PROTOCOL

Treatment protocol for
CLEFT LIP & PALATE

The common problems that are faced by cleft children and their parents are related to appearance, nutrition and speech. As the child grows up, multiple surgeries are required to be performed to restore good health and appearance and for the child to lead a normal life.

Age Treatment Rationale
At birth Feeding Plate Sucking milk
2-3 months   Lip repair Feeding and appearance
9-11 months Palate repair Sealing the communication gap between the mouth and nose to enhance feeding & speech
3 years + Pharyngoplasty  (if needed) Correction of nasal sounding speech (by preventing escape of air through the nose )
Speech Therapy Improving pronunciation
3 years    Premaxillary setback  (in case of bilateral cleft) Creation of labial vestibule (space between lips and upper front teeth), speech and esthetics
3 years Cleft alveolar bone closure using BMP

 

Closing alveolar cleft and enabling normal teeth eruption
OR
7 years Cleft alveolar bone closure with bone grafting Closing alveolar cleft and enabling normal teeth eruption
13 years Cleft orthodontics (correction of malaligned teeth) Normal positioning of teeth
14-16 years   Rhinoplasty  (nose correction) Esthetics
Depending upon the severity of the cleft, these procedures may be performed Distraction Osteogenesis Upper jaw advancement
Orthognathic Surgery (jaw correction surgery) Esthetics
Secondary Corrections Esthetics