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So cleft lip is seen immediately on birth. You’ll see that the patient’s lip is open, it’s very easy to see. And the thing that you tried to do immediately is help them feed as soon as possible. Patients, these little babies, can’t go very long without nutrition, so you get them the right type of nipple and then as soon as you can, you get them to surgery once they’re old enough to undergo the surgery. The youngest is probably about four weeks. Most patients around six weeks will undergo that surgery and that’s a very simple surgery to do for people who do it. But you do need a specialist. If they can’t get feeding that way, they have to get a nasogastric tube or orogastric tube, which is a tube that goes down into the throat to feed them. The cleft palate overall is not always seen immediately in other countries. But in our country we do check all the time to make sure the patient doesn’t have a cleft palate. And you see that simply by opening the mouth and looking for a gap. In those situations we plan for surgery a little bit further down the line to close it. And that’s a cleft palate surgery. Overall, if you look at the issues patients have until the lip is closed, the patient’s gonna have trouble swallowing and sucking. If the patient has a cleft palate, they will have a 100% incidence of having hearing issues or ear problems from otitis media or poor fluid drainage out of the nose. That’s a 100% chance. Every single one of them will, even if they get repair over time, they do have a very, very, very high chance of needing lifelong either procedures or maintenance of the middle ear to make sure that it ventilates well. So you can assume that if you have a child with a cleft palate, they will have some sort of hearing issues throughout their life. Otherwise, the differences that you see are the issues with patients with cleft palate are velopharyngeal insufficiency. And this can result in difference in resonance, meaning the patient sounds different as they speak, and this can cause other friends and family to make fun of them as they grow up, which is very traumatizing for them, and difficulty swallowing. So when they swallow, a lot of the fluid will come out through their nose, especially if it doesn’t close properly.
