Hare Lip: causes, operation
Congenital pathology, in which a cleft on the upper lip appears as a result of genetic abnormalities, is called a hare lip.Despite the fact that the defect does not affect the overall psychosomatic development of the baby, it attracts attention, complicates the process of eating, interferes with the formation of speech.You can diagnose it in the womb, as a rule, with other vices, for example, with a wolf mouth.Correction is carried out using the methods of plastic surgery.Table of contents: General information Hearing lip: causes of development Symptoms Classification Diagnosis Harelip: operation
In the first trimester of pregnancy, until about the 8th week, the development of the maxillofacial organs begins.If during this period the mother is diagnosed with a viral disease, a genetic malfunction is possible, as a result of which heilohisis develops, or a hare lip. This is an anomaly in which the upper lip is split into two parts by a cleft.It is interesting that this cleft can pass through the upper sky, and also be one of several malformations that are diagnosed in the baby.
Please note! Pathology occurs in one child of 1000. As a rule, it affects boys.According to available statistics, the cleft usually appears on the left.And in Asians, vice is detected 2 times more often than in fair-skinned people.
It is known that for the first time the anomaly was diagnosed in Ancient Egypt.At the same time, local healers began to make attempts to cure patients through surgical intervention, as evidenced by the remains of mummies.At that time, when sutures were applied, veins of animals were used.Later, the correction procedure was described in more detail in China.
At different times the attitude towards people with a hare lip was different.Some considered them punished gods for evil deeds, others called them special, endowed with supernatural powers.
Today, patients with this diagnosis are recommended to consult dentists and surgeons.Anomaly complicates their life from a small age, meanwhile it is successfully corrected with the help of plastic surgery.
Hearing Lip: causes of development of
The main cause of pathology development is mutations at the gene level.It involves TVX22-gene, which provokes the development of a split lip.This happens in cases when:
- the mother has a strong toxicosis;
- it is subject to frequent stresses;
- has an infectious or radiating effect;
- child's parents abuse alcohol, smoke, use drugs;
- family lives in a region with an unfavorable ecological situation;
- the mother diagnosed with chronic diseases or toxoplasmosis, herpes, rubella, smallpox, measles, cytomegalovirus, sexually transmitted diseases in the first trimester;
- treatment of diseases is carried out with the help of antibiotics;
- there is an avitaminosis - the mother lacks folic acid, vitamins B12, B6, A, E, C;
- has a late pregnancy - after 35 - 40 years;
- is diagnosed with a uterine tumor;
- in the mother's history had abortions;
- , a woman attempted to terminate a pregnancy;
- mechanical damage occurred as a result of falls from a height.
Heterogeneity plays an enormous role in shaping the hare's lip.That is why, parents of children with this diagnosis before a new pregnancy are advised to apply for medical genetic counseling.
You can make sure that you have unshaven lips when you first examine the baby.One will have one-sided or bilateral cleavage on the upper or lower lip of the .By itself, pathology affects the child's self-esteem in the future, and therefore requires immediate correction.
Important! The presence of a wolf mouth, an anomaly that accompanies a hare lip, aggravates the situation.Depending on the depth and size of the cleft, the doctor can prescribe the feeding of the baby through the nose probe, if otherwise impossible to produce.
The developmental flaw leads to deformation of the teeth, malocclusion. Children with such a diagnosis in the dentition may lack some teeth or, conversely, there may be additional teeth.They also have a wrong angle of tooth growth, and they themselves are prone to caries development.
Because of these problems, patients are hard to chew food, pronounce sounds.They appear nasal, consonants "disappear" from the speech.In some children, due to the presence of the cleft palate, the position of the auditory canals is disturbed, which increases the risk of getting disease bacteria in them.
Most often, a cleft appears on the upper lip on one side of the middle of the .Meanwhile, medicine is also known cases where the anomaly manifested itself on both sides of the middle or hit the lower lip.
Hare lip can have:
- full shape - when from lip to nose there is a deep crack from one or both sides, resulting from non-growth of the nasal process with maxillary;
- partial shape - when a slight indentation appears on the lip as a result of non-growth.
The depth and extent of the cleft differ in different patients.At best, it affects the soft tissues of the lips, at worst - the palatine bone and the upper jaw bone.
Important! In rare cases, the anomaly occurs isolated, but often it manifests itself along with other anatomical pathologies, such as: deformities of the nose, cleft palate.
It is best to spot the lip immediately after the birth of the baby, meanwhile during an ultrasound examination during pregnancy, a specialist may notice a defect in later terms, in the third trimester, or, more rarely, in 16-20 weeks.
This early diagnosis allows parents to prepare mentally for correction.Because of possible disorders of swallowing, chewing food, speech, breathing, this correction is necessary at an early age.
Hare lip: operation, photo about and after
The only treatment option for pathology is surgical intervention.The specialist performs a plastic surgery, as a rule, in several stages. If necessary, the patient is assigned a consultation with a phoniatrist or an orthodontist dentist.
Doctors recommend the operation from the second to the twelfth birthday of the child, and also during the period from the sixth to the eighth months of . Early surgical intervention reduces the risk of developing pathologies of the nose and upper lip.Meanwhile, newborns suffer a heavy loss of blood, provoked by them.The small size of the upper lip aggravates the situation. At the age of 6 - 8 months the risk of complications is reduced due to the stabilization of the rates of bone tissue development.
Please note! In the presence of bilateral cleft surgery is postponed until the child reaches six months.Repeated operations are performed no earlier than a few months.Bony and cartilaginous structures are corrected at the age of 4 to 6 years, and complete the correction after 16 years, when the development of facial bones stops.
If the pathology has not been corrected by three years, when the speech is being formed, the doctor prescribes logopedic treatment.If desired, plastic surgery is performed to remove the scar.
In order to get rid of the patient from pathology, the doctor conducts:
- Haloplasty is the simplest method that eliminates the cleft of the upper lip.In the course of its implementation, the functional and anatomical fullness of the problem area is restored.The procedure can be performed in several stages, depending on the severity of the situation.The incision is performed in a linear fashion, when one scar remains after the operation, or by the method of a triangular flap.In this case, a triangular flap is used to form a symmetrical shape of the lips.The method of quadrangular flap provides the application of the latter for the correction of severe pathologies.
- Rhinoheyloplasty - involves the correction of the upper lip and nasal septum.It can be primary( when the surgeon for the first time changes the position of the cartilaginous tissue) and secondary( when after the first operation began to develop other pathologies).
- Renoheylognatoplasty is a complex operation that corrects the deformation of the anterior part of the jaw, improves the shape of the lip, corrects the pathology of the nose.The procedure is indicated for patients with a cleft palate.In the process of its implementation, the mucosa on both sides is exfoliated to correct the nasal opening.The integrity of the jaw is restored by applying a periosteal graft taken from the anterior surface of the tibia.Then the flaps are cut from the upper lip in order to sew the wound.As a rule, after performing rhinoheylognatoplasty, patients are recommended to undergo dental treatment.
Important! The type of operation is chosen not only on the basis of the character of the cleft, but also on the basis of the child's age, weight, individual developmental features, the risk of complications.
Preparation and contraindications
Before the operation, examinations and tests are made to identify contraindications to it.Two weeks before the appointed time, patients are forbidden to take acetylsalicylic acid and anticoagulants.
- weight reduction;
- diseases of the cardiovascular system;
- problems with the respiratory system;
- congenital malformations of vital organs - the nervous system, digestive, endocrine;
- birth injuries;
- physiological jaundice;
Features and rehabilitation
The operation is performed under local or general anesthesia.In the first case patients with shallow clefts are operated, in the second case - with deep clefts or bilateral.General anesthesia can also be given to children who are restless during the operation.
The length of rehabilitation depends not only on the complexity of the procedure, but also on the general condition of the child, his reaction to anesthesia.After local anesthesia, feeding the newborn is allowed within a few hours.After the general - the time of food intake is determined by the doctor.
Please note! Sutures are removed on the 7th - 10th day after the operation.Then for 3 more months a tube is inserted into the nose, which prevents the deformation of its cavity and wings.In rare cases, a special headwear is recommended, which prevents stretching of the lips and divergence of the joints.The baby's hands are fixed with tires.
Rehabilitation rehabilitation stretches for a year.At this stage, the patient receives a consultation with a speech therapist, orthodontist, ENT, which allows to exclude the presence of developmental pathologies, to make sure the dentition is formed correctly and there are no problems with speech.
The most common complication after surgery is the seam divergence.It can occur as a result of a violation of the technique of performing the operation, and as a result of trauma, the development of inflammation.
In rare cases, scars are possible in the area of the mouth, which can cause deformation of the jaw.Also possible:
- narrowing of the nasal passage;
- face deformation;
- speech disorders.
If a problem is detected with the respiratory or digestive system after the operation, disability is put, meanwhile, to receive compensation, a child is assigned an examination.
Objective results are obtained one year after the operation.Most often it ends successfully. At the same time, a hardly noticeable scar appears in the nasolabial triangle in the patients, which, if desired, is eliminated by a laser.
Zayachaya lip is a rare pathology that leads to the development of an inferiority complex in children, as well as the emergence of problems with breathing, speech, eating in the absence of medical care.Despite the fact that modern medicine offers several options for its elimination, it is easiest to try to prevent its development.To do this, you need to monitor your health, avoid stress, and also accumulation of people during the exacerbation of viral diseases.
Chumachenko Olga, medical reviewer