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Case Study 115: Cleft Lip and Palate

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Case Study 115: Cleft Lip and Palate

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Case Study 115: Cleft Lip and Palate
Scenario
S.G. is a 6-month-old girl who is scheduled for sequential repair of her cleft lip
(cheiloplasty) and palate (palatoplasty). she has recently been adopted from China and
her past medical history is unknown. S.G. is scheduled for her cleft lip repair, and Mrs.
G. brings her to the same-day surgery unit the week before for her preoperative workup.
As you do her workup, you recognize that care of the child with clefting uses a
multidisciplinary approach.
1. Discuss additional health problems for which these patients are at
risk and who on the craniofacial team would address each issue:
Answer: Individuals with this type of health problem will be more susceptible to
sucking, latching, and feeding difficulties. They may also need help with speech
and language development. The craniofacial team members consist of the
primary care providers who specialize in children, a speech therapist, a
nutritionist, a plastic surgeon, and an orthodontist

2. S.G. weighs 6.5kg. Plot this finding on the Centers for Disease Control
and Prevention (CDC) growth chart (see
www.cdc.gov/growthcharts/data/set1clinical/cj41l018.pdf ). Which of these
statements best summarizes your findings?

a. S.G. falls below the 5th percentile.
b. S.G.'s weight is at or near the 25th percentile.
c. S.G.'s weight is at or near the 75th percentile.
d. S.G.'s weight is above the 95th percentile.

3. What information regarding her health history is important to obtain from her
mother to plan her perioperative care? Select all that apply and explain your
rationale.

a. Current known health status
b. Current method of feeding
c. Parent's employment status
d. Immunization status
e. Adoption status
f. Gross motor milestones

Rationale: There is no need to know the parent’s employment status or the
immunization status of the child because that has no effect on perioperative care,
or the infants status during surgery

4. Choose the laboratory tests that you expect to be obtained preoperatively and
discuss the rationale for your choices.



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