| Abstract | Rascjep usne i nepca urođeni je defekt s prisutnošću oronazalne komunikacije koji uključuje malformaciju ili agenezu zubi u blizini rascjepa i manjkav sagitalni i poprečni rast maksile. Orofacijalni rascjepi najčešća su malformacija u području glave i vrata. Malformacija može varirati od mikroformi do velikih, širokih, obostranih rascjepa. Mogu biti dio velikog broja sindroma ili su
nesindromski, tj. izolirani, ali u oba slučaja dijele se na rascjepe usne, rascjepe usne i nepca ili izolirane rascjepe nepca.
Orofacijalni rascjepi mogu uzrokovati brojne probleme, osobito u prvih nekoliko mjeseci nakon rođenja, prije početka terapije. To su obično teškoće s hranjenjem, problemi sa sluhom, problemi sa zubima i problemi s govorom. U literaturi se navodi da orofacijalni rascjepi imaju velik utjecaj na psihološki razvoj pacijenata, ali i njihovih obitelji. Od samog rođenja djeteta s rascjepom potreban je tim specijalista koji će ga pratiti tijekom razvoja. Liječenje djece s rascjepom traje od rođenja pa do završetka rasta i bitno je da je dijete u određenom razvojnom stadiju pod nadzorom odgovarajućeg specijalista. U to su uključeni
maksilofacijalni kirurg, neonatolog, pedijatar, logoped, otorinolaringolog i doktori dentalne medicine (dječji stomatolog, specijalist oralne kirurgije, ortodont i specijalist stomatološke protetike). Svaki specijalist ima svoju ulogu u određenoj fazi djetetova života i zato je potrebna stalna suradnja tima. Ključni su slijed i vrijeme pojedinačnih terapijskih postupaka u dojenčadi, ranoj mješovitoj denticiji, ranoj trajnoj denticiji te nakon završetka rasta lica. Individualni pristup svakom djetetu s rascjepom dovodi u konačnici do dobrih funkcijsko-estetskih rezultata, ali i psihosocijalne stabilnosti djeteta te se pogođena djeca gotovo ne razlikuju od vršnjaka.
Svrha je ovog rada dati pregled mogućnosti liječenja rascjepa usne i nepca s prikazom uloga pojedinih specijalista tima uključenog u terapiju. |
| Abstract (english) | Cleft lip and palate is a congenital defect characterized by a presence of an oronasal communication as well as a malformation or agenesis of teeth near the cleft, and a deficient sagittal and transverse maxillary growth. Orofacial clefts are the most common malformations in the head and neck area. Those malformations can vary from microform to large, wide, bilateral clefts. They can be a feature of a large number of syndromes or are non-syndromic, i.e. isolated, but in both cases they are divided into a cleft lip, cleft lip and palate, or isolated cleft palate. Orofacial clefts can cause a number of problems, especially in the first few months after the birth, before starting with the treatment. These are usually feeding difficulties, hearing problems, dental problems, and speech problems. The literature states that orofacial clefts have a great impact on
the psychological development of patients as well as that of their families. From the very birth of a child with a cleft, a team of specialists is needed to monitor the child throughout their development. The treatment of children with a cleft lasts from their birth to the end of their growth and it is important that the child at a certain stage of development is under the
supervision of an appropriate specialist. This includes a maxillofacial surgeon, neonatologist, pediatrician, speech therapist, otorhinolaryngologist, and dentists (pediatric dentist, oral surgeon, orthodontist, and prosthodontist). Each specialist has a role at a certain stage of the child's life, and, therefore, constant teamwork is required. It is vital to have the right sequence and timing of individual therapeutic procedures in infants, the early mixed dentition, the early permanent dentition, and after the end of facial growth. The individual approach to each child with a cleft lip and/or palate ultimately leads not only to good functional and aesthetic results, but also to the psychosocial stability of the child, so that the affected children are almost indistinguishable from their peers. The purpose of this paper is to provide an overview of the treatment options of the cleft lip and/or palate with an overview of the roles of individual specialists in the team involved in the therapy. |
