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"Mirror Image" Twins Examples Of Advances In Cleft Lip, Palate Surgery

9:55 PM, Feb 29, 2008   |    comments
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By Kay Quinn, Healthbeat Reporter Cleft lip and palate are among the most common physical birth defects, affecting about one baby in 700. Now, new surgical techniques developed right here in St. Louis are making a big difference in treatment for young patients. Kyra and Kaitlyn Swift are beautiful, ten-month-old twins. They're also great examples of the progress that's been made in the past decade in repairing tiny lips and mouths that don't form properly early in pregnancy. There was a special moment recently for a pediatric plastic surgeon at SSM Cardinal Glennon Children's Medical Center. Dr. Michael Carstens was able the check the results of an operation to repair the twin's cleft lips. The operation was performed in early December. Dr. Carstens is a pediatric plastic surgeon at SSM Cardinal Glennon, who specializes in the repair of cleft lip and palate. He is also the director of the Cleft Lip, Palate and Craniofacial Deformities Team at Cardinal Glennon and an associate professor for the division of plastic surgery at Saint Louis University School of Medicine. Children born with clefts have lips that don't form properly. Many have cleft palate, meaning there's a hole in the roof of their mouths. Kasey and Michael Swift remember getting the news while Kasey was pregnant. "It scared us," said Michael Swift, the girl's father. "We were real upset. We weren't sure if we did something wrong. We went thru a lot of emotions all at once just like that." "I was very upset," says the girl's mother Kasey, about learning of their diagnosis. Genes play a role, but no one knows exactly what triggers clefts. The good news is the surgical technique to repair has come a long way in the past decade thanks to this local doctor. "Interestingly enough all the parts fit back together," says Dr. Carstens. It used to take a series of six to ten operations to do it. Treatment that could stretch into a child's teens. But Dr. Carstens pioneered a technique called developmental field repair that now means clefts are repaired in the first few months of life, and babies only need two to three operations. "To get the nose repaired, get the lip repaired, and get the inner chamber of the roof of the mouth done in such a way that you can make that accurate for life," says Dr. Carstens. Kyra and Kaitlyn's clefts are mirror images of each other. Kyra's is on the right and Kaitlyn's is on the left. In their second operation in the fall, Dr. Carstens will use a piece of their rib and a substance called Bone Morphogenic Protein to stimulate the growth of new bone to form the roof of their mouth. "Our expectations weren't as high," says Michael. "We expected them to look really good, but we didn't expect them to look as good as they do."


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