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Schisis surgery
Schisis surgery is surgery on patients with a cleft lip, jaw or palate. These are congenital malformations that can occur separately or concurrently, and can be present unilaterally or bilaterally. The most common form of schisis is the unilateral lip, jaw and palate cleft. It is an embryonic fusion disorder. About 400 ?schisis babies? are born in the Netherlands every year. In Caucasians, schisis occurs in roughly 1: 800 births. In Chinese babies it is more common, occurring roughly every 1 : 400 to 1 : 600 births. It is less common in black babies (about 1 : 1000 births). Based on these data, and on the fact that it is more common in certain families, it can be concluded that genetics play a role in this malformation. A clear link has also been found between use of Diophantine (an anti-epilepsy drug) during pregnancy and the occurrence of schisis. Beyond this, we do not really know the cause of the schisis. This means it cannot be prevented (other than by not using Diophantine during pregnancy).  
Schisis can be treated very well these days. So-called schisis teams are in charge of treatment. Schisis teams can be differentiated into closed (all members work in one hospital) and open (members cooperate from a distance) teams. We work in open teams. This means the schisis operations take place in Leerdam and Gorinchem, but you can visit your local pediatrician, orthodontist, ENT specialist, speech therapist and dentist.
Schisis teams are generally composed of a surgeon (in our case a jaw surgeon), a pediatrician, an orthodontist, an ENT specialist, a speech therapist and a contact person or group that parents can turn to for support and information at any time (in our case, the vereniging voor aangeboren gelaatsafwijkingnen ? the association for congenital facial malformations ? in Ekeren, Belgium).
Children with schisis risk becoming estranged from their own home environments due to extended stays in hospitals; this is known as hospitalization. We are generally able to limit the number of operations to 4. Lip and vellum plasties take place at an age when long-term memory has yet to develop. Palatum plasty operations/closing of a cleft jaw and rhinoplasty/secondary lip correction/placement of dental implants take place around the ages of 9 and 18 respectively. Only prior to and immediately following these operations will the patient visit the hospital a few times. Hospitalization is therefore not an issue in our open schisis team. Click the appropriate topic in the main menu for information on operation techniques and the order in which they (normally) occur in the treatment schedule.
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