Episode Transcript
Announcer: 来自犹他大学医生和专家的医学新闻和研究，你可以用它来过上更快乐、更健康的生活. You are listening to The Scope.
Interviewer: 你在超声波检查中发现你的孩子可能患有唇裂. What should you do after that? 接下来会发生什么，你需要知道哪些事情? Dr. Barbu Gociman is a plastic surgeon and a specialist in pediatric plastic surgery at the Cranial Facial Program at University of Utah. First of all, what is a cleft lip exactly? What's going on?
Dr. Gociman: Yes, it's not an extremely easy question to answer. 这是一种反常的生物发育问题形成面部尤其是嘴唇, do not come together. It can be associated with a clefting of the palate. There are different degrees of clefting present. What a cleft means is basically an opening where, instead of the tissues coming together, they do not, and the bigger the defect, 显然，这些元素之间的差距就越大.
Interviewer: 所以在超声检查中，他们可能会指出可能有唇裂. It could be very minor to very major. And what's that extreme?
Dr. Gociman: Yes, exactly. There is a whole spectrum. 它可以从你在嘴唇上看到的皱纹开始，这在超声波上是看不到的. To mind comes, Joaquin Phoenix as an actor that has that deformity, as a personality that you can always look up. 从那时起，你可能会有不同程度的畸形, just small degrees of notching in the lip. 它可以一直延伸到鼻子延伸到肺泡, which is the bony part carrying the teeth, and all the way into back of the palate, which is the roof of the mouth, can be completely clefted.
Interviewer: And do the ultrasounds, 你能很好地预测到情况会有多糟吗? 或者父母在孩子出生后会更加惊讶?
Dr. Gociman: Yeah, the ultrasound, obviously is a good modality to diagnose, but as any diagnostic modality, it's not 100%. 所以你不能完全知道程度或确切的结构受到影响，直到你真正看到婴儿，你可以检查他.
Interviewer: 这个程度可能意味着在儿童时期进行一次手术或多次手术之间的区别, up until 18, 19 years old.
Dr. Gociman: Yeah, exactly. 所以这是一个循序渐进的过程在过去50年左右的时间里得到了验证, 显然，大发娱乐治疗这些病人的方法还在不断改进. 因此，如果只涉及到嘴唇，通常一次手术就足以矫正畸形. 对于唇部和上颚更严重的畸形的治疗顺序是大发娱乐开始用胶带或者做大发娱乐所说的鼻牙槽成型, 哪一种会重塑结构并使它们处于更解剖的位置以便于手术修复. That is done by our orthodontist, Dr. Duane Yamashiro, and requires multiple adjustment. 这将持续大约三个月的生命.
大发娱乐通常在三个月左右做唇部修复. At the same time we examine the palate, if the palate defect is really wide, we insert a palatal prosthesis, which is an obdurator that will facilitate feeding.
第二次手术在10个月到1岁左右进行，这是软腭修复. That is done right before the speech develops. 如果出现较大的硬腭裂大发娱乐通常会更换腭假体. We repair the hard palate at around four years. 在六岁时，大发娱乐用植骨术修复牙槽骨裂, if the baby has that problem. 最后大发娱乐会在青少年后期做一个正式的鼻整形手术如果鼻畸形仍然持续.
Interviewer: 我可以想象，父母最关心的问题之一就是孩子的外表. 听起来，如果不进行这些手术，很多功能上的东西也不会正常. But as far as physical appearance, 你能把一个人带回到你看不出他曾经有过兔唇的地步吗?
Dr. Gociman: 不幸的是，要完全、无疤痕地修复一个人，这是不可能的. 作为人类，大发娱乐通过留下疤痕来治愈，所以你总是会看到疤痕. The quality of the scar can be from a very, very thin line, 这对于一个不太了解自己所看到的东西的人来说是无法察觉的, 到一个相当厚的疤痕需要修复或类固醇注射或疤痕治疗. That is at the level of the lip.
As I said, because the nose is mis-shaped by the deformity, 通常眼睛会被那个畸形吸引. 这就是为什么大发娱乐花了很多努力用解剖学的方式重建鼻子，试图避免这种情况发生. We do the cleft lip repair at three months of age, 只是因为大发娱乐希望父母和所有接触过孩子的人都能看到一个正常的孩子. We do not want them to get used to the clefted baby.
All the other functional portions, the palate actually, functionally, 上颚的修复更为重要，因为上颚与语言有关, is involved in swallowing. So functionally that is more important. But what we see, and it's human, we judge, where most of the people, 嘴唇修复是最重要的一步，这就是为什么大发娱乐首先做它, and that's why we pay a lot of attention to it.
Interviewer: I'm sitting here, 听到这些，在某种程度上，我的心为那些发现这可能是他们的孩子将不得不面对的事情的父母而破碎. How do you even address that? What do you say? How can people find comfort?
Dr. Gociman: It's definitely not an easy process. 幸运的是，特别是现在有很多支持团体. 大发娱乐总是可以让你和那些经历过大发娱乐小组的家庭取得联系. That brings a lot of comfort. It's very difficult, 尤其是当你觉得自己独自面对这么大的, challenging problem. 但大发娱乐犹他大学的颅面项目有答案，大发娱乐很高兴能多次解决所有问题. Our phone number that you can reach us is 801-581-7719. The Cranial Facial Center is the way to go.
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