Actor Dileep, star, sound Thoma, bollywood, cleft lip, cleft palate, nose, plastic surgery, India, cosmetic surgery, India, Dr Alexander, cochin, kerala, India, medical tourism, kochi+ +

A lot of people - friends, patients, relatives and well wishers have been asking me about Dileep's new movie "Sound Thoma', in which Dileep plays 'Thoma', a gentleman from an affluent family, who suffers from a cleft lip deformity, with Namitha Pramod playing the heroine. The movie, produced by Anoop and directed by Vysakh, promises to be another hit. The picture below is from WWW. kerala9.com

Dileep is a wonderful and versatile actor who has wooed the audience with his acting skills in movies like ‘chandupottu’ and ‘kunjikoonan’ besides others. I too am a fan of Dileep having watched many of his movies and feel that he is now moving slowly into the class of Mamooty and Mohanlal.

That brings us to the topic of cleft lip and the question which everybody is asking me- do all cleft lip patients have speech abnormalities?

Not really!!

Cleft lip is part of a congenital (From birth) abnormality that may manifest by itself in its minor form or may be associated with other defects off the palate, jaw, and nose.

As the child grows in the mother’s womb the lip and palate start developing in the first 4-6 weeks. The clefting occurs because of the failure of the tissues to unite from either side as the face begins to develop.

Depending on the degree of failure of fusion the baby may have any of these abnormalities

Cleft lip only

Cleft lip and alveolus (the area where the teeth are attached to the jaw bone)

Cleft lip+ alveolus + nose deformity

Cleft lip + alveolus + palate + nose deformity

Cleft lip + alveolus +palate +nose deformity +premaxillary deformity (Upper jaw)

Cleft lip is more common in males as compared to females (2:1) and the overall incidence is 1 in every 1000 live births.

Interestingly the ration of cleft lip and palate deformity to cleft lip is only 2:1

The picture below is of a cleft lip and palate child. 

Why does cleft lip occur?

Sometimes they occur because the abnormality runs in the family or is carried in the genes. They can be part of a syndrome where other organs are affected. At other times, they may occur spontaneously without any family history.

Are there any risk factors that we can avoid to reduce the occurrence of cleft lip?

Yes during pregnancy avoid the use of these medications when possible- phenytoin, methyl prednisolone, steroids, Phenobarbital, diazepam, isotretinoin. Older parents (>30years) have a higher chance of getting a cleft lip baby. So plan your babies at an early age. Avoid smoking during pregnancy.

What abnormality does Dileep as ‘Sound thoma’ have?

From the movie still pictures he seems to have

1.     A cleft lip

2.     A nose deformity

What about a palate deformity and speech problems?

Well, since ‘Sound thoma’ has a significant speech defect, he must have a cleft palate or palate deformity. The whole movie is based on his speech problem and patients with only cleft lip do not have a significant speech problem as with cleft palate patients, except for certain alphabets and words. If the palate is clefted, air escapes into the nose, while we try to speak and a nasal toned speech develops and sounds funny and difficult to understand.

What can we do for ‘Sound Thoma?’

Well normally a cleft lip is operated at 3 months and the cleft palate at 6 months. Speech deformity is evaluated at 2 to 4 years and operated on if necessary if speech therapy fails. Teeth and alveolar deformity is corrected by 7 to 10 years. Nose deformity is corrected as it develops. Sometimes even jaw surgery may be needed. ‘Sound thoma’ has past all these ‘ages’. Still his lip and nose can be cosmetically corrected to make him more handsome. The palate can be operated and along with speech therapy the speech can be improved, but a normal speech is unlikely as speech in a baby develops by 2 years and it is very difficult to correct brain patterns and habits developed over years.

 

The secret in treating a cleft lip/palate baby is timing. By subjecting the child to surgery at the right time we can try to minimize his defects and problems and make him lead a normal social life. A child with a cleft lip operated as per the protocol is seen below.

Dileep has done a great service to the cleft lip patients by creating awareness through his film.

May this film be a super hit!!

+Am off to watch this movie…………..