Cleft Lip and Palate
Cleft lip and palate is one of the more common disorders seen in the Philippines. In fact, in 1 out of 1,000 Filipino live births, a cleft lip or palate patient is born. A cleft is a gap or a deficiency in the lip and / or palate (roof of the mouth). Clefts may occur when the two sides of the lip and palate do not grow or fuse together during the baby’s development in the first trimester of pregnancy. Though the main cause of cleft lip and palate still remains unknown, the risk factors of having a cleft lip and palate child include family history, poor maternal nutrition, taking of unprescribed medicines, early and delayed pregnancy and poor maternal pre-natal care. More than the physical deformities, the patients suffer from low self-esteem brought about by fear of humiliation and embarrassment and the social stigma and trauma which makes these patients emotionally scarred. Management of cleft lip and palate patients is a multidisciplinary approach as it involves different medical specialties (Cleft Care Team) to give optimal care to the patients. The advantages of having a cleft team of experts include feeding education and support, connection with other parents and children affected by clefts, parent engagement in treatment planning, education about clefts and speech development, and pre- and post-surgical care and support.
Cleft lip and palate may be diagnosed prenatally through different imaging techniques notably Ultrasound and CT scan. This gives the parents enough preparation to understand the treatment process and options cleft lip and palate.
Surgery for Cleft Lip (Cheiloplasty) starts as early as 3 months of age under General Anesthesia, provided that the baby is well-nourished and without any associated illness. Cheiloplasty involves rotating and advancing the skin and muscles around the lip and joining them together to create a normal lip appearance. This procedure usually leaves a small scar on the lip under the nose. For surgery of the cleft palate (Palatoplasty), patients as young as 9 months old can be operated on or until before the child begins to talk or develop speech. The procedure involves connecting the muscles of the soft palate and rearrange the tissues to close the cleft. The goal of palatoplasty is to create a palate that will work well for speech. Under the care of a qualified and certified specialist, the results of these procedures produce dramatic and significant outcomes.
The Section of Plastic and Reconstructive Surgery at St. Luke’s Medical Center-Global City performs Cheiloplasty and Palatoplasty and other procedures associated with Cleft Lip and Palate. They also coordinate and take the lead in the managing and caring for cleft patients along with the rest of the Cleft Care Team. It is best to seek consult and discuss treatment strategies and options so that parents and patients will be guided accordingly.
Dr. Gene Gerald SJ. Tiongco, MD, FPAPRAS, is a an active consultant of the Section of Plastic and Reconstruction of the Institute of Surgery in St. Luke’s Medical Center-Global City. He had his Plastic and Reconstructive training at the University of the Philippines - Philippine General Hospital (UP-PGH). He is a Fellow and presently the Secretary of the Philippine Association of Plastic, Reconstructive and Aesthetic Surgeons (PAPRAS). He is also an active volunteer for cleft surgery groups such as Smile Train and Operation Smile. To know more about cleft lip and palate care, visit the Section of Plastic Surgery at the 7th Floor of St. Luke’s Medical Center-Global City or call (632) 7897700 ext. 2106.