On the day of your surgery, Dr. Cohn and his friendly staff will welcome you and your child to the practice, and go over your child’s surgical plan making sure you agree with it. An anesthetist will then administer anesthesia to your child.
Even though sometimes, these surgeries are done in tandem, we shall discuss the cleft lip surgery separate from the cleft palate surgery. For those getting both, you will get a snapshot of them by reading below.
Cleft Lip Surgery:
The goal of cleft lip surgery is to repair the laceration in the upper lip. Cleft lip is typically repaired between the ages of 3 and 6 months. During those first few months, your child is monitored closely for adequate weight gain and nutrition, and to make sure that there are no issues relative to breathing while eating.
There are multiple techniques for this surgery. A rotation advancement repair is the most common one.
Dr. Cohn will make an incision on each side of the cleft from the lip to the nostril. The two sides of the lip are then sutured together. In addition to closing the lip, cleft lip repair realigns the muscle of the upper lip to provide normal lip function including free movement during breastfeeding. In some cases, a further operation might be needed. For example, patients with a bilateral cleft lip might need two surgeries, a month apart.
Furthermore, a primary nasal repair is often performed at the time of cleft lip surgery. This procedure involves liberating some of the nasal elements and resetting them to a normal proportion.
Cleft Palate Surgery:
The goal of cleft palate surgery is to fix the roof of your child’s mouth for ease of eating and speaking. Cleft Palate repair is a more complicated surgery than Cleft Lip repair and has the best outcome when the child is slightly older, around nine to eighteen months, and better able to tolerate the surgery, but also before speech development has begun.
There are a variety of different techniques that may be used for Cleft Palate Surgery. These include a Z-plasty or a V-Y pushback (Veau-Wardill-Kilner Palatoplasty). These procedures target the palate in three layers: the inner layers that form the nasal lining; the middle layers, the muscles at the back of the palate; and the final layer, which includes the lining of the mouth or the “oral mucosa”. A portion of the palate is usually left open to allow room for the mouth, palate, and jaw to grow.
Cleft Palate surgery not only targets these three layers, it also realigns the palatal muscles. That procedure is called intravelar veloplasty. That realignment of the muscles allows for the best function of the palate during speech, eating, and swallowing.
Cleft Palate Surgery not only helps with speech and mouth activities, but it also helps with the functionality of the nose as it separates the oral and nasal cavities. This separation involves the formation of a watertight and airtight valve that is necessary for normal speech. The repair also helps with preserving facial growth and proper dental development.
After Cleft Lip & Palate Surgery, typically no further surgery is performed for several years.
