Allowing Nasal Deformity Reconstruction During Cleft Lip Surgery

A child born with a cleft lip may also have other facial deformities produced by the cleft lip itself. Because the lip did not fuse properly in-utero, it most likely triggered other facial deformities as well. These deformities can generally be addressed by the surgeon during the initial cleft lip surgery. It is important to consider with your surgeon all possible procedures that can be performed simultaneously. By performing other procedures at the same time as the cleft lip surgery, your child will not only benefit medically but also aesthetically.

How Cleft Lip can Affect the Nose

When a child is born with a cleft lip is it probable that the nose will have deformities also. This is true even if your child has an incomplete cleft lip. An incomplete cleft lip is when the cleft does not extend up into the nostril. Since the structure of the lip is not formed correctly, the side of the lip that has the cleft can cause structural problems to the equal nostril.

Some common deformities of the nose caused by a cleft lip include:

• A deviated septum caused by a cleft lip.

• Buckling or flattening of the nose because the structure of the cleft lip disallowed proper growth of the tissue and cartilage of the nostril.

• The effected side of the lip causing the nostril to become widened and not symmetrical with the other nostril.

• A bulbous tip to the nose.

• Excess cartilage or skin in the nose.

• A deviated nasal tip due to cleft lip.

Complications of Not Having Nose Surgery with Cleft Lip Surgery

These disfigurements of the nose or nostril, if not repaired, can cause several issues for the child. Nasal abnormalities can cause respiratory problems as well as self-esteem concerns. These nasal deformities caused by a cleft lip can usually be easily reconstructed and/or repaired during the cleft lip surgery by the surgeon. Your child may have several different types of surgeons working on him/her during the lip closure surgery. An oral surgeon and a reconstructive surgeon will likely be the main surgeons operating on your child to provide an aesthetically pleasing facial structure as well as promoting a lesser chance of future surgeries.

The Importance of Having Nasal Surgery with the Cleft Lip Surgery

The reasons some parents opt not to have simultaneous surgeries performed during the cleft lip surgery is due to the fear of having 'simultaneous' surgeries. This is predictable and rational thinking and feelings on part of the parents. However, it is important and worthwhile to speak with your child's surgeon about the possibility of having these surgeries all at once. The benefits tend to outweigh any risks you may think are involved.

The Benefits of Having Simultaneous Procedures during Cleft Lip Surgery

By having surgical reconstruction or procedures to other parts of the face during cleft lip surgery your child can expect to have a better outcome from the surgery itself. After the lip is closed the issue of the nose is still a concern. Some of the more cosmetic reasoning's behind "fixing" some nasal deformities may not be enough to employ simultaneous surgeries during the cleft lip surgery, but the other risk factors of not having the nasal surgery performed at the same time as the cleft lip closure may be.

Have Nasal Deformities Fixed During the Initial Cleft Lip Surgery

Consider that if the surgery that needs to be done to the nose is not performed at the initial cleft lip surgery; it is highly likely that your child will require reconstructive surgery to their nose later in life. It is suggested by surgeons that if the nasal repairs are not done at the same time as the cleft lip surgery repair (usually in the first year of life), that the nasal reconstruction should not be performed until the child is in his/her mid-teens. The reason for this is the facial bone structure has to complete before reconstructive surgery can begin. The importance of having the surgery during infanthood is because bone structure is just beginning, meaning that the reconstruction done at this time will grow with the child and produce pleasant and medically helpful benefits.

Speak with your child's surgeon and weigh the options. Generally when additional procedures, such as fixing any nose deformities during a cleft lip surgery, only adds a little more time to the surgical process, the healing process is basically the same, and the outcome is statistically better than waiting until later in life to fix the abnormalities.

Having nose reconstruction at the same time as having cleft lip closure surgery reduces muscle tension, scarring, and provides a more natural facial structure to a child who has mouth and nose deformities causes by a cleft lip.

Sources:

http://www.csisite.com/cleft.html

http://www.samizdat.com/pp6.html

http://www.medsolution.com/surgery_cosmetic-cleftlip.asp

http://www.yourdentistryguide.com/cleft/

http://www.lookfordiagnosis.com/faq.php?term=Cleft+Lip〈=1