Cleft lip- soft tissue that grows in the central tab of the tip of the noseThere is unilateral and bilateral Cleft palate- hard palate, the roof of the mouth is composed of bones and muscle tissueHaving a bilateral in both types of clefts, patient may need multiple surgical interventions, from infancy to adulthoodIt really depends on how deep the cleft is going.
Soft tissue is when the tissues connect in order to support the structure of the organs in the bodySo in cleft lip, the soft tissue is unable to connect and therefore it creates a split in between the mouth and noseBone development is when the organs form vertebrates in order to function and move accordinglyAs far as cleft palate, we use our palate to move our mouth, and that part is created by the bone for movement, so the palate is what creates the roof of the mouth which makes it hard. The palate is supported by the bone.
Cleft lip is often visible through a routine ultrasoundIn some cases it is determined after birthCleft palate is harder to determine by ultrasound(http://www.operationsmile.org)
Difficult to feed baby through the mouth is when nasal distortion occursReoccurring ear infections Poor speech is very common on cleft affected kids because the cleft will have been noticed alreadyIf cleft is not properly repaired, parent may notice failure in weight gain of childAnother easy symptom to detect is growth retardation
Unknown causationBelieved to be a combination of geneticsInheritanceRisk maybe higher for kids who have siblings or parents who have a history of cleft lip or palate.Both mother and father can pass genes that contribute to the development of cleftingEnvironmental FactorsCertain drugs, use of alcohol while pregnant and any kind of illnesses(http://www.webmd.com)
More common in Asians and Native Americans Occurs more often in male children It is very rare in the African American race(http://www.marchofdimes.com)
Long term prognosis for a child who had cleft lip/palate may come with some difficultiesThe child will feel very different from others due to these effects
Parents should encourage their child to be able to respond positively to hostile, curious and ignorant questionsMany health insurance companies refuse to cover for treatment and careHard for child to fit in a certain community, they feel secluded from society
Can be a financial burden on the familyMoney problems can cause a drift in the familyBoth spouses can blame each other being that one of them might have had passed the gene to the childLearning that your child has a facial deformity may be overwhelming for both parentsUneven division in responsibilities
All are a procedure that one has to undergo Guaranteed surgery and physical therapySpeech and dental are a routine that one has to undergo
Depending on how serious the cleft is, at times there maybe a number of procedures to be performedIn most cases one surgery is necessary and it only takes 45 minutes to change a child’s life foreverIt helps close the gap in the mouth and it properly aligns the noseThe retainer is called a nasoalveolar molding appliance which is worn in the mouth before the lip is repaired
Child maybe placed in intensive careMedical team assists the child in many waysWatch closely for swelling or for any obstructionsPlaced in the Pediatric Intensive Care Unit for a closer watchRecovery may take up to a few days depending on the child’s ageThose with kids under the age of one have to stay longer in the hospital for help with breastfeeding, eating and breathing
Children with cleft palate are more likely to have trouble with speechMore than ½ have to undergo speech therapyTheir voice boxes cannot carry out clear sound and this causes the victim to produce a nasal voice while speakingTheir ability to verbalize is much harder than those affected with cleft lipDepending on the type of cleft, speech therapy may vary
Strict routineBrush teethFlossUse of mouthwash in adults is very importantArtificial teeth are required and one has a higher chance of getting bracesHowever If the size and shape of a child's mouth doesn't permit the use of a regular toothbrush, a toothette (a soft sponge containing mouthwash) can be used.That way it easier to navigate through harder places
Reduce risk of any infections during pregnancy, such as having open cutsWomen are recommended to eat healthy during pregnancyMother is highly recommended to healthy and stay away from bad toxins
For example: In India there are 25,373,884 children born every year of which 50,747 are born with a cleft and of most of them are untreatedOperation Smile have treated 2,964 patients in India but there are an estimated 1 million still suffering from a cleft and waiting for treatment reason for being unable to treat is family is financially unstable and insufficient income from the government.70% of all cleft patients also have a cleft palate meaning cleft palate is more common than cleft lip but both can occur at the same time.If one child in a family is born with a cleft, the risk increases by 2 to 4 percent that future children in the family will suffer from the same defect
Some live with insecurities when surrounded by peopleDiscomfort around many peopleAre insecure with their smile, don’t want to go out as much with others
Operation Smile was created by Dr. Bill and Kathy Magee they where repairing a cleft in the PhilliphinesOS has so many volunteer missions running across the worldHas a team of volunteers that provide medical treatmentMany celebrities are involved, including Jackie Chan who is the ambassador of OS in ChinaOperation Smile operates in 51 countries and we co-ordinate in excess of 100 medical projects in 42 countries
Said by Dr. Kathy MageeThat’s when her and her partner started off and she exclaimed that she felt pain and guilt
Map showing current offices located around the world, the star is where operation smile branched off (Norfolk, VA)Ones with the orange pin are more developed and have the larger resources
Gray areas show the current program countriesYellow shows the new program countriesBrown are shows second generation countries that are making their way to contribute to OSOrange are the resource countries, they provide more statistics than others
Safe surgery is number one concernFocus on each patient closelyProcedures should all be the sameHighly trained staff with good credentials shall perform a cleft affected patient no matter where they receive treatm
Money is collected through donations Spreading the word Ways to give, fundraising, creating a small chapter(http://www.operationsmile.org)
Left corner, a non cleft affected child without cleft lip2nd left, a normal cleftDown at the bottom is a slight opening of the cleft palateIn the middle is a child with an unilateral cleft lip and sometimes the cleft lip can partial split the palateRight corner is bilateral cleft lip goes through the two sides of the noseLast is the bilateral cleft lip with the split of the palate, can occur together.
After surgery she had to wear braces for 4 yearsIt is rare for a cleft palate patient to have a hearing lossIn the quote she means that she is great full for the outcome of the frequent surgeries and she has also made a self-discovery in which she is pursuing a doctorate of audiology, she wants to help others to better understand what she went through
Doctors could not determine her condition through ultrasound because she always had her hand in her mouth, so it was even harder to determine the cleft lip which is usually is to determine through ultrasound.However she had no physical problems but she has encountered many insecurities because her cleft lip scar is visible and many people ask her questions. She says she has difficulty smiling.Every year she has had to go for surgerie but her last one was performed as of March 2010 for her jaw reconstruction
Protein networks that feed in to additional protein networks help form the palate, which is the roof of the mouth, researchers have noticed that if protein network is less then there could be a formation of a split in the roof of the mouthBy modifying the protein networks, hopefully there maybe a way to prevent cleft lip and palate in newbornsScientists continue to perform tests on animals
Scientists have detected that at times the cleft palate may be to wide where by there is insufficient tissue to close up the gapInserting a plate made of hydrogel on the roof of the mouth, this gradually expands as fluid, helping the skin grown to form that extra tissue that is needed to close the gap. The plate is then removed using the extra tissue that was needed. Clinical trial are expected to take place early 2011.This performance will hopefully prevent complications particularly in speech and facial growth problem
Hypothesis was correctFound that in children born with cleft the gene is suppressed or at times not even thereHaving suppressed the protein gene in mice, they had cleft baby mice that was proportionate to the amount of humans that have cleft palate Although it has not been taken as truth that is the gene that controls the whole process of cleft palate, this test has shown that it may play a big part in the equation.
No matter how much one donates their contribution is helpful and changes livesOS’s Foundations and U.S. Chapters raise funds, recruit volunteers and raise awareness on a grassroots level More than 600 Operation Smile Student Clubs in the United States and around the world build awareness, conduct grassroots fundraising and educate students about values of commitment, leadership and volunteerism.
Early October is when I got the packageI would go back every 2 months to collect the money With the pamphlets I went to individuals and asked them if they wanted to donateHaving combined the loose change from the canisters and people making donations I collected 380Plus with the Bake Sale I held I got 150, in total I made 530 and all the proceeds went to OS
Cleft Lip and Palate SGP 2010 By: Jane Chigwerewe
Social, Economic & Emotional effects Some children maybe ashamed to show their face Afraid of being stared at and being teased Constantly going to doctor visits Insurance unable accommodate adequate expenses Isolation With public
Effects on family Spouses become distant Denial Anger Bond weakens Some families come together and grow stronger Bond and find solutions for their problems More dynamic
Treatment Surgery Physical therapy Speech therapy Dental work
Surgery Performed within two-three months after birth Prior to the surgery, a special retainer is molded in the mouth
Dental Work As a result of having had a cleft lip/palate Prone to missing teeth
Prevention Women have to take the right prenatal supplements to reduce babies’ chance of any facial deformity Nutrition Fruits Vegetables
Cleft Statistics Cleft lip and/or palate occurs in approximately 1 per 500-700 births 3rd most common birth defect Ratio defers across geographic areas or ethnic groupings Developing countries 75% cleft cases go untreated
Outlook Though the treatments may extend over the years, most children achieve normal appearance Live normal lives Slightly noticeable
Operation Smile Non-profit organization that was founded in 1982 Based in Norfolk, VA Provides repair surgery to children with cleft lip and palate Operates in 51 countries
Quote “It was guilt. We were invited to join a group going on a medical mission to the Philippines. We saw hundreds of children and saw many more turned away.”
Story of cleft palate Stephanie Mohrbacher Diagnosed with cleft palate after birth First surgery performed at the age of 19 months Problems that came along Hearing problems Found herself in the operating room frequently
Story of CL/P Nicole Giron Was born with unilateral cleft lip and together with a palate Had to undergo 2 different surgeries after birth Unilateral cleft lip Cleft palate Insecure
Ongoing Cleft Research Physicians continue to study an individuals gene Defining protein networks A specific gene encodes a small protein that then develops the cleft
Ongoing research cont’d Scientists working on a treatment for babies born with cleft palates New potential treatment Performing surgery on infants to toddlers may cause future complications as they develop into adults
Tests Scientists performed tests on mice Found that the gene that controls the proteins pathway deals with the mouth formation Suppressed the gene in mice that codes for protein
Support Every dollar counts Operation smile has a worldwide team of volunteers
Application Contacted OS Sent me a package with canisters, pamphlets and a shirt Put canisters at local stores Bake Sale
Conclusion I really enjoyed putting my time into this project because I was able to change two children’s lives in need of a smile. I hope to continue contributing and raising an awareness to give many other children new smiles.
Research "Breakthrough in treatment of cleft palate." Science and Technology. Research Councils UK, 18 Mar. 2010. Web. 4 Mar. 2010. <http://www.scitech.ac.uk/ PMC/PRel/STFC/Cleftpalatbreakthrough.aspx>. Charkins, Hope M.S.W. Children With Facial Difference: A Parents' Guide. Long Island, New York: Woodbine H, 1996. Print. "Childrens Health." WebMed. TRUSTe, 1 Mar. 2010. Web. 2 Mar. 2010. <http://www.webmd.com>. "Cleft Lip and Cleft Palate." Consumer Guide to Dentistry. HONcode, 1 Mar. 2010. Web. 2 Mar. 2010. <http://www.yourdentistryguide.com/cleft/>.
Research cont’d "Cleft Lip and Palate." KidsHealth. The Nemours Foundation, Spring 2010. Web. 15 Mar. 2010. <http://kidshealth.org/parent/medical/ears/ cleft_lip_palate.html>. "Cleft Lip and Palate News." Medical News Today. mediLexicon International Ltd, Winter 2010. Web. 9 Apr. 2010. <http://www.medicalnewstoday.com/ newssearch>. "Cleft Palate and Cleft Lip." MedicineNet. HONcode, Spring 2010. Web. 9 Apr. 2010. <http://www.medicinenet.com/cleft_palate_and_cleft_lip/ page2.htm#tocd>. "Global Standards." Operation Smile. Convio, Fall 2009. Web. 6 Feb. 2010. <http://www.operationsmile.org/our_work/global-standards-of-care/>.
Research cont’d Gruman-Trinker, Carrie T. Your Cleft Affected Child. Alameda, CA : Hunter House, Incorporated, October 2001. Print. "Mission Sechdule." Operation Smile. Convio, Fall 2009. Web. 9 Feb. 2010. <http://www.operationsmile.org/our_work/medical-missions/ mission-schedule.html>. Siegfried, Elaine. "Medical Specialities ." Cardinal Glennon. SSM Health Care, Oct. 2009. Web. 3 Mar. 2010. <http://www.cardinalglennon.com>. "Story of the Month." Cleft Palate Foundation. Samedis Design, 5 Mar. 2010. Web. 9 Mar. 2010. <http://www.cleftline.org/features/story_of_the_month>.
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