13/12/2025
Standard markings for a bilateral cleft lip Repir
Rule of Tripple 10 also very important
HB must 10 G/ DL
Weight must be 10 pounds which is about 4.5 kg
Age must be 12 weeks ( 3 months)
Management of syndromic patients need an ICU pediatrician specialist and it has been a great time working Dr Kandetu our Picu Consultant on the last cleft lip we repaired.
Usually the will have heart defects, craniosynostosis and sydromic facial features
Most common are
1; Vaude Vaunde ( classic two pitting on the lower lip and a cleft
2. Pierre Robin sequence
One with a clasic Triad of ( glossoptoptosis, cleft palate and micrognathia and genial
They present with a small lower jaw and hence tongue pulls back and occlude the airway
Simple method to keep baby thrive may include
1: proning of the baby
2. Et tube incubation
3. Nasal prons on high flow oxygen
4. Glossopexy the tongue is sutured to the lower lip
5. Early distraction osteogenesis even as thr baby is as young as 2 moths to cut an osteotomy and migrate mandible foward, the mother will turn the screw 1mm per day or divided into 0.5mm Bd
6. We normally advocate for a delayed tracheostomy given its complications and side effects on this growing infant
Thank you team , thank you Dr Vanwyk and Dr Mumba for yesterday's baby
If you child is syndromic and it was not picked up at ANC and or at birth it is never to late to call us at 061304042 for bookings
Dr Hange
