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Cleft palate


Cleft palate (cleft palate)

is a congenital deformity that develops due to improper fusion of the apophysis of the maxilla with the vomer (unpaired bone of the face). So between the nasal and oral cavity formed a message. Sometimes the defect is accompanied by cleft lip. This birth defect occurs most often with it is born of 0.1% of children.

Form

Cleft palate can be complete and incomplete. In the complete cleft palate is formed by the cleft in the soft and hard palate. At part of the sky seeing only the hole.

Often the defect is accompanied by a split process on the back of the upper palate of the so-called uvula. This occurs due to improper development of the connection of the nasal septum and the lateral, the medial Palatine process.

Reasons

The cause of cleft palate is called a genetic component. British scientists in 1991 discovered the gene 22 responsible for the development of cleft palate it is found on the X chromosome. A risk factor is teratogenic effect on the fetus. To date, the interrelation between the development of such defects as cleft lip, cleft palate and the use of the mother-alcohol, drugs and Smoking. The risk increases with obesity women and lack in her diet with folic acid.

Its negative role is also played by a bad environment in the region, where the pregnant woman transferred to it while carrying a child morning sickness, mental and mechanical trauma, and acute infection. Particularly dangerous first three months of pregnancy it was then formed of maxillofacial apparatus.

Nezareatmene sky is found as an independent defect, or in combination with any oral and maxillofacial pathology.

Complications

Problems associated with the presence of cleft palate, beginning with the first moments of life. During childbirth a chance of getting aspiration of amniotic fluid into the respiratory tract of the child.

Children with this defect are extremely painful. This is because the air that they breathe, not hydrated and not warmed, and the inhalation of cold and dry air causes the development of inflammatory processes of the respiratory system, but also the inner ear.

Such a child lags behind in development because his breathing is difficult, and sucking in a natural way is impossible. For feeding use a special tool spoon, worn on the bottle.

In addition to the upper respiratory tract, affecting the digestive system, there are serious problems with hearing. Children with cleft palate have speech problems, she changed because of incorrect formation of sounds. For this speech characteristic open rinolaliya. Quite often there are ear infections and sinusitis. Inflammation occur due to the fact that the use of fluid and food through the crevice ends up in the sinuses and Eustachian tubes. Bite and teeth are deformed, which reflects badly on the process of chewing food. For all these reasons, this birth defect needs to be eliminated as early as possible.

Treatment

Treatment of cleft palate is surgical method. For it to be successful, it is necessary to combine the efforts of many doctors pediatrician, oral and maxillofacial surgeon, an orthodontist and an otolaryngologist, neurologist, speech therapist.

To eliminate the effect have performed the plasty of the upper palate, restore the integrity of alveolar process and, if necessary, the upper lip.

For the first time such surgery was carried two hundred years ago in France. Today, armed with doctors several methods of treatment of the defect. The most successful cheiloplasty (repair of the defect of the upper lip) and uranoplasty (elimination cleft palate).

Operations are carried out in several stages. In some cases, 23 the procedures in the other 57 (all depends on the severity of the pathology). But even the most experienced plastic surgeons will not be able to save a child from post-operative scar, but over time it becomes almost invisible.

Experts disagree about when to hold surgery treatment cleft palate. Some believe that surgical intervention is needed as early as possible in 36 months, while others prefer to wait until the child grows up. However, they both agree that the complete correction of the defect and rehabilitation need to 6 years. In part, these terms are called because the child at this age should go to school where healthy children the presence of a palatal cleft does not affect the intellectual development of the child but to correct the flaw he is on account of disability.

Treatment of such defects is engaged in the profiled hospitals, where there are all necessary specialists. There is not only working to eliminate the physical shortage, but also help to overcome the trauma caused by external inferiority, with the goal of full integration into society.

Uranoplasty one of the most efficient methods, which eliminates cleft palate in children. It restores the anatomical structure of the hard and soft palate and middle pharynx.

Classical and basic version of such an operation uranoplasty on Limberg. She is successful in 9298% of cases.

Eliminating crevices require specialists to deal with the whole spectrum of tasks involving the recovery of each layer hard and soft palate, removal of perverse attachment velopharyngeal muscles, correct the exception during the surgical intervention the risk of damage to the nerves responsible for muscle contraction, etc.

Radical uranoplasty recommended for children under the age of 36. Patients with blind crevices operate in 35 years, through single and bilateral in 56 years.

Radical uranoplasty not recommended for children under 3 years of age. It is believed that it can lead to delayed development of the upper jaw. At the age of 2 years must be gentle uranoplasty.

Before surgery child is prescribed to wear a floating obturator. It allows you to eat normally, to breathe, to develop the correct speech. Two weeks before the operation, the fixture is removed.

After surgery, the child is shown bed rest for 23 days. Accepts solely pureed food, it is recommended rich alkaline water. The care of the oral cavity should be particularly careful. Before and after a meal the necessary irrigation of the mouth with a weak solution of potassium permanganate (potassium permanganate).

It is recommended to inflate the balloons several times a day. Starting from the second week after surgery, performed finger massage of the sky and special exercises.

To prevent postoperative infection, prescribed antibiotics, with the presence of pain pain. The extract is performed on 2128 the day after surgery.

In the future, patients undergoing physiotherapy for the restoration of velopharyngeal closure and mobility of the sky.