Cleft lip: defect classification and methods for eliminating it



Congenital abnormalities are a very scary and unpleasant thing. They are able to change a person’s entire life since birth. The pathologies of internal organs are not so terrible - they do not manifest themselves visually and a person can live quite comfortably with them. However, deviations that appear on a person’s appearance can cause various complexes, the development of depression, or, worse, completely destroy a person’s personality. One of these pathologies is cleft lip. According to medical staff, this deviation meets in one child out of a thousand. This is a serious deviation, which is pronounced on the face. Is it possible to fully recover from it? What types are there? Is plastic surgery necessary? All the answers to such urgent questions will be disclosed in this article.

What is a hare lip

Cleft lip (in medical terminology - cheilosis) - congenital pathology, defect. Characteristic features is the deformation of the upper (in very rare cases - lower) lips of an unborn child. The lip can be divided by a vertical stripe (down to the nose) or consist of several lips at the same time. The length and depth of the gap is always different. In some cases, through the gap, you can see the mucous membrane of the upper jaw.

This defect is possible only in babies, starting from the moment of birth. It occurs as a result of violations during pregnancy, the introduction of intrauterine infection or heredity.

As a rule, treatment must be made before the child is six months or a year old (this is the maximum). This is due to the fact that the torn muscle tissue is very soft and amenable to correction.



Defect classification

According to the classification, the cleft lip is divided into two forms: complete and incomplete.

The incomplete form is characterized by a one-sided hollow on the lip. It almost never reaches the nose and is considered quite safe for the health of a newborn baby. It is much easier to treat this form, because you need to connect a relatively small gap of soft tissues.

The full form is much more serious and is expressed by strong breaks on one or both sides of the lip. The cleft begins from the upper lip and ends with the nose (it seems as if the nozdryvo space is completely absent). There are difficulties with breathing, the child may begin complications in the lungs.

Cleft lip: the causes and the dangerous disease

The formation of this defect is due to the gene level. Simply put, a hare lip, the causes of which will be discussed below, is formed in the womb and may be caused by various factors in the behavior of the mother.

Consider the causes of the defect:

• Stress, depression, apathy. Psychosomatic condition of the mother.
• Abuse of alcohol and tobacco products throughout pregnancy.
• Serious infectious diseases and complications from them.
• Overdose of drugs, especially antibiotics.
• Pronounced toxicosis.
• Late delivery (aged before menopause).
• Intrauterine high water.

The impact of the above factors is considered particularly dangerous for the child in the first few months of pregnancy.

Also, the cause of cleft lip can be heredity. It is not necessary that a similar defect be in the first or second line of relatives. It may be distant relatives or the fifth or sixth branch of the genealogical tree.

To determine the presence of a birth defect by ultrasound examination of the fetus at 6-8 months of pregnancy. It is recommended to undergo a preliminary consultation to those people who are planning to have a second child, provided that the first one was born with a pathology like a cleft lip. The causes of the defect should be clarified in advance; parents should try to eliminate the provoking factor during the next pregnancy.

What is dangerous this disease

For a start it is worth noting that this defect is a deviation during the prenatal period (pregnancy) of the normal development of the nasal cavity and upper jaw. In very rare cases, based on medical statistics, mandibular deformities were observed. In general, doctors classify it as a different defect “ cleft palate ” and do not correlate with a hare lip.

There is a deformation of the upper lip. It seems to be divided (torn) in the interval from the upper jaw to the nose.

This defect can cause many negative consequences:

• Breastfeeding is difficult. A newborn can not fully use the oral cavity, so feeding is performed through a special nasal probe.
• Possible deviation in the development of the jaw apparatus. Extra teeth may erupt, some fall out at a very early age, or simply do not erupt. Tooth enamel is broken, bite is incorrect, teeth are caries at an early age. Moreover, the jaw may slightly shift to the side, which can significantly aggravate the further full development of the jaw apparatus.
• At a later age, deviations in the speech apparatus are manifested. There is a burr, lisping, a problem with the pronunciation of vowels. With more complex forms, speech becomes practically nonseparable, distorted. In this case, even a full rehabilitation course at a speech therapist may not bring results.
• In addition to physical abnormalities, mental personality disorders are observed : notorious, extremely low self-esteem, isolation in oneself, frequent depressions, stresses.

In general, it can be noted that the pathology of the cleft lip negatively affects the future life of a person. People with a similar deviation are very negatively perceived in society. The process of socialization takes place with great difficulty, the child (at that time already a teenager or a young man) is hard to find a common language with people. There are deviations in the development of personality, a person stands still. It is also difficult for a patient to express his thoughts because of a disturbed speech apparatus.

Moreover, a hare lip can be a provoking factor for many diseases of the maxillofacial structure and entail serious consequences.

Is it possible to prejudice the formation of cleft lip and newborn

Yes it is possible.

To prevent a child from having such a defect, it is enough to adhere to a relatively small set of rules:

• Before planning a pregnancy, you need to make a comprehensive examination. Make sure there are no infectious diseases or other viral diseases.
• It is necessary to maintain a balanced diet, try to eat less fried and flour. Enrich your body with vitamins (eat vegetables and fruits).
• Dress warmer, try to avoid hypothermia.
• It is strictly forbidden to use any antibiotics or other potent drugs. The adoption of any potent drugs increases the chance of intrauterine pathology by 50%.
• Eliminate all negative habits (use of alcohol and tobacco products). Try to avoid contact with smokers, not be in the same room with him.
• Avoid toxic poisoning. Gasoline, paint and other toxic substances should be avoided.
• Do not contact people who are carriers of viral diseases.

At first glance it seems that there are too many restrictions. But they are all necessary for the birth of a healthy and strong baby.

Chlorinoplasty as a way to fix the problem

Preparation for surgery begins immediately after birth. In terms of duration, all preparatory measures take up to six months. By the time the child must be fully prepared for the operation without possible consequences.

The operation to restore the torn soft tissue of the maxillofacial structure is called chelorinoplasty. This is a very precise and serious procedure requiring comprehensive preparatory measures.

Many specialists take part in the preparatory measures: pediatrician, anesthesiologist, surgeon (including plastic), speech therapist. If necessary, specialists of other profiles are involved.

The pediatrician controls the somatic state of the child. It establishes the presence of other congenital pathologies that may hinder the further restoration of the lip, and prescribes a comprehensive treatment to eliminate them.

Especially acute abnormalities that prevent the operation on the lip include:

• Congenital heart disease (heart disease, heart failure).
• Congenital pneumonia or other diseases of the respiratory system.
• Disturbance of endocrine regulation in the body.

Only by eliminating side diseases, it becomes possible to conduct surgery.

One of the most significant places in the preoperative procedure is massage. Massage exercises are designed to stimulate the tone of non-fused muscles of the upper lip. Such procedures can be carried out by the mother, being at home. It is worth noting that throughout the preparatory stage it is not necessary to be in a medical facility. If necessary, the doctor can call the mother with the child to the hospital (for regular examinations or procedures) or visit the patient on her own at home.

Speech therapist recommends from birth to use the innate desire of the child to lick from the lips those particles that should not be present on them. This allows the maximum use of language motor skills and prejudice possible deviations in the development of the speech apparatus.

Operational remedy

After a long and thorough preparation, a period of direct operation begins.

Chlorinoplasty is needed to restore the aesthetic appearance of the lip, to return to the original anatomy and functionality. This is a universal operation, which is aimed at the complete elimination of all the negative consequences of pathology and, directly, the hare lip itself.

Much depends on the severity of the pathology in the child.

In a particularly severe form, the operation can be performed within a week from the moment of birth, but at the same time, two criteria must be met:

1. The child must consistently gain weight.
2. There must be no other serious pathologies (diseases of the cardiovascular system, disorders of the gastrointestinal tract).

If the child is completely healthy and his initial development passes without obvious complications, an emergency intervention can be made.

The operation is divided into two categories, depending on the form of pathology: complete and incomplete.

When the form is incomplete (when the gap is relatively small and does not reach the nose), doctors connect the torn space between them, in other words, they sew soft tissue. At the initial stages of a child's life, the main adaptation to the environment occurs and his body is most susceptible to change. Solving a problem in this way is most humane and practical and does not require further intervention by a plastic surgeon. Soft tissue will grow naturally and the only thing that will be required is to remove the seams in time.

With complete pathology (also called a severe form), a much more complicated operation follows. There is no possibility to sew between them a soft fabric, as the cleft is too large. To eliminate this problem, artificial muscle tissue is used, which is sewn into the crevice between the lip and the nose. In some modern clinics with high-tech equipment can be grown artificial muscle tissue from the cells of the child. This guarantees a 100% perception by the body of a new biological material and the fastest regeneration.

Much will depend on the size of the cleft lip and the preliminary measures taken. It is very important to complete the preparatory stage for a successful and efficient operation.

How many operations are required to completely eliminate the defect

Operations are divided into two types: surgical and correctional.

Surgical operations, as a rule, account for no more than two for a single case. If the defects in the area of ​​the nose belong to a severe (complete) form, then the operation is not performed in one stage. The need for a second operation arises if there is a gap on both sides of the lip.

If obvious deformities of the nose are present, a third operation may be necessary. This is necessary to eliminate possible complications on the breathing apparatus and increase the chance for a successful cosmetological adjustment.

In any case, the need for a second (and further) operation will be established after performing at least one procedure.

Cleft lip and defect removal methods

As soon as the main reconstructive surgery is performed on the part of the surgery, it is the turn of postoperative cosmetology. It is necessary for the visual improvement of a pronounced defect and the elimination of all external defects.

First of all, the scar is removed after surgery. This can be done in a variety of ways, from skin plastics to laser burning. After carrying out all the necessary procedures, the scar from the surgical intervention will be almost imperceptible.

If the upper lip has been enlarged, then plastic surgeons or cosmetologists will eliminate this. They trim or suture it, giving it a natural look and size.

It is worth noting that the cleft lip, in its very slight manifestations, can be eliminated through plastic surgery. It is enough to make an adjustment of the skin and soft tissue and the defect will disappear forever. This is possible only if the child does not have complications in the general physical condition.

Rehabilitation after surgery

The postoperative period consists of a set of procedures and indications that are most strictly necessary for execution. Compliance with all prescribed recommendations by a doctor will allow you to go through the rehabilitation period smoothly and without obvious aggravations.

At the end of the operation, a special gauze pad will be placed in the child’s nose. It is necessary to prevent deformation of the nasal openings.

After removing the gauze in the nose is placed a special corrective tube. It is necessary to prevent its narrowing and deformation of the wings of the nose.

During rehabilitation, the child will be assigned a special corrective headgear. It is necessary to correct the operated upper lip and fix its state. Thanks to this device possible consequences in the form of suddenly diverged seams or stretching are prevented. It is very important that the cleft lip does not succumb to infection, otherwise it will lead to a very deep and long course of rehabilitation.

It is necessary to conduct a routine examination by a doctor according to the prescribed schedule. Any changes in the child's well-being should be recorded, in case of complications, appropriate measures are taken.

Cleft lip - congenital pathology, manifested in the gap of the upper lip. This terrible and serious disease, modern medicine, including plastic surgery, provides all the chances for successful treatment.

If there is an opportunity to prejudice the intrauterine development of pathology, then this chance should definitely be used. The operation and postoperative rehabilitation is much more complicated than, for example, the rejection of alcohol or tobacco products during pregnancy.

The preparatory series of procedures for the operation must be started from the moment the baby is born. The training will involve a multitude of specialists of various profiles who will produce a comprehensive series of procedures for further successful operation.

You should never forget that from the faithful measures taken by the mother, the whole further life of the child will develop. The hare lip is not only a visual defect. Of course, the pathology is displayed on the general state of health, but first of all, on establishing contact with the outside world. In time not rendered medical care can break the life of the future person. He will develop many internal complexes, possible mental instability, unbalance. That is why you should not delay the operation for later, but carry out immediately after the birth of the child.