Pediatric Surgery

 

Cleft Lip & Cleft Palate

A cleft lip is a deformation of soft tissues in which the upper lip (usually in the nose) is divided by one or more crevices. In the majority of cases, this pathology is combined with the cleft palate – splitting the palate. Accordingly, the treatment of this violation involves the correction of the cleft lip and surgery to close the cleft palate.

The cleft lip can be combined with the non-fusion of only the soft (consisting of soft tissues) palate or with the non-fusion of the soft and hard (bone) palate. In addition, this malformation can affect both one and two sides of the upper jaw.

The plastic surgeon will:

  • perform cleft lip removal by suturing the defect;
  • restore the integrity of the soft tissues of the palate;
  • close the crevice in the hard palate.

In the postoperative period, you must carefully monitor the oral hygiene. 2 weeks after the correction, the patient is prescribed a special complex of recovery exercises and finger massage of the soft palate.

Cleft Rhinoplasty

Cleft rhinoplasty is a rhinoplasty performed for people, who may have abnormalities because of the cleft lip or cleft palate treated at a young age. This procedure is suggested for patients 16-18 years old when their bones stop growing. However, the surgery can be performed at a younger age, but the correction will mostly take place on the tip of the nose.

Upon completion of plastic surgery on the nose, a rigid plaster bandage is applied to the operated area, which prevents the displacement of cartilage and soft tissues. It is removed after 7-10 days after rhinoplasty, and together with it, the surgeon removes the sutures (if not self-absorbable are used).

Regardless of the type, the natural consequence is hematomas and edema. They pass on their own within 3-4 weeks. Three months after rhinoplasty, restoration of the tissues of the nose is fully completed.

Tongue Tie Release

Ankyloglossia in children is a congenital anomaly expressed by a shortened frenum of the tongue. As a result of this disturbance, the child has difficulty with sucking, proper sound pronunciation, problems with bite formation, etc. Ankyloglossia is diagnosed in 2% of newborns.

The main cause of congenital pathology is the abnormalities of the child’s development in the perinatal period.

The main manifestations of pathology include:

  • difficulty swallowing and sucking;
  • malocclusion;
  • problems with the development of speech;
  • displacement of the dentition;
  • the child’s inability to get his upper teeth out with his tongue;
  • V-shaped tip of the tongue;
  • snoring and others

The main way to treat ankyloglossia in children is surgery (plastic frenum of the tongue). The optimal age of the child for the operation is the period of loss of primary teeth. Surgical treatment of infants is carried out if the presence of a defect interferes with normal feeding.

Pierre Robin Sequence

Pierre Robin’s syndrome is a congenital malformation, manifested by three main signs: cleft palate, underdevelopment of the lower jaw, glossoptosis. The birth rate is 1 per 10 000-30 000 newborns.

In newborns and infants, this syndrome is often accompanied by a violation of two important functions:

  • Respiratory: on inspiration, the child wheezes with retraction of the chest. Sometimes a child cannot breathe at all, and then an intubation tube is installed in the trachea in the maternity hospital to ensure breathing. The common name for such a breathing disorder is obstructive sleep apnea, which is a life-threatening condition and can cause sudden death syndrome.
  • Swallowing. In this case, nutrition can be carried out only through a gastric tube.

The main problem is the underdevelopment of the lower jaw, because of which the tongue is shifted back and blocks the lumen of the respiratory tract. If you extend the lower jaw, then the tongue will move forward behind it and open the airway.

There is a method that allows you to lengthen the lower jaw – mandibular distraction osteosynthesis. The method consists in installing devices on the lower jaw from 2 sides. After 5-6 days after the surgery, fragments of the jaw gradually, at a speed of 1 millimeter per day, are bred by the device to the required size.

Spontaneous breathing becomes possible on average already at 4-6 days of distraction, which continues until the correct jaw ratio is achieved.

After 3 months the child is re-hospitalized for removal of devices, which is also carried out under general anesthesia.

Other services include:

  • Ear molding;
  • Head shape abnormalities;
  • Speech surgery;
  • Jaw Surgery;