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The issue and our medical approach

The issue and our medical approach:

Cleft lip and palate (harelip) is one of the most common malformations of the human body. It occurs one- or double-sided, in varying severity. The issue’s frequency is rising constantly. At the turn of the century the likeliness of being born with it was 1:1700, today it’s 1:500 (in Central Europe). But there is a noticeable difference between the ethnical affinities, cleft lip and palate is much more common in Asian countries; it’s estimated to be 1:300.

The medical reason for this malformation is mostly unknown. The most important influences are inheritance and antenatal deficiency of vitamins an folic acid. The different parts of the face all develop separately during the embryogenesis, later on, they grow together. Either only a part of the upper lip (notch), the whole upper lip, or the upper lip and the jawbone can be affected, depending on when and how severe the issue appears. So there are a lot of different types of cleft lip and palate. One can differentiate between the common cleft lip and an additional cleft palate, but in most cases, they occur together.

A cleft lip can happen to be limited to the prolabium only (in this case it appears as a notch), or the complex of muscles and vermilion.

A cleft lip, combined with a cleft palate. The nasal entrance and a nostril, as well as the upper jaw’s periodontium are affected, too.

A fully developed cleft lip and palate causes a continuous connection of the patient’s nasal cavity and oral cavity. Thus, the premaxilla is displaced.

The cleft palate is either limited to the soft palate only, or involves the hard palate, too.

Millard-incision

This method is applied to elongate the upper part of the lip with the help of a triangular lobule. The most notable benefit of this method is the remain of a small scar only.

Closing the palate

Closing the soft palate, prevents growth inhibition and incorrect language development. By doing so, the surgeon detaches the flawed musculature and afterwards sutures it correctly, creating a muscle loop, that’s rebuilding the anatomically correct functioning, which is to open up the auditory tube when lifting the soft palate. If the hard palate is the malformed part, the nasal mucosa and the oral mucosa are being surgically separated, allowing a two-layered closure. A fusion of the nasal mucosa is possible in most cases, while the oral part has to be stabilised, using bridges or artificial palate shelves.

Middle ear treatment

Incorrect aeration of the middle ear is a result of the palatine muscles’ malfunction. There is a risk of ear infection, deafness and failing language development, if this issue stays untreated. A reliable treatment is the so called paracenteses, where any effusion is being extracted from the ear. A tympanostomy tube helps assuring a permanent drainage.

Rhinoplasty

Deformation of the nose is a more complex problem. During surgery, the attending doctor has to rebuild the nasal floor an the nasal entrance and adjust the wing of the nose, which is on the same side as the cleft. An important goal is to achieve an aesthetically pleasing result.

Postsurgical treatment

In the recovery room, mother and child are reunited. Seeing a familiar person helps to keep the children calm when they wake up. Nurses watch the patients cardiovascular system and perform an adjusted pain therapy. After the surgeon determines the necessary aftercare and fills out then childrens’ data sheets, skilled native workers care for them an control their medication. Every morning and every evening, the responsible physicians visit all the patients and see if everything is fine. After receiving palate surgery, it is essential to start eating again, so the healing process is able to take place correctly. Moreover, regular checkups take place to detect and treat potential complications and problems with wound healing as early as possible.

Nowadays there is a close and trustful friendship between the MIT and the native nursing staff. Everyone’s main goal is to provide the possibly best treatment for every child in need, so professional and conscientious work is indispensable. Unexpected or aggravating situations can’t lessen the team’s commitment and motivation, even when surgery lasts until late into the night.

 

 

Medical Intervention Team

The Medical Intervention Team is a non-profit association, registered at the local court of Frankfurt am Main. Our association is funded by donations only. The participating doctors, nurses and medical students are working on a voluntary basis. Our guiding theme is: Humanism, Empathy and Responsibility. By donating, you are supporting our work.

Address

Medical Intervention Team e.V.
c/o HNO-Praxis am Goetheplatz
Rossmarkt 23
60311 Frankfurt am Main
Germany

Phone

+49 (0) 69 - 26 49 50 150

Email

info@mit-ev.org

Donation account

Medical Intervention Team e.V.
Deutsche Bank
IBAN: DE05 5007 0024 0016 7999 00
BIC: DEUTDEDBFRA