tennison-Randall Technique
- Primary cleft lip repair
- Secondary cleft lip revision
- Mohler Technique
- Lip Adhesion Technique
- Presurgical Nasoalveolar Molding (PNAM)
Primary Cleft Lip Repair
This is the first surgery that is performed on children usually when they are around 3 to 6 months old. The goal of this surgery is to close the separation in the lip and create a more normal appearance. Surgeons carefully realign the tissues and muscles for proper healing and try to minimize scarring.
Secondary Cleft Lip Revision
Sometimes, as the child grows, further adjustments might be needed to improve the appearance and functionality of the lip. These secondary surgeries are typically performed when the child is older, usually between 6 and 12 years old. These procedures can help to resolve issues like scar revision, improving symmetry, and improving the appearance of lips.
Millard Technique (Rotation-Advancement Technique)
This is one of the most widely used techniques for cleft lip repair. It involves making a "Z" or "W'' shaped incision on the affected side of the lip. The tissue is then rotated and attached to close the gap between lips and create a more natural-looking lip shape.
Tennison-Randall Technique
In this technique, a triangular flap is created on both sides of the defected lip. The flaps are then brought together and sutured to close the gap. This technique can be particularly useful for wide clefts.
Mohler Technique
This technique is used for repairing cleft lips present on both sides. It involves creating smaller triangular flaps on both sides of the cleft and suturing them together. This technique helps to achieve good symmetry and a more natural appearance.
Lip Adhesion Technique
When the child is too young for a complete repair, a lip adhesion procedure may be performed. This involves joining the edges of the cleft lip temporarily to make future surgeries easier and more effective.
Presurgical Nasoalveolar Molding (PNAM)
This is a technique used in some cases to reshape the gums, nose, and lip before surgery. It involves using a custom-made appliance that is placed in the baby's mouth to help mold the tissues into a more suitable position for the surgical process.
Procedure of Cleft Lip Surgery
The general overview of the procedure for cleft lip is as follows:
- Anesthesia: The patient receives anesthesia to ensure their comfort and pain relief during the procedure. For young children and infants, general anesthesia is commonly administered.
- Incision: A skilled surgeon makes incisions on both sides of the cleft. The choice of incision type depends on the selected surgical method.
- Tissue Adjustment: The surgeon realigns the tissues, muscles, and skin and brings them together to close the gap in the lip. Special techniques are used to achieve a natural and fine lip shape.
- Suturing: Delicate stitches are used to close the incisions and hold the tissues in position. These stitches are designed to dissolve over time and do not require removal.
- Dressing and Bandaging: A protective dressing or bandage might be applied over the treated area to support healing and reduce swelling.
- Recovery: After the surgery, the patient is monitored in a recovery area for some time. Some degree of swelling, bruising, and mild discomfort in the treated region is normal.
- Postoperative Care: The medical team provides the instructions for managing the surgical site, relieving pain, and preventing infection.
- Secondary Procedures: In some complex cases, additional surgeries might be necessary as the individual grows and matures. These secondary procedures help to further refine the appearance and function of lips.
- Long-term Care: Children who undergo cleft lip surgery require additional care from a team of specialists, including speech therapists and orthodontists for complete development and growth.
Cost of Cleft Lip Surgery in India
The cost of cleft lip surgery in India ranges from 1000 USD to 1600 USD. The cost can vary according to the type of technique used in surgery. The cost can also increase if there is a requirement for additional treatment like speech therapy and secondary revision surgery.
Cleft Lip Surgery : 1173 USD - 1562 USD
Symptoms and Risk factors
Here are some of the common symptoms of a cleft lip:
- Visible gap in the upper lip
- Nasal deformity
- Difficulty feeding
- Potential speech issues
- Increased risk of ear infections
- Asymmetry
- Excessive Saliva
- Respiratory Issues
Risk factors for Cleft Lip
Some of the risk factors that are associated with cleft lip are:
Genetic Factors
A positive family history of cleft lip in newborn babies increases the risk of cleft lip twofold.
Environmental Factors
Exposure to harmful environmental factors during pregnancy such as tobacco smoke, alcohol, various medications, and viral infections can increase the risk of cleft lip.
Nutritional Deficiencies
Poor diet and low nutrition during pregnancy can increase the risk of many developing disorders in babies. Folic acid deficiency in mothers during pregnancy can increase the risk of cleft lip in babies.
Maternal Health
High blood sugar levels and large amounts of fat in pregnant women can increase the risk of cleft lip in babies.
Advanced Maternal Age
The old age of the mother at the time of birth, especially women 35 years and older, has a higher risk of babies born with cleft lip.
Male Gender
A cleft lip is more commonly present in males. So baby boys are at greater risk of developing cleft lip than baby girls.
Multifactorial Inheritance
Sometimes cleft lip results from a combination of genetic and environmental factors that make it the cause of multiple conditions.
