Treatment protocol for

cleft lip and cleft 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.

AgeTreatmentRationale
At birthFeeding PlateSucking milk
2-3 months  Lip repairFeeding and appearance
9-11 monthsPalate repairSealing 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 TherapyImproving 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 yearsCleft alveolar bone closure using BMP

 

Closing alveolar cleft and enabling normal teeth eruption
OR
7 yearsCleft alveolar bone closure with bone graftingClosing alveolar cleft and enabling normal teeth eruption
13 yearsCleft 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 performedDistraction OsteogenesisUpper jaw advancement
Orthognathic Surgery (jaw correction surgery)Esthetics
Secondary CorrectionsEsthetics