Facial Plast Surg 2018; 34(06): 605-611
DOI: 10.1055/s-0038-1676381
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Postoperative Management of Cleft Lip and Palate Surgery

Ullas Raghavan
1   ENT, Doncaster Royal Infirmary, Doncaster, United Kingdom
,
Vishwas Vijayadev
2   ENT HNS, RajaRajeswari Medical College and Hospital, Bangalore, Karnataka, India
,
Dipesh Rao
3   Department of Plastic and Maxillofacial Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia
,
Gautham Ullas
4   Department of Otorhinolaryngology, North Cumbria University Hospitals NHS Trust, Whitehaven, Cumbria, United Kingdom
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
28. Dezember 2018 (online)

Abstract

Cleft lip and palatal clefts are one of the most common birth defects with a global incidence of 1 in 700 live births. The majority of these orofacial clefts are nonsyndromic. However, a general screening for syndromes and other organ anomalies should always be performed as their association with orofacial clefts cannot be overlooked. With the recent progress in the knowledge of cleft repair, the procedures to correct cleft lip and palate though complex, have been simplified to allow improvisation in outcome and to achieve even better finesse of surgical result. The procedural complications and the pursuit of having near perfect esthetics and functionality, make this deformity a recipient of multiple procedures. This ensures that the patient is under the care of the treating surgeon for long term and allows the surgeon to follow-up on the result, not only to provide care but also to intercept any deviation in the desired outcome. Postoperative care of cleft lip and palate surgery is largely underdiscussed and a set of fixed guidelines will help the treating surgeon to provide the most comprehensive care to the cleft patients. The authors review the practices followed at their hospitals—a high volume cleft and craniofacial care center, a tertiary care multispeciality teaching hospital, and a community teaching and training hospital. The commonly followed practices with suitable evidence in postoperative care of these patients are enlisted here.

 
  • References

  • 1 Kobus K, Kobus-Zaleśna K. Timing of cleft lip and palate repair. Dev Period Med 2014; 18 (01) 79-83
  • 2 Clarren SK, Anderson B, Wolf LS. Feeding infants with cleft lip, cleft palate, or cleft lip and palate. Cleft Palate J 1987; 24 (03) 244-249
  • 3 Kaye A, Thaete K, Snell A, Chesser C, Goldak C, Huff H. Initial nutritional assessment of infants with cleft lip and/or palate: interventions and return to birth weight. Cleft Palate Craniofac J 2017; 54 (02) 127-136
  • 4 Pandya AN, Boorman JG. Failure to thrive in babies with cleft lip and palate. Br J Plast Surg 2001; 54 (06) 471-475
  • 5 Gopinath VK, Muda WA. Assessment of growth and feeding practices in children with cleft lip and palate. Southeast Asian J Trop Med Public Health 2005; 36 (01) 254-258
  • 6 Turner SR, Rumsey N, Sandy JR. Psychological aspects of cleft lip and palate. Eur J Orthod 1998; 20 (04) 407-415
  • 7 Darzi MA, Chowdri NA, Bhat AN. Breast feeding or spoon feeding after cleft lip repair: a prospective, randomised study. Br J Plast Surg 1996; 49 (01) 24-26
  • 8 Johnson HA. The immediate postoperative care of a child with cleft lip: time-proved suggestions. Ann Plast Surg 1979; 2 (05) 430-433
  • 9 McHoney M, Eaton S, Pierro A. Metabolic response to surgery in infants and children. Eur J Pediatr Surg 2009; 19 (05) 275-285
  • 10 O'Kane S. Wound remodelling and scarring. J Wound Care 2002; 11 (08) 296-299
  • 11 Kim S, Choi TH, Liu W, Ogawa R, Suh JS, Mustoe TA. Update on scar management: guidelines for treating Asian patients. Plast Reconstr Surg 2013; 132 (06) 1580-1589
  • 12 Giebler FR, Giebler EF. Creating invisible scars. Int J Cosmet Surg Aesthetic Dermatol 2002; 4 (02) 107-110
  • 13 Studin JR. , Inventor; SG Licensing Corp, assignee. Method and composition for the treatment of scars. United States patent: US 6337076; 2002 January 8
  • 14 Ahn ST, Monafo WW, Mustoe TA. Topical silicone gel: a new treatment for hypertrophic scars. Surgery 1989; 106 (04) 781-786 , discussion 786–787
  • 15 Kiil J. Keloids treated with topical injections of triamcinolone acetonide (kenalog). Immediate and long-term results. Scand J Plast Reconstr Surg 1977; 11 (02) 169-172
  • 16 Evans AK, Rahbar R, Rogers GF, Mulliken JB, Volk MS. Robin sequence: a retrospective review of 115 patients. Int J Pediatr Otorhinolaryngol 2006; 70 (06) 973-980
  • 17 Katzel EB, Basile P, Koltz PF, Marcus JR, Girotto JA. Current surgical practices in cleft care: cleft palate repair techniques and postoperative care. Plast Reconstr Surg 2009; 124 (03) 899-906
  • 18 Duarte GA, Ramos RB, Cardoso MC. Feeding methods for children with cleft lip and/or palate: a systematic review. Rev Bras Otorrinolaringol (Engl Ed) 2016; 82 (05) 602-609
  • 19 Beirne JC, Barry HJ, Brady FA, Morris VB. Donor site morbidity of the anterior iliac crest following cancellous bone harvest. Int J Oral Maxillofac Surg 1996; 25 (04) 268-271
  • 20 Dashow JE, Lewis CW, Hopper RA, Gruss JS, Egbert MA. Bupivacaine administration and postoperative pain following anterior iliac crest bone graft for alveolar cleft repair. Cleft Palate Craniofac J 2009; 46 (02) 173-178
  • 21 Petersen PL, Mathiesen O, Torup H, Dahl JB. The transversus abdominis plane block: a valuable option for postoperative analgesia? A topical review. Acta Anaesthesiol Scand 2010; 54 (05) 529-535
  • 22 Cheung LK, Chua HD. A meta-analysis of cleft maxillary osteotomy and distraction osteogenesis. Int J Oral Maxillofac Surg 2006; 35 (01) 14-24