Multi-speciality care – what does it mean?
We always emphasize that in order to achieve success with the treatment and rehabilitation, knowledge, experience and cooperation of a number of specialists are crucial.
Now such professional help you will find all in one place in Formmed.
Here are the specialists who in our facility are engaged in cleft lip and palate treatment:
SURGEON / MAXILLOFACIAL Surgeon
Due to the open connection between the oral cavity and nasal cavity the treatment of a child with the cleft defect starts with the surgical fusion of soft tissue of the nasal and mouth cavity.
The operation is essential for the further, correct development of your child!
During the first visit, usually around 4-6 weeks of age, the surgeon gives all the information about the preparation of the child for the procedure. He schedules the date of the first operation as well as he discusses the surgical treatments to follow. See the paragraph: Procedures schedule.
Each of the surgical procedures is a huge experience both for the child and its parents. Adults should though take control over their emotions since the child feels their anxiety, loses the feeling of security and therefore experiences additional stress, which influences the process of healing.
The surgical procedure is always a strain for the body. It should be remembered though that the child is left only with a postoperative wound in the mouth while his or her body and all the tracts he uses for the wound to heal faster are healthy.
Currently our team uses methods which enable cutting down the time and number of surgical procedures to 2 or 3 in children with complete cleft lip and palate. All the operations are done in preschool age children.
Consecutive visits at the surgeon’s have a follow up character and are connected with consultations with other specialists, according to the schedule of the child’s health checkups. Usually those take place at the age of 3, 5-6, 10, 15 and 18. Such visits include consultation with specialists, taking a photograph, recording the speech and mimics with a video camera. Such documentation shows the course of the treatment and its final effect. It is a proof of effectiveness of the therapeutic actions taken by our team. At the same time it enables fast reaction whenever any anomalies occur, because it has to be remembered that to existing congenital disorders some genetic conditions may additionally occur.
A baby with a cleft disorder should as fast as possible be referred to a speech therapist. In Formmed the parents together with the child are directed to that specialist already before the first surgical procedure. First meetings consist mostly of a detailed interview with the parents. Important information is e.g. that concerning labor, feeding and the way of laying the baby in bed. It gives initial picture of skills of the little patient. In a direct examination the speech therapist assesses the sensitivity of the face towards stimuli. In children born via c-section an oversensitivity of the face may occur. Including massages done in a cosy atmosphere becomes of great importance, because it makes the future therapeutic procedures less stressful for the baby. During the first visit it is necessary to assess the structure of the speech organs. Here – apart from the obvious anomaly as cleft – it is important to assess the fitness of lips, the length of the frenulum of tongue and of lip. While the frenulum of the upper lip does not raise concern even if it’s short (often its shortening is recommended by orthodontists), the frenulum of tongue requires precise assessment, because it determines the correct functioning of the tongue in the process of articulation. In the event of finding any deviation from the normal state, the speech therapist advises parents on the application of stimulation procedures and systematic rehabilitation exercises depending on the needs of child.
Between the operation and the consecutive visit at speech therapist at least 6 weeks should pass. It is the time when the postoperative wound heals and the child gets used to new anatomic conditions in its oral cave.
Regularity brings good results!
In the initial period after the operation logopaedic consultations should take place at least once a month. It is the most intensive developmental period and simultaneously the best time for preparing the child to master such difficult skills as speaking.
With the help of various braces the orthodontist corrects anomalies appearing during shaping of dental occlusion in children with cleft defects. The orthodontist prepares the patients for coming up operations (early and late transplant of the bone to the alveolar process and possible other operations of the jaw bone).
At our facility also adults with cleft deformations will find help.