8. CLEFT LIP AND CLEFT PALATE

Cleft Lip

Failure of fusion of the maxillary and median nasal processes

Cleft Palate

An opening of the palate, usually in the midline and may involve just the anterior palate, the posterior soft palate, or both

Surgical Correction: Cleft Lip

Cheiloplasty : 2 to 10 weeks old (For suctioning) then revisions may be between 4-6 years (Body image disturbance)

Surgical Correction: Cleft Palate

Palatoplasty: 12-18months old (need to wait til atleast 1 year, para hindi ang expand ang palate) (earlier surgery will eventually open the palate due to growth)

Potential Problems

• Risk for aspiration

• Feeding difficulties

• Colic (air ingestion)

• Body image disturbance

• Risk for middle ear infections (eustachian tube)

Types of Cleft Lip / Cleft palate

1. Cleft Lip

2. Unilateral Cleft

3. Bilateral Cleft

4. Cleft Palate

Pre- Operation Management

Feed in upright position/ sitting position (Breck’s feeder)

Post Op Care: Cleft Lip

• Meta, appliance/ adhesive strips (LOGAN BOW)

• Elbow restraints (1 elbow- to promote circulation)

• Provide meticulous care to suture site

Position: side lying

• NPO for 4 hours, then plain water is introduced for

Logan Bow

A protective metal device used after cheiloplasty.

• U shaped curved metal bar placed externally over the upper lip, extending to the cheeks.

Post Op Care: Cleft Palate

Position: Prone position

• Feeding:

• Oral packing secured to palate

• Restraints

  Avoid:

  a. Use of suctions, tongue blades, thermometers, spoons, straws

  b. Toast, hard cookies

  Administer Narcotic (Demerol) as prescribed