Unilateral Cleft Lip and Palate with Wide Gap and Very Small Minor Segment

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Little Girl born with Unilateral Cleft Lip and Palate Deformity

This 3-month-old little girl is from Tenali in Andhra Pradesh, India. She was born with a very wide unilateral cleft lip and palate defect. There was a hole in the roof of the mouth. Upper lip and nose were a part of this deformity.

Alignment of permanent teeth in the cleft region is often affected. Lateral incisors can also be absent. Reconstructive surgery culminates with the placement of dental implants. Board certified cosmetic surgeons perform these surgeries in the west.

This is the second most common birth defect in infants. Her parents were stoic about this and sought guidance about its management. Children with clefts get to lead normal lives with adequate surgical correction.

Parents Conduct Research for Best Cleft Hospital in India

They researched in-depth about the best cleft hospital in India. This led them to meet many facial cosmetic surgeons and facial plastic surgeons. They enrolled in many cleft support groups and traveled for counseling. Convinced by the extensive research, they presented to our hospital for management.

Causes and Research into Occurrence of Cleft Deformities

The etiology of cleft lip and palate defect is very varied. It can arise due to genetic, environmental factors or mutation. Many mothers with cleft deformity give birth to babies with similar presentation.

Sources of heavy electromagnetic radiation are another alleged cause in recent years. Research is ongoing into this and there is no proof yet about this connection.

Center for Cleft Lip and Palate Correction in India

Our hospital is a specialty center for cleft lip and palate surgery. We are a nodal referral center for facial deformity surgery in Asia. Many patients have had facial esthetics restored through our facial trauma surgery.

We have over 30 years experience in cleft lip surgery and cleft palate surgery. Patients from all over the world come for facial cosmetic surgery.

Recognition from International Organizations

Our hospital is an affiliate of the World Craniofacial Foundation of USA. Our hospital has won awards from the International Cleft Lip and Palate Foundation. Many complex craniofacial cleft patients referred by these organisations undergo treatment with us. There is minimal scarring from surgery due to surgical innovations adopted by us.

Initial Presentation and Treatment Planning at our Hospital

Dr SM Balaji, Cleft Lip Surgeon, examined the patient in detail. The minor segment was very low and not visualized. This increased the degree of difficulty.

He explained that the ideal time for cleft lip surgery was 3 months. Cleft palate surgery was at 11 months and cleft alveolus bone grafting at 3-1/2 years of age. The parents of the girl then signed the consent for cleft lip surgery.

Surgical Correction of Cleft Lip Defect

A modified Millard’s technique was the technique of choice for surgery. Scarring is less compared to other techniques. Functional and esthetic results are also better with this technique.

An ambidextrous approach is the optimal technique for best results in this surgery. Our hospital is a pioneer for this approach in India.

Minimal Postoperative Scarring Following Surgery

This surgery, the first in April, was at the height of the Covid-19 pandemic. Dr SM Balaji donned a protective suit with a separate oxygen supply. This suit ensured the surgeon’s comfort throughout the surgery.

It utilized a two fan system. One fan was to blow out exhaled air and the other fan was to bring in fresh oxygen-rich air. All safety precautions were to ensure the protection of patients and other OT personnel. The surgeon remains enclosed within the suit throughout the procedure.

Optimal Results from Cleft Lip Surgery
A C flap was first raised to recreate the nasal sill followed by an M flap to create the floor of nose. Optimal tissue usage ensured that there was no tissue wastage. There was good adaptation of the two halves of the cleft lip. Results were optimal despite the difficult presentation.

Her parents were very happy with the results of the surgery. Postoperative scarring was very minimal by the time of discharge from the hospital. Cleft palate repair will be at the age of 11 months.
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Video

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