Purpose

To repair the congenital anomalies at an appropriate age, balancing risks from anaesthesia and the potentially harmful effects from late repair.

Details

Parents of affected newborns are usually referred to specialized centres for assessment by a multi-disciplinary team of doctors which should at least include, initially, a plastic surgeon, an ENT surgeon, a dental surgeon, an orthodontist and a speech therapist. Related parent-patient societies are very helpful as they provide support and information which are precious amongst affected families.

Different centres may have different protocols for surgery. A commonly adopted schedule is to repair cleft lips at around 3 to 4 months and palates at 9 to 12 months, depending on the health status of the baby. Pre-surgical nasoalveolar molding (NAM) may be advised to enhance the results of repair. Modern day surgery aims at restoration of form as well as function.

Results

Treatment outcome can be variable due to the quality of repair and changes with growth. Revisional touch ups are to be expected in some patients.

Caution

Patients with cleft lip and palate require a coordinated programme of multi-disciplinary reassessments and treatment well into early adulthood. It is a misconception to assume that primary repair of the anatomical anomaly present at birth would be sufficient treatment for these patients.