Postoperative Management of Cleft Lip and Palate Surgery

Abstract

Cleft lip and palatal clefts are one of the most common birth defects with a global incidence of 1 in 700 live births. The majority of these orofacial clefts are nonsyndromic. However, a general screening for syndromes and other organ anomalies should always be performed as their association with orofacial clefts cannot be overlooked. With the recent progress in the knowledge of cleft repair, the procedures to correct cleft lip and palate though complex, have been simplified to allow improvisation in outcome and to achieve even better finesse of surgical result. The procedural complications and the pursuit of having near perfect esthetics and functionality, make this deformity a recipient of multiple procedures. This ensures that the patient is under the care of the treating surgeon for long term and allows the surgeon to follow-up on the result, not only to provide care but also to intercept any deviation in the desired outcome. Postoperative care of cleft lip and palate surgery is largely underdiscussed and a set of fixed guidelines will help the treating surgeon to provide the most comprehensive care to the cleft patients. The authors review the practices followed at their hospitals—a high volume cleft and craniofacial care center, a tertiary care multispeciality teaching hospital, and a community teaching and training hospital. The commonly followed practices with suitable evidence in postoperative care of these patients are enlisted here.

Perioperative Complications And Concomitant Diseases Of Patients Followed In Intensive Care Unit After Cleft Lip-Palate Surgery

“…Most of the ICU indications in the first 24 hours of patients undergoing CLCP surgery are airway problems due to surgical procedures (11) . Our patients had also similar indications for ICU follow-up.…”

Detection and classification of unilateral cleft alveolus with and without cleft palate on panoramic radiographs using a deep learning system

“…The frequency of babies born with CLP is approximately 1 in 500 in Japan 3 . Although various treatment protocols have been applied, soft tissue parts such as the lip and mucous membrane covering the hard plate are surgically treated within a relatively short period from birth 4 . Hard palatoplasty with bony transplant is frequently applied in patients with cleft alveolus (CA) to stabilize the maxillary segments, provide bony support for the teeth adjacent to the cleft, provide additional support to the lip and nose, and induce the canine eruption 5 , 6 .…”

Impacto dos tratamentos de fissuras labiopalatinas na qualidade de vida: avaliação pelo CLEFT-Q

“…Fissura labiopalatina (FLP) é um dos tipos mais comuns de lesões maxilofaciais congênitas (Sato et al, 2021;Ono et al, 2015) com incidência global de 1 para 700 nascidos vivos (Raghavan et al, 2018) e, no Brasil atinge 1 em cada 650 nascidos vivos (Ministério da Saúde, Brasil).…”

“…Dentre estes, a correção labial de um resultado insatisfatório, correção da disfunção velofaríngea, após palatoplastia; cirurgia ortognática para correção maxilar; rinoplastia para deformidade nasal secundária e cirurgia para incompetência velofaríngea (Raghavan et al, 2018). Geralmente, esperam-se resultados mais desejáveis quando são aplicados protocolos que preconizam que as estruturas de tecidos moles, como o lábio e a membrana mucosa devem ser tratadas cirurgicamente em um período relativamente curto desde o nascimento, até 3 meses.…”