Bilateral Cleft Lip and Unilateral Cleft Palate with Unilateral Renal Agenesis: A Case Report
Cleft lip and palate (CLP) are one of the most frequently
occurring craniofacial congenital anomalies. A syndromic association is
frequently seen in such cases. A feeding obturator is a prosthetic aid
that assists a patient in obturating a cleft until surgery is performed.
Cleft lip surgery or cheiloplasty is often performed three months after
birth, while palate surgery or palatoplasty is typically performed
between the ages of six and fourteen months. A 2-day-old
newborn presented to the Pediatric Emergency with a complaint of
difficulty in feeding. On examination, bilateral cleft of the lip and
unilateral cleft of the palate was present. The ultrasonography of the
fetus before the birth had revealed non-visualized left kidney, so an
ultrasonography (USG) of the abdomen and pelvis was advised which
confirmed the finding i.e., left renal agenesis. Electrocardiography
(ECG) revealed an arterial septal defect (ASD) of 4.5
mm. Such presentation is commonly seen in cases of isolated
gonadotropin-releasing hormone (GnRH) deficiency (IGD). A custom-made
feeding obturator was fabricated and delivered to help the baby overcome
feeding difficulties. Parents were instructed and well-taught to feed
the child with the appliance in place. Apart from giving appropriate
instructions regarding feeding and maintenance of the appliance, parents
were also informed about the surgical procedures that would be followed
at a later date. Also, considering the exceptional psychological
situation of the family and the need for a long-standing relationship
between the cleft team for a successful outcome, appropriate
counseling with reassurance was rendered to the family members.
occurring craniofacial congenital anomalies. A syndromic association is
frequently seen in such cases. A feeding obturator is a prosthetic aid
that assists a patient in obturating a cleft until surgery is performed.
Cleft lip surgery or cheiloplasty is often performed three months after
birth, while palate surgery or palatoplasty is typically performed
between the ages of six and fourteen months. A 2-day-old
newborn presented to the Pediatric Emergency with a complaint of
difficulty in feeding. On examination, bilateral cleft of the lip and
unilateral cleft of the palate was present. The ultrasonography of the
fetus before the birth had revealed non-visualized left kidney, so an
ultrasonography (USG) of the abdomen and pelvis was advised which
confirmed the finding i.e., left renal agenesis. Electrocardiography
(ECG) revealed an arterial septal defect (ASD) of 4.5
mm. Such presentation is commonly seen in cases of isolated
gonadotropin-releasing hormone (GnRH) deficiency (IGD). A custom-made
feeding obturator was fabricated and delivered to help the baby overcome
feeding difficulties. Parents were instructed and well-taught to feed
the child with the appliance in place. Apart from giving appropriate
instructions regarding feeding and maintenance of the appliance, parents
were also informed about the surgical procedures that would be followed
at a later date. Also, considering the exceptional psychological
situation of the family and the need for a long-standing relationship
between the cleft team for a successful outcome, appropriate
counseling with reassurance was rendered to the family members.