2. CLEFT LIP AND PALATE (CLP)CLEFT LIP AND PALATE (CLP)
THE MOSTTHE MOST
COMMON BIRTHCOMMON BIRTH
DEFECT AFFECTINGDEFECT AFFECTING
THE FACIAL REGIONTHE FACIAL REGION

3. CLP- The Indian StatisticsCLP- The Indian Statistics
(Tata Institute of Social Studies – 2000)(Tata Institute of Social Studies – 2000)
► BIRTH RATE- ROUGHLYBIRTH RATE- ROUGHLY
25 MILLION CHILDREN25 MILLION CHILDREN
PER YEARPER YEAR
► INCIDENCE OFINCIDENCE OF
CLEFTING IN INDIA- 1:CLEFTING IN INDIA- 1:
800 LIVE BIRTHS800 LIVE BIRTHS
► TOTALS TO 45,000TOTALS TO 45,000
CLEFT CHILDREN PERCLEFT CHILDREN PER
YEARYEAR

4. KARNATAKAKARNATAKA
►IN KARNATAKA IT IS ESTIMATEDIN KARNATAKA IT IS ESTIMATED
THAT 4000 TO 4200 NEW CLEFTTHAT 4000 TO 4200 NEW CLEFT
BABIES ARE BORN EVERY YEARBABIES ARE BORN EVERY YEAR
►In MYSORE Dist we have an estimatedIn MYSORE Dist we have an estimated
800 new cleft babies born each year800 new cleft babies born each year

5. CLP- The PHYSICAL ProblemCLP- The PHYSICAL Problem
PHYSICALPHYSICAL
► APPEARANCEAPPEARANCE
► FEEDINGFEEDING
► SPEECHSPEECH
► FUNCTION (DENTAL)FUNCTION (DENTAL)
► ADDITIONAL DEFECTSADDITIONAL DEFECTS
(HANDS, LEGS, EYES)(HANDS, LEGS, EYES)

6. CLP- The SOCIAL ProblemCLP- The SOCIAL Problem
SOCIALSOCIAL
►STIGMA FROM SOCIETYSTIGMA FROM SOCIETY
►LOW SELF ESTEEMLOW SELF ESTEEM

7. Worthy to note the associatedWorthy to note the associated
problems a cleft child would have toproblems a cleft child would have to
cope withcope with
►Functional Problems : (difficulty in sucklingFunctional Problems : (difficulty in suckling
and swallowing as a result of absence of theand swallowing as a result of absence of the
palatal shelves ----this in turn would givepalatal shelves ----this in turn would give
rise to poor nutritional statusrise to poor nutritional status
►Repeated respiratory tract infection ,earRepeated respiratory tract infection ,ear
infectionsinfections
►Growth problemsGrowth problems
►Speech problems.Speech problems.

8. ►In brief , the dimensions of this malformationIn brief , the dimensions of this malformation
(Clefts and Craniofacial deformities) affect(Clefts and Craniofacial deformities) affect
the structure ,function and the very psychethe structure ,function and the very psyche
of an individual.of an individual.

9. An illustration

10. Causes of CLEFTCauses of CLEFT
 HEREDITARYHEREDITARY
 GENETICGENETIC
 NUTRITIONALNUTRITIONAL
 MECHANICALMECHANICAL
 ENVIRONMENTALENVIRONMENTAL

11. CLP- THE FINANCIALCLP- THE FINANCIAL
PICTUREPICTURE
►THE BARE MINIMUMTHE BARE MINIMUM
FOR LIFETIMEFOR LIFETIME
TREATMENT FOR ONETREATMENT FOR ONE
CHILD WHICH STARTSCHILD WHICH STARTS
AT BIRTH TILL THEAT BIRTH TILL THE
CHILD IS ABOUT 18CHILD IS ABOUT 18
YEARS OF AGE IS INRYEARS OF AGE IS INR
1,50,000 IN CHARITABLE1,50,000 IN CHARITABLE
SETUPSETUP

12. CLP- Is It TreatableCLP- Is It Treatable
YESYES

13. CLP- Treatment StatisticsCLP- Treatment Statistics
► ONLY 25% GET ANYONLY 25% GET ANY
FORM OF TREATMENTFORM OF TREATMENT
► 75% FAMILIES – BELOW75% FAMILIES – BELOW
POVERTYPOVERTY
► TOTAL TREATMENT ANDTOTAL TREATMENT AND
REHABILITATIONREHABILITATION
ABYSSMALY LOWABYSSMALY LOW

14. Concept of comprehensive Cleft careConcept of comprehensive Cleft care
from birth to adulthood atfrom birth to adulthood at
DCKH CENTREDCKH CENTRE
MYSOREMYSORE

15. An insight in toAn insight in to
PROCEDURESPROCEDURES

16. TREATMENT PROTOCOLTREATMENT PROTOCOL (( Treatment cost shown below includes A-ZTreatment cost shown below includes A-Z
cost from Admission to Discharge with all included with ZERO cost to patient)cost from Admission to Discharge with all included with ZERO cost to patient)
► NAM therapy (Rs 8000/-)NAM therapy (Rs 8000/-)
► 3 months- Lip repair ( Rs15,000/-)3 months- Lip repair ( Rs15,000/-)
► 9-12 months- Palate Repair ( Rs 20,000/-)9-12 months- Palate Repair ( Rs 20,000/-)
► Sequential follow-up with speech therapy & SpeechSequential follow-up with speech therapy & Speech
related surgery ( Rs 10,000/- to Rs 15,000/-related surgery ( Rs 10,000/- to Rs 15,000/-
depending on whether surgery is performed or not)depending on whether surgery is performed or not)
► Vomerine osteotomy/revision/fistula repair ( RsVomerine osteotomy/revision/fistula repair ( Rs
15,000/-)15,000/-)
► Orthodontics ( Rs 15,000/-)Orthodontics ( Rs 15,000/-)
► 8-10 years- Alveolar bone grafting (Rs 15,000/-)8-10 years- Alveolar bone grafting (Rs 15,000/-)
► Revisions ( 10,000/-)Revisions ( 10,000/-)
► Rhinoplasty- 14-16 years ( Rs 20,000/-)Rhinoplasty- 14-16 years ( Rs 20,000/-)
► Orthognathic Surgery 17-19 years ( RsOrthognathic Surgery 17-19 years ( Rs
20,000/-)20,000/-)

17. Pre SurgicalPre Surgical
NasoalveolarNasoalveolar
MoldingMolding
for Infants withfor Infants with
Cleft Lip,Cleft Lip,
Alveolus &Alveolus &
PalatePalate
Children in Crisis

18. Our protocolOur protocol
► Prenatal:Prenatal:
Parent counselingParent counseling
► Birth:Birth:
Multidisciplinary evaluationMultidisciplinary evaluation
Parent counselingParent counseling
► Ist week:Ist week:
ImpressionImpression
Appliance deliveryAppliance delivery

19. NAMNAM
PRIMARYPRIMARY
IMPRESSION(20/8/09)IMPRESSION(20/8/09) PRIMARY CASTPRIMARY CAST

20. NAM APPLIANCENAM APPLIANCE

21. APPLIANCE DELIVEREDAPPLIANCE DELIVERED

22. POST NAMPOST NAM
(17/3/10)(17/3/10)PRE NAM (20/8/09)PRE NAM (20/8/09)

23. LIP REPAIRLIP REPAIR

28. CLEFT PALATE SURGERY

32. SPEECH THERAPYSPEECH THERAPY

33. BONE GRAFTING

35. ORTHODONTICSORTHODONTICS

38. CRANIOFACIAL SURGERIESCRANIOFACIAL SURGERIES

40. BENEFITS FOR THE PATIENTS ARE……..
UNIQUENESS OF DCKH CLEFT CENTRE
MYSORE
DEDICATED TEAM OF DOCTORS AND STAFF
COMPREHENSIVE & FREE CARE
NO WAITING PERIOD ONCE ADMITTED
USE OF LATEST SAFE ANESTHETIC DRUGS
OTHER ASSOCIATED CRANIOFACIAL ANAMOLIES Too
Operable
 EXCELLENT PATIENT CARE

41. FACILITIES OFFERED IN OUR
CENTRE

43. How can YOU help ?How can YOU help ?
1. IDENTIFY CLEFT PATIENTS FOR1. IDENTIFY CLEFT PATIENTS FOR
DEFINITIVE TREATMENTDEFINITIVE TREATMENT
2. BUILD AWARENESS IN LOCAL2. BUILD AWARENESS IN LOCAL
POPULATIONPOPULATION
3. HELP CONDUCT SURVEY TO3. HELP CONDUCT SURVEY TO
ACCURATELY ESTIMATEACCURATELY ESTIMATE
PREVAILENCE OF CLEFT AND OTHERPREVAILENCE OF CLEFT AND OTHER
CRANIOFACIAL ANOMALIES.CRANIOFACIAL ANOMALIES.

44. How can YOU Help?How can YOU Help?
► TO PREVENT CHILD DISCRIMINATIONTO PREVENT CHILD DISCRIMINATION
IN SOCIETYIN SOCIETY
► CREATE AWARENESS THROUGHCREATE AWARENESS THROUGH
MEDIA/MEDIA/
PRESENTATIONSPRESENTATIONS

45. THANK YOUTHANK YOU