CMCH surgery gives voice to girl with congenital defect

Selvi, a resident of Thiruvannamalai, found that her new-born daughter appeared malnourished even though she fed her till the child refused food. Worried, she took the toddler to a hospital where a diagnosis revealed that she had a cleft palate.

It is a condition in which the roof of the mouth contains an opening into the nose. This results in air flow going out through the nose while the person is speaking, instead of the mouth, as is the case with normal result. This results in feeding, speech and hearing problems.

However, the doctors ruled out a surgery for the 11-month-old child, deeming her not healthy enough.

“The doctors said that a surgery at that stage would have posed a risk to my daughter’s life. Scared, I did not take her to a doctor till she reached 11 years of age,” recalls Selvi. However, by then her condition had worsened and an initial surgery at that stage at the Coimbatore Medical College Hospital’s Paediatric Department did not ensure full recovery.

Even after attaining 18 years of age, the girl had severe problems while speaking. However, today she is able to converse fluently and pronounce even complicated Tamil words, thanks to a follow-up corrective surgery performed at the CMCH and speech therapy sessions.

B. Asokan, Medical Superintendent of the hospital, told journalists here on Saturday that normally cleft palate surgery should be done at the age of one before the child develops speech ability to achieve full recovery. Hence, the surgery was complicated in this girl’s case as it was performed now after she turned 18.

Acting under guidance of Hospital Dean A. Edwin Joe, the Plastic Surgery Department performed Sphincter Pharyngoplasty to address her congenital defect.

Explaining the procedure, he said that velopharyngeal sphincter, located between oral and nasal cavities, coordinated the airflow between various chambers.

In this girl’s case, the posterior pharyngeal flap or a lid-like structure was not functioning properly as it failed to prevent the air from flowing through the nose while she was speaking. This defect was corrected during the two-hour procedure performed by Dr. Asokan, Assistant Professor M. Sundararajan, anaesthetist T. Sadagopalan and postgraduate student S. Sivakumar.

Dr. Asokan says the rate of cleft lip and cleft palate cases are one for every 700 live births. Such complicated surgeries show that skill and competency levels of government hospitals. The girl is working as a tailor in Tirupur.