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We can all appreciate a smile in these times of pandemic when our mouths are often covered. Bringing smiles back to the faces and hearts of children born with a cleft lip and palate is the daily mission of a team of multidisciplinary professionals at the University of Utah Health.
These birth defects occur when a baby’s lips or mouth do not form properly during pregnancy. The journey to correct these conditions can be difficult for children and their families. But with the support of a caring group of surgeons, pediatric orthodontists, speech language pathologists, and social workers, a child with a cleft can achieve significant milestones in their physical, social, and emotional development.
Barbu Gociman, MD, Associate Professor of Plastic Surgery at the University of Utah Health and Medical Co-Director of the Cleft and craniofacial center at Intermountain Primary Children’s Hospital. He explained the complexity of the lunge trip who often takes a child from birth to late adolescence. “It’s not a simple clinical solution where you only have one operation, and everything is done. It’s a longer process where you have a series of operations and non-surgical procedures to get the best. possible outcome for children affected by these conditions, âsaid Gociman.
In most cases, the diagnosis of cleft lip is made before birth during an ultrasound. It is much more difficult to identify a cleft palate before a baby is born. However, once the diagnosis is made, the cleft team mobilizes to make sure the baby has every chance to grow up like a normal child. Most often, a baby’s cleft lip, gum tissue, and hard, soft palate are all involved in their condition. So Gociman and his team will work with a feeding specialist to ensure these infants get the nutrition and calories they need in the first few months of life.
Plastic surgeons begin labor when the baby is about three months old and has grown enough to withstand the effects of anesthesia. The first series of surgeries are performed to reconstruct the lip and nose and restore the shape and function of the soft palate which directly affects speech. These are life changing surgeries, but these are only the first steps in the lunge journey.
Dana N. Johns, MD, is another plastic surgeon on the cleft team at U of U Health and Intermountain Primary Children’s Hospital. She shared her experiences of working closely with these special patients. âYou rarely have the opportunity to act as a surgeon, and as a primary care physician, which means you get that longevity of care that you don’t often see in most surgical specialties. them for 18 to 20 years of their lives. “
At every stage of their growth and development, Johns and Gociman verify that their patients are strong enough physically and mentally to meet the challenge of another surgery. “We identify kids who may be having a hard time in school, or who may be teased or bullied, and if they need to have major surgery, then we know we need to make mental health preparations. with them because it’s definitely not going to get any easier. as they recover from some of these surgeries. It just gives us the ability to make sure that we take care of these kids from head to toe and from head to toe. inside out, instead of just focusing on solving anatomical problems, âJohns said.
The slot team individualizes a plan for the care and treatment of each patient over time and involves the family in the process. Doctors believe this is especially important for parents who have never had a child with a disease that requires long-term treatment by several health professionals. Johns said, âFor parents, have the peace of mind that this is the step we need to take, and this is where we are going, and it will be okay because we can kind of take it one step at a time. time. “
It might be hard to believe, but a girl’s face isn’t fully developed until she is 16, and for boys, it’s around 18. These facts explain why the child with a cleft is with their team from birth to adulthood. This is also why Gociman says that the professional cleft team model has been so effective in producing positive results for cleft patients. âWe want every patient who comes and receives care here to ultimately be as close to normal as possible after treatment is complete,â said Gociman.
Ultimately, Gociman, who is also a geneticist, would like to solve the mystery of what causes cleft lip and palate. In the United States, about 1 in 1,600 babies are born with these birth defects, according to the Centers for Disease Control and Prevention. Gociman has been researching these conditions for several years and continues to explore the genetics of clefts.
âAt this point, nothing really conclusive has been discovered that would explain the majority of clefts. The genetics of cleft remain elusive despite many efforts to try to identify the genetic disease,â Gociman said. Without a cause or a means of prevention, doctors like Gociman and Johns remain focused on using the best treatment practices to give their patients a bright future and a reason to smile.