The Orofacial Cleft
An orofacial cleft involves the lip, the palate, the tooth bearing part of the upper jaw. It affects the nose, the ear and the midface. It also affects the person’s appearance, speech, swallowing, hearing and causes intense physical and psychological suffering for the child and the family. How does this happen? We know that the orofacial cleft happens due to failure of fusion of parts of the embryo in the 4th week of intrauterine life. Often the damage is already done even before the mother realises, she is pregnant. However, what we do not know is to tell for sure how it happens – leave alone predict it or reliably prevent it, though there are several suspect genetic and environmental factors. Our best bet yet seems to be to treat the baby once it’s born since all the deformities are eminently correctable.
Secondary Deformities Following Primary Cleft Lip and Palate Repair
Unfortunately, in India like in many other parts of the developing world the quality of care varies widely. Several children have their lips and palates repaired and are never followed up. Even these operations are sometimes done inexpertly by Surgeons who either had no interest in doing this delicate surgery or just did not have the necessary expertise. Because of this, we get patients from all over the country who had primary lip and palate repair and little else at other centres. So, we went one step ahead and developed a unique protocol to suit our situation to deal with these deformities.
Rare Craniofacial Clefts
These are clefts of the face and facial bones resulting into major deformities of face. Some of these defects may involve the eyelids and child may not able to cover the eyes completely resulting into loss of vision. And therefore, it is very essential to reconstruct these deformities immediately after the birth to preserve the vision.