In the majority of children, the palate is also affected by the cleft, in addition to the lip. The cleft lip is ideally closed in a first operation between the fourth and sixth month of life; the second operation to close the palate should also take place in the first year of life.
But time and again we see patients in our project countries who have lived with cleft palates for many years. Because once the obvious flaw has been removed by the lip operation, the parents sometimes no longer see the need to close the palate. The children then suffer from severe impairments for their entire lives.
Like sixteen-year-old Sifa. The girl is very shy, cannot speak properly. As a baby, her cleft lip was closed. The surgery was not done well, as the scar on her face shows. But what’s worse is that the important palate surgery was never done. Sifa comes alone to seek help from our mission in Rwanda on its penultimate day. We don’t know how she found out about our offer of treatment. Her cleft palate is huge, about four centimeters. The procedure is not easy: The larger the cleft, the greater the risk that the suture will open again. For our two volunteer project leaders, Dr. Dr. Oliver Blume and Gunther Au-Balbach, an intervention such as this so shortly before their departure is a major challenge. But everything goes well. The two experienced oral and maxillofacial surgeons are relieved when Sifa cheerfully shows up for a check-up on the last day before their departure. At their farewell she speaks her name – for the first time in her life.
If a cleft palate is not treated or treated late in life, many problems for the patient are the result. Due to the lack of separation of the mouth and nasal cavity, the interaction of the lip, tongue and palate muscles is disturbed. In addition, there is a change in the position of the tongue, which shifts backwards into the cleft. Serious functional disorders are the result. Swallowing and breathing, basic pronunciation and the sound of the voice are affected.
In babies, breathing and feeding problems can become life-threatening. Food getting into the nose is still a handicap later in life, and is associated with shame for the affected patients.
The disturbances in sound formation result in a delayed language development. Hearing deficits caused by chronic inner ear infections can make learning to speak even harder. Due to their unclear pronunciation and an often nasal voice, the children are often stigmatized as disabled.
In order to promote language development in children, we offer language and functional therapy wherever the structures in our project countries allow. The same principle that applies for the surgeries also applies here: the earlier the therapy is started, the more effective it is.
