"Hare lip" and "wolf mouth." Myths about the congenital crevice of the lips and the sky

Congenital crevice of the lips and the sky (VRGN) is the splitting of soft tissues in the middle part of the lips and the rupture of the sky. The condition occurs during the period of embryonic development. This is one of the fairly common innate features. Despite this, it is surrounded by many myths.

Photo: University of London, Francis Galton Laboratory for National Eugenics. London

About two thousand children with VRGN are born annually in Russia. This is one of the most common congenital malformations of the upper jaw. In total, in Russia with this vice of about 35 thousand children under the age of 18 years. VRGN is surrounded by myths and vernacular euphemisms: “Hare lip” and “Wolf sky” . “Such things” asked the founder of the Foundation “Star of Mercy” to Tatyana Kireeva to tell about the most popular errors about the innate crevice of the lips and the sky.

Matvey Ch., 13 years old photo: BF "Star of Mercy"

Myth 1. Cleastal must be operated directly in the hospital

This false belief appeared in the 70s of the XX century. From 1963 to 1970 in Moscow maternity hospitals, children were sewn out of the crevice immediately after birth. At that time, without an ultrasound, it was impossible to identify a feature in advance, so they often refused children with VRGN. To prevent this, doctors resorted to the early adjustment methodology . Due to the large number of complications after operations, they were abandoned over time.

Early surgical interventions lead to scarring and can negatively affect the further development of tissues. Early operated patients in the future are forced to make numerous corrections, often they face complications.

“Until now, there are no approved uniform terms in the surgical correction of the lips and the sky,” says Kireeva. - But most surgeons believe that the initial operation should be done no earlier than at the age of two to four months, when a child forms more mature tissues, and a good level of hemoglobin ensures oxygen delivery to cells. Thanks to this, the child’s body is more likely to cope with anesthesia. It is important to note that all of the above applies only to the correction of the upper lip. A solid and soft sky operates even later, the timing and methods of surgeons may vary. ”

Myth 2. Capture is enough just sew up

Treatment of VRGN is long and complex. Patients are carried out on average two or three operations, as well as several surgical corrections. In addition, people with VRGN need to work on diction with a speech therapist, to be observed at the orthodontist and regularly contact the otorhinolaryngologist.

Stepa K., 1 year and 11 months photo: BF "Star of Mercy"

“The mother of the child with VRGN should understand that the correction of the congenital crevice of the upper lip and the sky is a long process. The plastic of the upper lip and the sky is only the beginning of the path. Parents should be prepared for the fact that their child will undergo rehabilitation up to adulthood, ”Tatyana notes.

Myth 3. Such children are born only among alcoholics and smokers

Alcohol and smoking negatively affect the development of the fetus. But this is far from the main reason for the emergence of VRGN. “ The issue of heredity is still little studied. According to various sources, its influence does not exceed 15-30%, ”Tatyana notes.

The risk of developing this state is higher if the mother lives in areas with poor ecology, next to the chemical or metallurgical industry, if she took potent drugs during pregnancy. “In Bashkiria, due to the proximity of the chemical industry, such children are born an order of magnitude more. If in central Russia this is one patient out of 800, then in this region the indicator reaches one by 300, ”Tatyana Kireeva says.

The transferred viral and infectious diseases also play a large role, even those that have passed asymptomatic.

Myth 4. People with this diagnosis cannot be normally socialized

The topic of bullying and bullying to children with VRGN is too exaggerated, Tatyana notes. The Foundation "Star of Mercy" conducted a survey among parents about the stigmatization of children with BRGN. According to these data, a small number of children reported about the persecution towards the child.

Dasha F., 3 years photo: BF "Star of Mercy"

According to Tatyana, the interaction of the child with VRG with other people largely depends on the upbringing of parents, on the general psycho -emotional situation in the family. A large share of responsibility for the socialization of the child lies precisely on parents, the expert believes.

“The faster the mother talks to the class teacher or teacher, the faster he works with this topic with other guys, the less problems the child with socialization will be. But it is also impossible to exclude a situation where persecution may not stop. You need to work with this with the support of specialists, everything is very individual, ”adds Tatyana Kireeva.

Myth 5. Complete rehabilitation is impossible

Even with the most severe, bilateral crevice of the lip and the sky, the rehabilitation process can end by 15-16 years. The main thing is not to try to solve this problem as quickly as possible and contact only trusted specialists. So patients can recover without complications and to eliminate both external features and speech defects to their age.

“It is very important not to rush treatment,” Tatyana draws attention. - If you often operate the patient, then scars are inevitably formed. Unfortunately, scars in the sky are a common complication. It leads to tightening the fabrics and, as a result, to the underdevelopment of the upper jaw. Then the patient is forced to undergo long -term orthodontic rehabilitation. Therefore, the choice of a surgeon and his technique is very important. Do not forget that each crevice is individual, and only a surgeon with an orthodont determine the algorithm of treatment and rehabilitation. ”

Myth 6. It is better to operate the child for a fee than on the state quota

Parents can operate the child for free, according to the MHI or Navy, or contact a paid specialist. Regardless of their choice, all surgeons will operate the same. However, the commercialization of this sphere has negative consequences for patients, Tatyana believes. According to her, due to competition, many surgeons neglect risks and shift the terms between surgical operations to keep the patient. This may affect further rehabilitation.

“Any mother wants to eliminate this defect as soon as possible, but everything is not so simple. She will certainly find a paid specialist who agrees to operate in the early stages, in a short time, and this is very dangerous , ”Tatyana Kireeva notes.

Kirill D., 3 years old photo: BF “Star of Mercy” If the mother is not a specialist, and even in a state of anxiety and stress, it is much easier to convince her of the need to make her choice now Dima K., 2 years photo: BF "Star of Mercy"

Commercial experts often manipulate the fears of parents and enjoy their ignorance. Therefore, before making a decision on a paid operation, it is necessary to use the rule of three opinions - to get a consultation of at least three surgeons.

“An experienced maxillofacial surgeon should not only own the methodology, but also conduct 80-100 operations per year. Also, to confirm his competence, he must maintain a base with photographs of patients before and after operations, with a recording of their speech by age. This is a fairly good indicator that says that this specialist can entrust the face of his child, ”Tatyana adds

Myth 7. Abroad, surgeons operate better than in Russia

Tatyana Kireeva emphasizes that children's maxillofacial surgery in Russia is one of the best in the world. Our experts improve the methods of Western colleagues and now not only actively exchange experience abroad, but also go as invited to operating surgeons abroad, and hold international conferences and symposia in Russia.

Another question is in a complex approach to the treatment and rehabilitation of such patients. So far, in Russia there is not a single center for the comprehensive support of children with VRGN, where patients could receive high-quality assistance not only to the surgeon and orthodont, but also to the otorhinolaryngologist, genetics, neurologist, speech therapist, a defectologist and psychologist.