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Hasmik Hovhannisyan

Cleft Lip and Palate Deformities are Treatable

Congenital deformities of the palate or upper lip, known colloquially as ‘wolf’s mouth or hare’s lip, are pathologies known as far back as the middle ages.

People would run from individuals having these deformities as they fled from lepers. In fact people suffering from clefts were often regarded as animals back then. French dentists were the first to surgically treat cleft palates some two centuries ago. Modern medicine now offers several avenues of treatment for this maxillo-facial disorder.

In Armenia, successful surgeries for these conditions are carried out at the Third Clinical Hospital under the skilled hands Associate Professor Gagik Kocharyan, Candidate of Medical Sciences, Head of the Chair of the Maxillo-facial Surgery Department at the Mkhitar Heratsi State Medical University of Yerevan and Chief of the Children’s Maxillo-facial Clinic at the University Hospital No. 3. While similar surgeries are performed at other Yerevan hospitals, it’s only Clinical Hospital No. 3 that really specializes in such treatment procedures.

Statistics show that globally one in a thousand children are born with this disorder. According to Doctor Kocharyan 40-50 children are born with the disorder annually in Armenia.

Mr. Kocharyan states that, “The cause of the medical anomaly is mostly genetical in nature. However, developmental/environmental factors may also play a role such as a mother suffering from a serious flu during the first 2-3 months of pregnancy when then baby’s craniofacial features are formed, a pregnant mother who is subject to physical trauma or who works in an industrial environment where chemicals are used. Risk factors also include drinking large amounts of alcohol or smoking during pregnancy.

Dr. Kocharyan points out that the condition does not affect the mental development of a child with the disorder. The condition may prevent the child from physically developing at the same rates as children of like age. Children with the disorder are more prone to fall sick than their peers. These children face problems related to the facial skeleton, hearing and the teeth.

This maxillo-facial disorder can be completely treated and removed through surgical techniques. Often times several surgeries are necessary for a complete removal of the condition. Sometimes a small scar remains that can later be corrected by plastic surgery.

Dr. Kocharyan states that, “Such surgeries are considered to be complex in nature. However, we are able to perform 40-50 such procedures a year without any practical complications since we have fifteen years of experience under our belt; experience based on the Soviet school and by studying the latest in European and American innovations. Starting in 1997 we have been using procedures perfected in Europe. During the Soviet era such surgeries lasted some four hours and recovery time was around two weeks. Today, such operations are performed in two hours with only six days of recovery time required. We collaborate with hospitals in the United States and Europe and, if I may modestly say, they have something to learn from us as well.”

“Both before and after surgery the child remains under the watchful eyes of the medical team, Dr. Kocharyan states. The treatment doesn’t end with surgery. There’s an entire team that works with us comprised of pediatricians, psychologists, orthodontists, speech therapists and other specialists. It’s a complete system of care that the child needs to receive.”

The doctor states, “The average cost tag for such surgery in Europe is about fifteen thousand Euros. In Armenia, this procedure as with other medical surgeries performed on children is performed at the expense of the government. The hospital is fully equipped to perform such procedures. The biggest problem the hospital faces is obtaining an adequate supply of surgical stitching. The stitching needed for one of these operations costs about 136 Euros.”

According to the doctor the government doesn’t have the resources to insure an adequate supply of medical stitching. In addition, many of the children afflicted with this condition come from needy families. It’s true that the surgery is performed at no cost to the patient’s family but child needs special care and adequate nutrition afterwards. In these cases both Armenian and foreign charitable agencies and sponsors assist to cover such expenses. These organizations include the 
Fund for Armenian Relief, World Vision International and the benefactors Jack Mazmanian, Levon Toros and others.

Unfortunately, despite all this work, many times parents of these kids prefer to hand them over to institutions that deal with developmentally challenged children.

Dr. Kocharyan says that he sits down with these parents and explains at length that such deformities can be corrected by surgery and that the mental development of these kids isn’t negatively affected and that they will be taken of the disabled list after undergoing rehabilitation. The doctor was able to sway the parents on one occasion. The hospital collaborates with various children’s homes and he has performed surgery on kids already sent to such institutions. There have been cases when the parents have removed their child from such homes after surgery. Sadly, these cases are the exception. More often, such children are adopted by foreign citizens and are relocated overseas.

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