Cleft Lip and Nose
CIRUGIA PLÁSTICA PEDIÁTRICA
All children with facial fissures in Chile have guaranteed their attention through the GES program. Family members should approach their health insurance system to find out where these guarantees are fulfilled. The most frequent cleft are lip-palate clefts, but there are other less frequent facial cleft. Patients can choose to be treated where they think is best for their children, forgoing GES. In general, they need care from multiple professionals, such as pediatric physician, maxillofacial surgeon, plastic surgeon, speech therapist, nurses, social worker, otorhinolaryngologist, orthodontist and pediatric dentist.
Soft Palate Cleft
Lipcleft is reconstructed (Cheiloplasty) after 3 months of age, in infants with good weight gain. In addition, surgery is performed on the nose to fix the position of the cartilage. (Primary rhinoplasty) and on the gingiva (gingivoplasty)
Bifid Uvula and Submucosa Palate Cleft
Palate Cleft can be complete or partial and only involve the soft palate (veil) or the entire palate. Generally, palate cleft should be operated near 12 month of life. The goals of the surgery are to separate the mouth from the nose and reposition the palate muscles to aid in speech development.
Bifid Uvula or Submucosal Cleft Palate
Having a separate uvula or bell does not always cause abnormal speech. When it exists, most of the children respond to speech therapy. If the difficulty of pronouncing some phonemes persists, it must be repaired surgically. More important than the volume of the uvula is the position of the soft palate muscles, to prevent air from escaping into the nose when speaking.
The repair of the bone continuity of the maxilla is generally performed between 8-12 years of age, with the aim of closing the communication of the vestibule with the nose and helping to lower the teeth of the cleft maxilla. These patients are managed very close with the orthodontists and the surgeon
Pits of the lower lip
The persistence of a communication between the mouth and the nose after having performed the palate closure is called palatal fistula. It produces discomfort such as feeling the passage of liquids or food towards the nose. Depending on the size of the defect and its location on the palate, there are several surgical techniques for its closure.
Despite adequate closure of the palate, some children evolve with a hoarse voice that does not respond to speech therapy. These children may need surgery on the pharynx to decrease nasal air flow during speach.
The Nose in the cleft patients presents a deformity that must be treat in order to improve symmetry. Cartilage is generally repositioned at 3 months along with lip closure, and then depending on the nose, it can be operated again in the preschool age and after facial growth is finished, in adolescence.
Pits of the lower lip
The dimples of the lower lip are salivary glands that have exit towards the vermilion or red lip. They are associated with two syndromes; Van der Woude syndrome and popliteal pterygium syndrome. When they appear in the newborn, look for clefts of the lip, gums or palate. His surgery requires resection of the glands and regularization of the vermilion.