Cleft lip and cleft palate repair in Amman: Doctors and Clinics

Cleft lip and cleft palate are congenital conditions that arise before birth when the tissues of the lip or the roof of the mouth do not fuse completely. A cleft may involve the lip alone, the palate alone, or both, on one side or on both sides. Repair is not a single operation but staged care that begins in the first days of life and continues for years with a team: a maxillofacial or plastic surgeon, a paediatrician, a feeding specialist, a speech and language therapist, an ear nose and throat doctor, a dentist and an orthodontist.

The first priority is not appearance but feeding and growth. Most babies need specially shaped teats and bottles, a modified feeding technique, and careful weight monitoring. Parents are told clearly that a cleft is not the result of anything the mother did wrong and is not a reason for blame, a widespread and harmful belief, and that with organised care most children grow, speak and live entirely normal lives.

Usual timing is lip repair at around three to six months of age and palate repair between about nine and eighteen months, depending on the child's growth, weight and the team's judgement. In selected cases, appliances that shape the nose and gum precede surgery. Operations are performed under general anaesthesia after a full preoperative assessment.

The limits must be stated plainly. One operation does not complete the journey. A surgical scar always remains, although it usually fades considerably with time and care. Palate repair improves speech, yet a proportion of children need prolonged speech therapy or an additional procedure to reduce air escaping through the nose while speaking. Middle ear problems are common and require hearing follow-up, and later the child may need orthodontic treatment, a bone graft to the gum area, and in some cases jaw surgery in the teenage years once growth is complete.

At every stage the decision rests on examining the child, their weight and general condition and the team's assessment, not on a fixed age applied to all children.