This week, Bobbi Conner talks with Dr. Phayvanh Pecha about treating children born with cleft lip and palate. Dr. Pecha is an Associate Professor of Otolaryngology and a cleft surgeon on the craniofacial team at MUSC.
TRANSCRIPT:
Conner: I’m Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Cleft lip and cleft palate are conditions a baby may be born with, which often requires surgery in the first months or years of life. Doctor Phayvanh Pecha is here to talk about the details. Doctor Pecha is an Associate Professor of Otolaryngology, and she's a cleft surgeon on the craniofacial team at MUSC. Doctor Pecha, tell us briefly about cleft lip and palate.
Dr. Pecha: Cleft lip and palate are one of the most common birth differences that babies can be born with. A person can be born with a cleft lip, a cleft palate, or both. And, a cleft lip is an opening in the upper lip that can range from a small notch to a complete gap in the upper lip, and can involve the gums where the teeth will grow. And, the cleft palate is an opening in the roof of the mouth.
Conner: What type of medical care does a child with this condition typically need?
Dr. Pecha: A baby born with a cleft lip and palate should be seen by an accredited team of specialists. A cleft team has received approval from the American Cleft Palate Craniofacial Association, which is a pretty rigorous process so that they can offer quality care to any child with cleft or craniofacial differences.
Conner: And I understand surgery is a part of the treatment. Tell us about that surgery.
Dr. Pecha: Cleft lip surgery usually happens during the first few months of life. If a baby also has a cleft palate that's repaired a little later, just before the child turns a year old. Lip repair surgery and repair surgery are major milestones in a child's treatment. There are several techniques that can be used, especially if a baby is born with a cleft lip that is very wide and involves the gums. It is called NAM, which stands for nasoalveolar molding. And it's a technique that really reshapes the gums, lip, and nose in infants born with a cleft lip and palate. It involves using a custom-made appliance, kind of like what you would see with an orthodontic retainer to gently guide the growth of these tissues. And the goal of the NAM is to reduce the size of the cleft, give symmetry, and minimize the need for more surgeries in the future.
Conner: And do children with cleft lip and palate sometimes need additional surgeries?
Dr. Pecha: Sometimes they do need additional surgeries, especially in babies born with a cleft palate. We'll monitor them very closely for their speech outcomes. We use a special technique that allows the palate to be long. And, with a long palate, kids have less problems with speech when they're a little older. So, this helps avoid any kind of additional second speech surgery.
Conner: What additional follow up care might be needed over time for a child born with this condition.
Dr. Pecha: It is very important to follow kids with a history of cleft lip and or palate. That's because there can be issues with hearing, speech, and they will need special dental care as well as they get older.
Conner: Tell us more details about follow-up care that might be needed for a child in this scenario, related to hearing.
Dr. Pecha: All kids should get a newborn hearing screen, and in kids with a cleft palate, they have a higher chance of having fluid in the middle ears. So, we do need to follow them in clinic and make sure that their hearing is good. And if there is fluid, we often need to put in ear tubes.
Conner: Doctor Pecha, thanks for information about treatment for children born with cleft lip and palate.
Dr. Pecha: You're so welcome.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
