Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral
CPT4 code
Name of the Procedure:
Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral.
Summary
The surgical procedure to repair a cleft lip and associated nasal deformities is aimed at correcting congenital defects where the lip and/or nose have not formed properly. This procedure restores normal appearance and functionality.
Purpose
The procedure addresses cleft lip and nasal deformities, congenital issues that affect the mouth and nose. The primary goals are to improve the patient’s ability to eat, speak, and breathe, and to enhance facial appearance.
Indications
- Presence of a cleft lip, either partial or complete, on one side (unilateral).
- Associated nasal deformities.
- Difficulty in feeding, speaking, or breathing due to the cleft.
- Children usually undergo this surgery when they are around 3-6 months old.
Preparation
- Patients (or their guardians) will receive instructions to fast for several hours before the surgery.
- A thorough medical examination, including blood tests and possibly imaging studies, will be conducted.
- Parental consent and counseling are critical components.
Procedure Description
- The patient is put under general anesthesia.
- An incision is made along the edges of the cleft to create flaps of tissue.
- These flaps are then repositioned and stitched together to close the gap in the lip.
- Any nasal deformities are corrected simultaneously, often involving reshaping the nostrils and nasal cartilage.
- Fine sutures are used to minimize scarring and ensure proper healing.
Tools and techniques used may include scalpels, fine suturing needles, and sometimes special lip adhesion devices.
Duration
The procedure typically takes 1-2 hours.
Setting
This surgery is performed in a hospital or surgical center equipped with pediatric care facilities.
Personnel
- Pediatric plastic surgeon
- Anesthesiologist
- Surgical nurses
- Support staff
Risks and Complications
- Infection
- Bleeding
- Scarring
- Asymmetry or irregularities in lip and nose appearance
- Need for additional surgeries
Benefits
- Improved ability to eat, speak, and breathe.
- Enhanced facial symmetry and appearance.
- Boost in self-esteem and social interactions. Benefits are usually realized within a few weeks post-surgery as the healing progresses.
Recovery
- Patients may stay in the hospital for a day or two for monitoring.
- Pain can be managed with prescribed medications.
- Instructions include keeping the wound clean and avoiding any trauma to the surgical site.
- Follow-up appointments will be necessary to monitor healing.
- Full recovery typically takes a few weeks, with most normal activities resuming within a month.
Alternatives
- Non-surgical options are limited and mostly involve temporary feeding aids.
- Delaying surgery until an older age if initial surgery isn’t feasible. Compared to surgical repair, alternatives do not offer permanent solutions.
Patient Experience
During the procedure, the patient will be under general anesthesia and won’t feel any discomfort. Post-procedure, there might be mild to moderate pain, managed effectively with medications. The patient may experience some swelling and bruising, which typically subsides within a week or so. Feedback from caregivers and continuous support contribute greatly to a positive recovery experience.