Each year approximately 4,200 babies in the United States are born with cleft lip or cleft palate. Oral clefts are the fourth most common birth defect in the U.S. and are more common in children of Latino, Asian or Native American origins. Clefts develop very early in a woman's pregnancy and result when there is not enough tissue in a baby's mouth and lip area to join properly. Ultrasound can often detect a cleft in an unborn baby. This allows the family to meet with a member of the cleft palate team before birth, receive educational materials, and begin a treatment plan.
At Children's Hospital, R. Mark Ray, M.D., an ear, nose and throat specialist and reconstructive surgeon can even begin treating a child with an oral cleft before they take their first breath. Dr. Ray meets with parents whose baby has been diagnosed with a cleft to inform and reassure them about their child's condition and treatment. Dr. Ray also works with parents adopting out-of-country children who may have an oral cleft. In 2015, Dr. Ray and members of his team volunteered to go on a medical mission to the Middle East as part of the Palestine Children's Relief Fund (PCRF) and The Smile Train. While there, they treated children with cleft lips and palates and helped train health care providers there to do so in the future.
"A cleft lip or palate is no longer a roadblock, it's merely a speed bump that, with proper treatment, can be overcome." - R. Mark Ray, M.D.
The Children's Hospital Cleft and Craniofacial Clinic is the only approved cleft palate team in Tennessee. Cleft palate management is complicated, so the team must include:
The cleft palate team is approved by the Commission on Approval of Teams and currently treats more than 200 patients in our region with both efficiency and compassion. The cleft palate birth defect causes abnormal facial appearance, unclear speech, poor hearing, learning issues and poor dental health. Our cleft palate team understands that better hearing, improved speech and positive self-image are essential tools for children to develop and grow into adults.
ENT doctors often work closely with audiologists. These speech and hearing specialists do tests with your child to measure his hearing, brain's response to sound and how well all parts of his ear are working. The audiologists can fit your child for a hearing aid, ear plugs and even cochlear implants. They also may test your child for central auditory processing disorder, which happens when your child does not process the information they hear because his brain is not fully coordinated with his ears.
After your child is diagnosed with a communication disorder or hearing loss, our audiologists will work with his primary care doctor, teachers and family to create a special plan for him. He will also be referred to communications specialists and speech language pathologists to receive the most comprehensive care possible.
One of the most common surgeries in the country is the tonsillectomy, which is the removal of the tonsils. Your ENT doctor will recommend the removal of your child's tonsils if they are affecting your child's breathing, sleeping or swallowing or causing frequent infections.
A tonsillectomy takes between 30 to 45 minutes for most patients. The ENT doctor will remove your child's tonsils through the mouth. Your child will have a sore throat after the surgery and require medicine to ease the pain. Your child will have to be excused from school for one week to recover.
Babies and young children tend to get more ear infections than older children and adults. Because their body parts are smaller and always developing, it is harder for fluid to drain from the middle ear, which causes infection. Many children grow out of ear infections before surgery is required.
Symptoms of ear infections include:
If your child is having repeated ear infections in a year, he may need ear tubes put into his eardrum by our ENT doctor. The tubes allow fluid to drain into the ear canal without getting caught in the eardrum. Tubes last between six months and two years. The body will push out the tubes on its own when the ear canal has fully developed.
The ear tube surgery takes about 15 to 20 minutes and is done under anesthesia. Your child may be able to hear better almost immediately after the surgery.
Learn about the Pediatric Otolaryngology specialists who are part of East Tennessee Children's Hospital: