Treatment measures
Surgical reduction should be performed. After 2 years old, it is more suitable before 5 ~ 6 years old. Surgery can not only close cleft palate, but also provide correct conditions for children's pronunciation. Children should be trained in pronunciation after operation. The basic principle of cleft palate repair surgery is to prolong the soft palate, close the palate and pharynx, and restore normal swallowing and pronunciation functions. At present, the commonly used operations are: ① modified Langerhans operation; ② pear bone mucosal flap operation; ③ Operation of palatal flap of arterial island; ④ Retropharyngeal mucosal muscle flap transplantation.
Although the good opportunity for treatment has passed, it can still be treated, that is, the recovery may be slower and the pain may be greater!
cheilopalatognathus
During fetal development, cleft lip and cleft palate are caused by facial abnormalities.
What is a cleft lip?
Cleft lip refers to a person with a cleft upper lip, which is a congenital deformity, commonly known as "rabbit lip". Cleft lip is more common in infants, accounting for about one thousandth of infants. It may also be caused by acquired factors, such as trauma. Lateral cleft lip is more common. Lateral fissure refers to one or both nasolabial sulcus, which may be accompanied by cleft palate. Cleft palate is the defect of the bottom of nasal cavity, that is, the top of oral cavity-hard palate, commonly known as "wolf pharynx"
How is cleft lip and palate formed?
One reason is consanguineous marriage, and the other reason is that the mother is sick during pregnancy, especially when she is pregnant for 1-4 months. The mother suffers from virus infection, such as rubella and flu, or takes some drugs, such as cortisone, diphenhydramine, chlorpheniramine, and librium, or receives radioactive substances, such as X-rays and isotopes. All these factors will mutate embryonic cells.
What are the manifestations of cleft lip and palate?
Cleft lip and palate seriously affect breastfeeding, and sick children are easy to inhale into human respiratory tract by mistake when breastfeeding, causing tracheitis and pneumonia. Because they can't breastfeed normally, children with chronic diseases will suffer from malnutrition and various nutritional disorders. In severe cases, it is even life-threatening.
Lip is one of the vocal organs. Children with cleft lip can't pronounce clearly when speaking, which affects the pronunciation of language. In cleft palate, the oral cavity communicates with the nasal cavity. In addition to food choking into the nasal cavity, there may be nasal opening, which may also lead to unclear pronunciation. Language is a social tool, and language pronunciation disorder can also cause psychological disorder and indirectly cause mental retardation. The development of teeth near cleft lip is also inhibited, resulting in uneven arrangement and ectopic.
Treatment and nursing of cleft lip and palate
Long-term feeding of children with cleft lip may lead to suffocation or infarction. A mother should have the patience to breast-feed her children. If breast-feeding, full breasts and rich milk, you can hold the baby vertically and stuff the nipple into the population, so that you can put the nipple in the floating population near your mouth. Newborns can be fed with a spoon, or with a long, big-hole nipple. Milk can be placed at the back of the mouth, so that the milk can slowly drip into the root of the tongue for easy swallowing. Children with cleft lip are easy to swallow a lot of air when feeding, so they should often clap their backs and burp, and then rinse their mouths with a small amount of water after eating milk.
Surgical treatment is the only way. Appropriate operation time should be selected. Neonatal tissue is thin, the body resistance is low, and it can't stand the blow of surgery. At this time, surgery is not recommended. The best time is 6-9 months. At this time, the sick child has a certain resistance, and the front teeth have sprouted. Timely surgery can also avoid the protrusion of the upper incisors. It turns out that the postoperative recovery is also fast. The operation time of cleft palate should be later, because the mouth of the sick child is too small and the operation is difficult, but it is best not to be later than 5 years old. It is best to choose the operation in spring and autumn, and necessary language training should be carried out after the operation, so as to create conditions for going to school in the future.
The key point of postoperative nursing care of cleft lip and palate is to prevent the wound from re-splitting and infection. Whether it is cleft lip or cleft palate, if you don't take good care after repair, there is a risk of re-cleft. To prevent the baby from crying, opening his mouth and crying, the tension of lips and palate will increase, which may lead to the re-opening of the wound. Sedatives can be given to children who are particularly fond of crying, and sensible children should do a good job in educating their children and explain the benefits of crying. In addition, be careful not to fall when you are in the wild. If you encounter something hard at the suture, the wound will split again.
Always keep the wound clean, and wipe the lip wound with normal saline and 75% alcohol cotton swab after each feeding or eating, with gentle movements. It usually takes 5 days to remove stitches. After cleft palate repair, children should be taught to gargle with light salt water or D'Aubert solution to keep their mouths clean.
The suture can be removed two weeks after cleft palate surgery, and special attention should be paid to diet when you go home for one day. Before the operation, we should strengthen nutrition, enhance resistance and avoid catching a cold. Clean your mouth a few days before operation to prevent postoperative infection.
Eat liquid food and semi-liquid food (such as milk, juice, noodles, custard, etc.). ) During hospitalization, I ate soft food, noodles, soft rice and porridge. Within two months after discharge, avoid dry and hard food with residue, so as not to stimulate the wound and affect healing or re-cracking.
For children with cleft palate, parents should teach their children to practice pronunciation as soon as possible after operation. Once bad language habits and incorrect pronunciation are formed, it is difficult to change them. The younger they are, the more important this language training is.
Cleft lip is a congenital deformity, commonly known as rabbit lip, which is mainly manifested in the fact that cleft lip can be found after birth. The occurrence of this deformity is often related to heredity, premature illness of pregnant women or drug treatment.
According to the size of the crack, it can be divided into I degree, II degree and III degree. The fissure is only located in the red lip, the first degree, the second degree reaches the white lip but not the base of the nostril, and the third degree runs through the white lip and the red lip, often accompanied by alveolar cleft. According to the fracture site, it can be divided into unilateral cleft lip and bilateral cleft lip, and sometimes the upper lip or lower lip can be seen, but it is rare.
For such children, it is advisable to operate as soon as possible. At present, there are different views on when children are better treated. One thought that it should be completed within 24 hours after birth. Because the child has antibodies at this time and has certain resistance, the pain is not obvious, and surgery can be performed without anesthesia; However, it also has some shortcomings, that is, the child still has physiological jaundice at this time, and the anatomical marks of the lips are not very clear, which brings certain difficulties to the surgical design. Another view is that it should be done when the child is 3 months old. Because the child's physiological jaundice has disappeared at this time, the anatomical signs of the lips are also very obvious, and the child also has certain resistance. No matter when you are treated, you should pay attention to feeding your child with a spoon after operation. Don't let it suck, so as not to affect wound healing. Also avoid catching a cold, because too much nasal mucus will erode the wound and affect the surgical effect.
After cleft lip repair, there will be no secondary nasal and lip deformity due to uneven development. Severe cases can be corrected by early secondary surgery or treated when the development is basically finalized (such as 18 years old).