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Moebius Syndrome

what is moebius syndrome?

Moebius Syndrome is a disorder that affects the nerves of the face – the facial nerve, or the 7th cranial nerve. It is very rare.

what causes it?

We don’t really know. Rarely it runs in families, but usually other members of the family are not affected. One theory is that the blood supply to the affected nerves in the embryo are disrupted. Another is that there is something different about the nerves and brain themselves that make them not develop properly. Certain medicines taken during pregnancy may also cause it.

how do i know if someone has moebius syndrome?

People with Moebius syndrome cannot move their faces, they cannot smile, frown or blink their eyes. They have no facial expression which makes it difficult to know if they are happy, sad, angry or laughing.

Both sides of the face are usually affected but not always. The face may be asymmetrically affected. Some people cannot move their face at all and others may have weak movement.

Sometimes they have crossed eyes because the nerve to that muscle is also not working, the 6th cranial nerve.

Less often other nerves are also involved and the person may not be able to hear, cough, talk clearly, swallow.

Not all people with facial weakness have Moebius Syndrome – there are other ways in which the Facial Nerve can be damaged: Injury, infection, stroke.

how is it treated?

1. When a baby with Moebius Syndrome is small, the main priority is that they feed and grow well.

2. Speech therapy helps with speaking, eating and drooling.

3. Eyes need to be protected because the person can’t close their eyes, especially at night when they are sleeping.

4. Eye problems may be improved with surgery to correct a squint.

5. When the child is older, surgery can be done to create a smile by moving muscles to the face and joining them to nerves that are working.

Cleft lip/palate

Caring for a child born with a cleft palate or another congenital deformity can be emotionally taxing and stressful for a family, but through surgery and the correct treatments, it is possible for him or her to grow into a perfectly healthy adult.

WHAT IS IT?

These are the common terms used to refer to a cleft which can occur in either the lip and/or palate of a child. Cleft palate causes are a complex result of environmental and genetic factors during pregnancy. It can occur once in perhaps every 700 births, and it is an affliction which can affect both sexes and all ethnic groups.

The three major types:

A cleft lip

Which is either complete or incomplete and either unilateral or bilateral, which means it affects one side of the lip or both sides simultaneously. Surgery can be performed between three and six months after birth and involves stitching the skin of the lip together.

A cleft palate

This is when the palate cleft affects parts of the soft palate and extends into the hard palate and the gum. The corrective surgical procedure can be performed between four and 12 months after birth and involves repairing the area in layers. First the soft palate muscles are reconstructed to aid better speech and swallowing functions, then the gap in the gum is closed. If needed, there may be follow up adjustment surgery after this procedure.

A cleft lip & palate

Is a unilateral or bilateral cleft that runs from the base of the nose through the gums and palate. It is possible for this to occur while the nose and gum remain joined. Surgical procedures for this involve a combination of the above two.

Surgery is the only way to repair these malformations and is normally performed under general anaesthesia. Your surgeon will provide information on what to expect from the operation, how to treat your baby pre and post op, as well as give you advice on the best methods of feeding your baby while he or she is recovering from a cleft palate or lip surgery.

can it be repaired?

Cleft lip and a cleft palate are birth defects that continue to affect many children all over the world. For sufferers and their families, these deformities can cause a lot of emotional strain. But the good news is that cleft lips and cleft palates can be fixed with surgery, which allows children born with these conditions to grow up to become happy and healthy adults.

Surgery for cleft lip

This is often done when a child is between three and six months old. Patients may have a minor cleft or one that stretches to the base of the nose. A cleft may also be bilateral, affecting both sides of the lip, or unilateral, affecting one sides. Surgeons stitch the lip carefully together and trim away unnecessary tissue.

Surgery for cleft palate

Surgery on a cleft palate is generally performed when a child is between four months and one year old. Sufferers often have a split running backwards from the front gum along the hard palate. Sometimes the soft palate is also affected. Surgeons repair the cleft by starting with the soft palate and then moving onto the hard palate. Finally, the opening in the gum is closed. On some occasions, further surgery is needed to make adjustments.

Surgery for combined cleft lip and cleft palate

In an extreme case, a child will have a lip cleft that continues through the gums and palate. When this happens, surgery will consist of a combination of both of the above procedures.

During all of these operations, patients are given general anesthetic. Prior to surgery, medical professionals will give parents enough information so that they know exactly what the operation involves and what results to expect. In addition to this, parents will be informed on how to care for their child before and after the operation, as well as how to feed their child while he or she is recovering from cleft lip or cleft palate surgery.

what causes it?

Scientists have found that there are certain genes that make a baby more likely to develop a cleft than other babies, resulting in cleft lips and palates often running in families.

How is a cleft palate and a cleft lip formed?

A cleft palate forms early on during pregnancy when the roof of a baby’s mouth doesn’t close properly. This results in an opening, known as the cleft, which extends from the front of the mouth in a backward direction along the hard palate. Sometimes the cleft can affect the soft palate as well.A cleft lip is similar in that it also forms during the early stages of pregnancy. In this case, the front upper lip fails to form completely, resulting in a split in the tissue. This opening can stretch right up to the base of nose, and can also affect one or both sides of the lip area.In extreme cases, a child may suffer from both a cleft lip and cleft palate. When this happens, the child is left with an opening that runs from the bottom of the nose all the way through the gums and palate.

What outside influences may contribute to the development of cleft?

The following factors can also increase the chances of a cleft forming:

Mother smokes while pregnant
Mother drinks alcohol or takes drugs during pregnancy
Pregnant mother has a lack of folic acid in her diet
Mother is extremely overweight

While scientists continue to learn more every day, the positive news is that surgeons can repair clefts, no matter what the cleft lip and cleft palate causes may be. As a result, sufferers have the chance to become healthy adults.

what to expect after surgery

After cleft lip surgery, the main aim is to ensure that the repaired area stays protected until it has fully healed. In order to do this, various short-term changes will need to be made to your child’s feeding and sleeping habits, while your surgeon will show you how to care for the surgical wound.

After the operation, an IV will be used to provide your child with enough fluids until his or her drinking improves. Children generally stay one night in the hospital and leave as soon as they are able to consume a suitable amount of fluids.

When it comes to feeding, younger children will not be able to suck on a bottle or nipple for roughly 10 days after surgery. Instead, they will initially be given clear liquids using a syringe until they are able to tolerate their regular formula. Older children, on the other hand, may drink blended food from a cup.

When sleeping, your child will also need to lie on his or her back or side for a few days after surgery. This will help keep the repaired area from rubbing against the bed.

Most importantly, the stitches must be cleaned to prevent infection. Cleaning, which is often done after your child has eaten, involves dipping an earbud in mild soapy water and gently rolling it along the line of stitches. Afterwards, another earbud is soaked in warm water and is used to rinse the stitched area. Additionally, doctors might also want you to apply an anti-bacterial ointment as well.

Apart from regularly cleaning the repaired area, gentle restraints will be used for around 10 days or so to ensure that your child does not rub his or her face, as this would hinder the healing process. It is also better for younger children not to use a dummy until the wound has healed completely.

Throughout the recovery stage, there will be a number of follow ups with your surgeon. Generally, the first meeting occurs between 5 and 7 days after the cleft lip surgery has taken place. After that, the next visit occurs in about 2 weeks.

When a child is born with craniosynostosis, a parents dream of a normal life for them is put on hold. The condition is caused by the premature closing of one or more of the sutures of bones in the skull, which may give the child an abnormal skull shape or forehead, asymmetrical eyes and or ears, or a raised intracranial pressure (pressure inside the skull) and can cause delays in development or permanent brain damage if not corrected. Smile Foundation helps these children and their families affected by craniosynostosis by providing critical surgery that allows them to live life freely.

BEFORE

AFTER

Microtia occurs in 1 out of 8 000 to 10 000 births. It is a congenital deformity where the pinna (external ear) is underdeveloped (microtia) and can be unilateral (one side only) or bilateral (affecting both sides). In unilateral microtia, the right ear is most commonly affected. A completely undeveloped pinna is referred to as anotia. In most cases, surgery is offered for this type of condition though, when surgery is out of reach for families, Smile Foundation facilitates these specialised procedures to make it possible for affected children to live a normal life.

Burn treatment makes up a sizeable portion of the work that we do at the Smile Foundation. South Africa has a high occurrence of serious injuries due to burning, largely because of a variety of socio-economic factors including lack of electricity, inadequate housing and drug and alcohol abuse. A large percentage of major burn are the of shack fires, which are often caused by accidents with paraffin stoves, open fires and candles.

Each and every burn has unique requirements and the treatment process is both complex and prolonged. Most require extended stays in hospital where they will be subjected to stringent infection control measures, procedures to minimise burns scarring and post-trauma treatments including extensive reconstructive surgery.

Tissue expansion is the most common treatment for burn. This is a relatively straightforward procedure in which a silicone balloon expander is inserted under the skin near the area to be repaired and then gradually filled with salt water over time. This causes the skin to stretch and grow, providing extra skin, which can be used to reconstruct almost any part of the body.

Considering the complexity and sensitivity of the treatments required, it is easy to see how costly these treatments can become. Smile Foundation sets out to bring people together for the purpose of providing expert surgical intervention to those who could not otherwise get it. By providing the very best possible burn treatment to those who need it most, we hope to make a difference in the lives of child burn.

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Moebius Syndrome

what is moebius syndrome?

what causes it?

how do i know if someone has moebius syndrome?

how is it treated?

Cleft lip/palate

WHAT IS IT?

can it be repaired?

what causes it?

what to expect after surgery

BEFORE

AFTER

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