Interdisciplinary approach to early rehabilitation of newborns with cleft lip and cleft palate

The article discusses the interdisciplinary interaction of pediatricians, surgeons, orthodontists, anesthesiologists, and otorhinolaryngologists in the complex rehabilitation of newborns with bilateral cleft lip and palate. Purpose. The aim of the study was to increase the effectiveness of treatment of newborns with bilateral cleft lip and palate due to preliminary orthodontic treatment. Characteristics of children and research methods. A comprehensive diagnosis and treatment of 32 patients with a diagnosis of complete bilateral cleft lip and palate were carried out. The patients were divided into two subgroups. In the first subgroup (n=16), newborns were fed using an anatomical nipple; in the second subgroup (n=16), newborns underwent presurgical orthodontic treatment using individual obturators. Results. Early presurgical orthodontic intervention with the use of individual obturators allows normalizing the process of breastfeeding in newborns. It is proved that the interdisciplinary interaction of doctors of related specialties allows for a comprehensive diagnosis, counseling and subsequent surgical treatment of newborns with bilateral cleft lip and palate. Conclusion. The proposed approach can be useful for doctors of all pediatric profiles. The development of an integrated approach in the newborn period allows specialists to implement a competent step-by-step treatment of patients from birth to 18 years old.

1. Arsenina O.I., Malashenkova E.I., Pashchenko S.A. Algorithm of orthodontic treatment of patients with congenital cleft lip, palate and alveolar process before and after bone autoplasty. Stomatologiya 2017; 5: 62–65. (in Russ.)] DOI: 10.17116/stomat201796562–65

2. Mamedov Ad.A., Maclennan A.B., Blinder Z.A., Mazurina L.A. Surgical treatment of children with cleft lip and palate in newborn period, Transactions of 10th World Cleft Lip and Palate Congress (ICPF) Diagnosis, Prevention, Genetics and Mamegement of Cleft and Craniofacial Deformities. Current Techniques, research and Future directions, 24–28 October, 2016; Chenna, India p. 117

3. Lin L., Zhang R., Mazzaferro D., Hoppe I., Perl R., Swanson J. et al. Infuence of repaired cleft lip and palate on layperson perception following orthognathic surgery. Plastic and Reconstructive Surgery 2018; 142(4): 1012–1022. DOI: 10.1097/PRS.0000000000004778

4. Bogoroditskaya A.V., Radzig E.Yu., Prityko A.G., Sarafanov M.E. Condition of the nasal cavity and paranasal sinuses in children with congenital cleft of the upper lip and palate. Vestnik otorinolaringologii 2015; 80(6): 19–21. (in Russ.)] DOI: 10.17116/otorino201580519–21

5. Visser E.E., Kruger E.E., Kritzinger A.M. Feeding difficulties in infants with unrepaired cleft lip and palate and HIV-exposure. African Health Scie 2018; 18(4): 1098–1108. DOI: 10.4314/ahs.v18i4.31

6. Panfilova V.N. Pediatrician’s thoughts about infant feeding. Rossiyskiy Vestnik Perinatologii i Pediatrii 2020; 65(1): 100–104. (in Russ.)] DOI: 10.21508/1027–4065–2020–65–1–100–104

7. Skidan I.N., Gulyaev A.E., Belmer S.V. Prebiotic components of breast milk and the possibility of repeating their effects in infant formulas. Rossiyskiy Vestnik Perinatologii i Pediatrii 2019; 64(3): 37–49. (in Russ.)] DOI: 10.21508/1027–4065–2019–64–3–37–50

8. Pyryeva E.A., Safronova A.I., Gmoshinskaya M.V., Toboleva M.A. New trends in complementary feeding: theory and practice. Rossiyskiy Vestnik Perinatologii i Pediatrii 2019; 64(2): 117–122. (in Russ.)] DOI: 10.21508/1027–4065–2019–64–2–117–122

9. Grechanyk D.A., Chuikin S. V., Davletshin N.A., Makusheva N.V. Surgical treatment of congenital cleft lip of children. Problemy stomatologii 2018; 14:(1): 99– 105. (in Russ.)]. DOI: 10.24411/2077–7566–2018–000018

10. Arshad A.I., Alam M.K., Khamis M.F. Assessment of complete unilateral cleft lip and palate patients: Determination of factors effecting dental arch relationships. Int J Pediatr Otorhinolaryngol 2017; 92: 70–74. DOI: 10.1016/j.ijporl.2016.11.006

11. Stock N.M., Ridley M., Guest E. Teachers’ Perspectives on the impact of the Cleft lip and/or palate during the school years. Cleft Palate-Craniofac J 2019; 56(2): 204–209. DOI: 10.1177/1055665618770191

12. Bimbas E.S., Blokhina S.I., Menshikova E.V., Yershova O.Yu. Application of modern orthodontic and surgical technologies in complex rehabilitation of children with congenital cleft of the upper lip, alveolar process and palate Problemy stomatologii 2018; 17(4): 71–76 (in Russ.)] DOI: 10.18481/2077–7566–2018–14–4–71–76

13. Kaye A., Che C. Differences in weight loss and recovery after cleft lip and repair. Cleft Palate-Craniofac J 2019; 56(2): 196–203. DOI: 10.1177/1055665618774020