Tygerberg Hospital is seizing the opportunity during National Cleft and Craniofacial Awareness and Prevention Month to shed light on cleft lip and palate (CLP) and other conditions affecting the head and face.
CLP, one of South Africa’s most common congenital disorders, often goes unreported, leaving parents confused and scared upon diagnosis.
However, Tygerberg Hospital’s specialised services are here to provide hope and assurance that children can face the world with confidence.
With the ability to treat about 200 new and follow-up cases each year, Tygerberg Hospital plays a crucial role in addressing the medical difficulties and facial differences resulting from cleft lip or palate.
Through a series of surgical procedures, children receive the necessary care to repair their conditions, allowing them to embrace life with a sense of self-assurance.
Through their efforts during National Cleft and Craniofacial Awareness and Prevention Month, the hospital aims to increase public knowledge about these conditions and the importance of early detection and intervention.
According to Dr Mosadi Mahoko, a plastic surgeon at Tygerberg Hospital, one in 2 000 children in Africa suffer from cleft lip and palate deformities. While 20% of these are related to a genetic syndrome, most deformities occur sporadically.
In addition, environmental risk factors such as smoking and alcohol use during pregnancy also play a role.
The Centers for Disease for Control and Prevention describes cleft lip and cleft palate as birth defects that occur when a baby’s lip or mouth does not form properly during pregnancy. Together, these birth defects commonly are called “orofacial clefts”.
According to Mahoko, cleft palate symptoms can include challenges with breast-feeding or bottle-feeding, fatigue and taking a long time to finish a feeding session, and regurgitation of milk through the nose during or shortly after feeding.
To alleviate the strain of sucking, specialised bottles and teats are available.
She said: “Craniofacial deformities are relatively common birth defects that affect a significant number of children. These conditions can have a range of physical and developmental impacts, but with early intervention and a multidisciplinary approach, children can lead healthy and fulfilling lives.”
One of the most recognisable craniofacial deformities is cleft lip and palate. This condition is characterised by a split in the lip and/or the roof of the mouth, known as the palate.
“It can be easily identified during a routine examination, and if poor weight gain is observed in a child’s ‘Road to Health Card’, a referral to a specialist is triggered. In some cases, only a split in the uvula is present, and the palate appears intact.
“While feeding issues may not be immediate, speech abnormalities, such as a nasal voice and difficulty making certain sounds, can develop as the child grows older,” explained Mahoko.
Treating children with cleft lip and palate requires a multidisciplinary approach involving various medical professionals, including paediatricians, geneticists, speech therapists, plastic surgeons, maxillofacial surgeons, orthodontists, and social workers.
Dental care throughout childhood is crucial and individualised advice and treatment plans are provided. Surgical reconstructive procedures are often necessary, with lip repair typically performed at three to six months and palate repair between nine and 12 months.
Braces and orthognathic surgery may be required around eight to 12 years old to correct misaligned teeth, followed by a corrective rhinoplasty at 16 to 18 years.
Another common craniofacial deformity is craniosynostosis, where the bones in a baby’s skull fuse together prematurely before the brain is fully formed. This can result in an abnormal head shape, facial asymmetry, and increased pressure on the brain.
Symptoms may include headaches, seizures, vision loss, learning difficulties, and behavioural changes. Early diagnosis and intervention are crucial to address these issues.
She emphasised that caring for children with craniofacial deformities involves a comprehensive approach. It requires a multidisciplinary team to evaluate the child’s normal development and provide social and psychological support to their families.
Surgery may be necessary to relieve pressure on the brain or improve the shape of the head for both cosmetic and physiological reasons.
By raising awareness and understanding of these craniofacial deformities, we can ensure that children receive the necessary care and support from a young age.
With early intervention and a collaborative approach, we can help these children thrive and overcome the challenges associated with their conditions, enabling them to lead fulfilling lives.