Short notes of Managing CLP (harelip) with some demonstrating pictures and a video.

1. Mohammed A. Alawadh
SURGICAL MANAGEMENT OF
CLEFT LIP & PALATE

2. Care of the patient within a multidisciplinary team requires
the development of a protocol of care or care pathway
to enable the team members to function most effectively and
to maximize the benefits of this system to the patient.
Management protocol

3. A surgical procedure is done to achieve closure of the cleft in the lip and palate.
1. Cosmetic restoration of a normal appearance to the baby at an appropriate time.
2. Functional restoration of the lip and particularly the palate to provide normal eating and drinking and
produce a functionally adequate palate to allow the development of normal speech.
3. Optimum facial growth and development to prevent deformity developing in association with impaired growth.
Surgical Management

4. 4. Lip repair is performed at 3 months of age. If there’s cleft palate at the same time, the anterior hard
palate and alveolar defect are closed with a single layer flap of mucosa from the vomer.
Surgical Management

7. 5. The lip is repaired using a modification
of the Millard technique.
Rule of 10:
Approximately 10 weeks of age
10 pounds (4.54 kg)
Bood haemoglobin not less than 10%
Surgical Management

8. 6.The resulting scar reasonably follows the line of the philtrum.
Surgical Management

9. 7. Palate repair is performed at 8 months of age.
8. Mucoperiosteal flaps are elevated from the hard palate and
repaired in the midline.
9. The elevator muscle in the soft palate is dissected free from
its abnormal attachments to the back of the hard palate and
medial margin of the cleft.
10. Mucosal releasing incisions are used only where necessary
and their length is kept as short as possible.
Surgical Management

10. Surgical Management

11. Cleft
Palate
Surgical Management

12. REFERENCES:
Slade P, Emerson DJM, Freedlander E. A longitudinal comparison of the psychological impact on mothers of
neonatal and 3 month repair of cleft lip. Br J Plast Surg 1999; 52: 1–5. 43
Sell D. Speech in Sri Lankan cleft palate subjects with delayed palatoplasty. Unpublished PhD, De Montford
University 1992. 44
Bohn A. Dental anomalies in harelip and cleft palate. Acta Odontol Scand 1963; 21: 1–109

13. THANK
YOU