by 
By DR SOMASUNDARAM SATHAPPAN
Consultant Plastic and Reconstructive Surgeon
Subang Jaya Medical Centre (SJMC)
It might be rare but Cleft Lip is one of the most common birth defects affecting children in Malaysia. According to reports, it is found in about 1 in 700 live births.
These deformities, although it may present as a mild form, if untreated, can grow wider affecting other spectrums of orofacial.
1. How is cleft lip detected during scanning in the mother’s womb?
It is detected in first trimester using high-definition ultrasound scan. Nowadays many of these children are diagnosed in utero.
2. What causes cleft lip?
Most of the time it is unknown, but genetic influence plays a major role. If there are relatives with cleft lip and palate then the chances of a child being born with it is higher. Other factors that increase the risk of cleft lip is smoking, diabetes and mothers who take epilepsy medicine.
3. Can we call it a birth defect that can or could be rectified?
Definitely. It can be rectified with surgery and treatments by a multi-disciplinary team consisting of speech therapist, ENT surgeon and Orthodontist.
4. What are the factors involved or mothers to avoid during pregnancy that could possible cause cleft lip?
Must avoid smoking, taking unnecessary medications and getting diabetes treated early.
5. Does cleft lip expand in nature if not treated as soon as possible?
Yes, as the child grow the cleft lip and palate can become wider.
6. Let’s talk about the surgery procedure. Is it painful?
Generally, the pain level is very minimal, and the children tolerate it very well. Medications are always given.
7. How many corrective surgeries are there?
1. Cleft lip repair
2. Cleft palate repair
3. Nose repair
4. Alveolar bone graft
5. May need middle ear surgery
6. May need pharyngoplasty
7. Maxillary advancement if the central face is not growing
8. Are there any latest technologies available for these cases?
Yes, surgical techniques and rehabilitation methods are constantly improving.
9. What is the recommended age for surgery?
1. Lip repair at 3 months
2. Palate repair at 9 months to 1 year
3. Nose repair before starting preschool
4. Alveolar bone graft at ages 10 to 11 and other surgeries as needed.
10. What would your advice be to parents with children on cleft lip?
I would tell them to be strong and bring their child for regular follow up and treatments. My own patient that I operated 26 years ago is now a medical doctor. So, having a normal life is definitely possible.
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