Rawat Sumbing Bina Keyakinan

Jangan siang ikan nanti dapat anak sumbing, atau suami yang memancing tidak dibenarkan membuang ikan yang terlekat mata kail joran kerana dikhuatiri mulut bayi yang dilahirkan turut sumbing sepertimana ikan itu.

Demikian pelbagai pantang larang dalam masyarakat kita yang perlu dijaga ketika tempoh kehamilan ibu. Pelanggaran pantang-larang ini akan menyebabkan kecacatan bayi kononnya terkena kenan haiwan itu.

Sumbing atau klef adalah rekahan atau celahan pada struktur bibir atau lelangit. Ketika kira-kira bulan ketiga perkembangan janin, bahagian kepala dan muka terbentuk berasingan sebelum bercantum, namun kegagalan dalam percantuman mengakibatkan rekahan iaitu sumbing.

Klef bibir adalah rekahan pada sebelah atau kedua-dua belah bibir atas sehingga ke dalam hidung termasuk tulang rahang atas dan gusi atas. Klef sebelah (unilateral) berlaku pada satu bahagian bibir, manakala klef kedua-dua belah (bilateral) ialah rekahan pada kedua-dua bahagian bibir.

Klef lelangit pula berlaku apabila bumbung mulut tidak bercantum sepenuhnya, yang menyebabkan pembentukan lubang di lelangit. Ini boleh menjejaskan lelangit lembut iaitu bahagian berdekatan tekak atau lelangit keras iaitu bahagian depan berdekatan mulut, atau kedua-dua bahagian sekali.

Bagaimanapun, punca sumbing tidak diketahui tetapi faktor genetik dan persekitaran seperti pengambilan ubatan tertentu atau alkohol oleh ibu ketika hamil, merokok, kecacatan lain, jangkitan virus dan terdedah kepada bahan kimia boleh menyumbang kepada berlakunya sumbing.

Perunding Pakar Bedah Plastik dan Rekonstruktif Pusat Perubatan Sunway, Dr Margaret Leow berkata, risiko lebih tinggi jika dalam keluarga ada sejarah mengalami kecacatan mulut sama ada sumbing bibir atau lelangit atau kedua-duanya sekali.

“Bayi yang sumbing lelangit akan menghadapi komplikasi seperti sukar menyusu. Pembentukan mulut tidak sempurna menyebabkan bayi tidak berupaya menghasilkan tekanan untuk melakukan hisapan lancar ketika menyusu badan.

Bukaan dalam hidung menyebabkan susu mengalir keluar dari hidung. Susu juga mudah masuk ke dalam hidung dan bayi yang sukar menyusu berdepan masalah malnutrisi.

“Bagi mengatasi masalah ini, menyusukan bayi dalam kedudukan tegak dengan badan dan kepala disokong dapat membantu penyusuan selain mengurangkan susu masuk ke dalam hidung. Penggunaan botol susu khas dan puting untuk bayi klef juga membantu,” katanya.

Jelasnya, kanak-kanak dengan klef lelangit juga berisiko tinggi mendapat jangkitan telinga kerana cenderung berlaku pengumpulan air di bahagian telinga tengah. Jangkitan yang tidak dirawat boleh menjejaskan pendengaran. Bagi mengatasi masalah, tiub khas dimasukkan ke dalam gegendang telinga untuk mengeluarkan cecair.

Pemeriksaan telinga (audiometry) boleh dilakukan bagi menilai tahap pendengaran. Ini kerana, kekurangan pendengaran boleh merencat perkembangan pertuturan. Seterusnya pertuturan juga tidak fasih kerana otot lelangit tidak berfungsi dengan sempurna.

“Masalah pertuturan juga membabitkan klef bibir dan suara yang dihasilkan berbunyi sengau. Oleh itu, penilaian dan terapi pertuturan oleh pakar patologi pertuturan dapat membantu mereka bercakap dengan lebih baik.

“Kecacatan pada gusi atas dan lelangit akan menyebabkan bayi klef mempunyai bentuk gigi yang tidak normal atau tiada gigi. Masalah ini diatasi dengan pembedahan ortodontik, namun kebersihan mulut mesti senantiasa dititikberatkan,” katanya.

Dr Margaret berkata, disebabkan banyak komplikasi membabitkan pertuturan, pendengaran, pergigian dan masalah kosmetik, bayi klef selalunya menghadapi masalah kurang keyakinan diri, sekali gus menjejaskan psikologinya.

“Klef bibir dan lelangit boleh diperbetulkan menerusi pembedahan dan rawatan lanjut selepas pembedahan yang perlu dilakukan sedikit demi sedikit mengikut usia.

“Bibir sumbing diperbetulkan ketika bayi berusia tiga bulan, manakala pembetulan lelangit dibuat antara usia sembilan hingga 18 bulan.

“Pembetulan bahagian atas gusi bertulang (alveolus) dilakukan dengan pemindahan tisu tulang dari pinggul ketika berusia tujuh hingga 10 tahun,” katanya.

Dr Margaret seterusnya berkata, pasukan pembedahan dan rawatan untuk bayi klef membabitkan pakar bedah plastik, pakar bedah maksilofasial, pakar kanak-kanak, pakar gigi kanak-kanak, pakar telinga, hidung dan tekak, pakar pergigian, pakar terapi pertuturan, pakar genetik dan jururawat.

“Pembedahan lain mungkin diperlukan seperti membuang tisu lelangit lembut (pharyngoplasty) untuk pertuturan lebih baik dan pembedahan pembetulan rahang membabitkan tulang mulut dan dagu (orthognathic) dalam tempoh kanak-kanak klef membesar.

“Pembedahan kecil untuk mencantikkan lagi bibir atau hidung mungkin perlu berdasarkan tahap kecacatan dialami. Rawatan dilakukan seawal bayi dan berterusan sehingga dewasa.

“Lebih baik susulan rawatan dilakukan berkala setahun sekali bagi mengesan masalah lain yang boleh dicegah awal. Rawatan pemulihan dan kaunseling psikologi serta interaksi dalam kumpulan sokongan juga membantu mereka yang sumbing berasa lebih yakin dengan diri masing-masing,” katanya

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