{"id":7363,"date":"2026-08-13T06:00:00","date_gmt":"2026-08-13T06:00:00","guid":{"rendered":"https:\/\/www.belodonte.es\/?p=7363"},"modified":"2026-06-23T07:09:03","modified_gmt":"2026-06-23T07:09:03","slug":"llavi-lepori-la-fenedura-palatina-abordatge","status":"publish","type":"post","link":"https:\/\/www.belodonte.es\/ca\/llavi-lepori-la-fenedura-palatina-abordatge\/","title":{"rendered":"Llavi lepor\u00ed i la fenedura palatina: abordatge"},"content":{"rendered":"\n

El llavi lepor\u00ed i la fenedura palatina<\/strong> s\u00f3n les malformacions cong\u00e8nites craniofacials m\u00e9s freq\u00fcents. Es produeixen durant les primeres setmanes de gestaci\u00f3, quan les estructures que formen el llavi superior i el paladar no es fusionen correctament.<\/p>\n\n\n\n

Encara que el seu diagn\u00f2stic genera una preocupaci\u00f3 comprensible en les fam\u00edlies, l’abordatge quir\u00fargic actual, amb un tractament multidisciplinari planificat per etapes, permet obtenir resultats funcionals i est\u00e8tics excel\u00b7lents en la gran majoria dels casos.<\/p>\n\n\n\n

Qu\u00e8 s\u00f3n el llavi lepor\u00ed i la fenedura palatina?<\/h2>\n\n\n\n

El llavi lepor\u00ed (o llavi fissurat) \u00e9s una esquerda en el llavi superior que es produeix quan els processos facials embrionaris no es fusionen completament durant la sisena i setena setmana de gestaci\u00f3.<\/p>\n\n\n\n

El fenedura palatina \u00e9s una esquerda en el paladar (el sostre de la boca) que resulta de la falta de fusi\u00f3 de les estructures palatines entre l’octava i la dotzena setmana de desenvolupament embrionari.<\/p>\n\n\n\n

Totes dues condicions poden presentar-se de forma a\u00efllada o combinada (llavi lepor\u00ed amb paladar fenedura, la presentaci\u00f3 m\u00e9s freq\u00fcent), i poden ser unilaterals o bilaterals, completes o incompletes. La seva incid\u00e8ncia global s’estima entorn d’1 de cada 700 nascuts vius, amb variacions significatives segons l’origen \u00e8tnic i geogr\u00e0fic de la poblaci\u00f3 estudiada.<\/p>\n\n\n\n

Quines s\u00f3n les causes d’aquesta malformaci\u00f3 cong\u00e8nita?<\/h2>\n\n\n\n

L’origen del llavi lepor\u00ed i la fenedura palatina \u00e9s multifactorial, resultat de la interacci\u00f3 entre predisposici\u00f3 gen\u00e8tica i factors ambientals durant l’embar\u00e0s.<\/p>\n\n\n\n

Hi ha un component hereditari ben documentat: el risc augmenta significativament quan hi ha antecedents familiars de la mateixa malformaci\u00f3.<\/p>\n\n\n\n

Entre els factors ambientals amb m\u00e9s evid\u00e8ncia es troben el consum de tabac i alcohol durant l’embar\u00e0s, el d\u00e8ficit d’\u00e0cid f\u00f2lic en les primeres setmanes de gestaci\u00f3, determinats f\u00e0rmacs anticonvulsius utilitzats durant el primer trimestre, la diabetis materna mal controlada i les infeccions virals durant l’embar\u00e0s.<\/p>\n\n\n\n

En aproximadament el 30% dels casos l’esquerda forma part d’una s\u00edndrome gen\u00e8tica m\u00e9s \u00e0mplia (com la s\u00edndrome de Van der Woude o la s\u00edndrome velocardiofacial), mentre que en el 70% restant es presenta com una anomalia a\u00efllada no sindr\u00f2mica.<\/p>\n\n\n\n

Com afecta aquesta condici\u00f3 a l’alimentaci\u00f3 i el desenvolupament del beb\u00e8?<\/h2>\n\n\n\n

La fenedura palatal, especialment quan afecta el paladar complet, interfereix de manera directa amb la capacitat del beb\u00e8 per a generar la pressi\u00f3 negativa necess\u00e0ria per a succionar de manera efica\u00e7, la qual cosa dificulta significativament la lact\u00e0ncia materna convencional i obliga amb freq\u00fc\u00e8ncia a l’\u00fas de biberons i tetines especials dissenyats espec\u00edficament per a aquests casos.<\/p>\n\n\n\n

La comunicaci\u00f3 an\u00f2mala entre la cavitat oral i la nasal tamb\u00e9 afavoreix el pas de l\u00edquids i aliments cap al nas durant l’alimentaci\u00f3, aix\u00ed com un risc m\u00e9s elevat d’otitis mitjana recurrent per alteraci\u00f3 de la funci\u00f3 de la trompa d’Eustaqui.<\/p>\n\n\n\n

El seguiment nutricional especialitzat en les primeres setmanes de vida \u00e9s fonamental per a garantir un guany de pes adequat mentre es planifica el calendari quir\u00fargic.<\/p>\n\n\n\n

Quin \u00e9s el calendari quir\u00fargic habitual?<\/h2>\n\n\n\n

El tractament del llavi lepor\u00ed i la fenedura palatal segueix un protocol per etapes, escalonat al llarg de la inf\u00e0ncia i l’adolesc\u00e8ncia, dissenyat per a optimitzar tant el resultat funcional com el desenvolupament craniofacial del nen.<\/p>\n\n\n\n

La cirurgia del llavi (quelopl\u00e0stia) es realitza habitualment entre els 3 i els 6 mesos d’edat, quan el beb\u00e8 ha aconseguit un pes i un estat general adequats per a l’anest\u00e8sia general. La cirurgia del paladar (palatopl\u00e0stia) es realitza posteriorment, entre els 9 i els 18 mesos, abans de l’inici del desenvolupament actiu del llenguatge, ja que el tancament palat\u00ed \u00e9s determinant per a l’adquisici\u00f3 d’una fonaci\u00f3 normal.<\/p>\n\n\n\n

En etapes posteriors poden ser necess\u00e0ries intervencions addicionals com l’empelt ossi alveolar (entre els 8 i els 11 anys, coincidint amb l’erupci\u00f3 del can\u00ed permanent), la cirurgia nasal correctiva i, en l’adolesc\u00e8ncia, la cirurgia ortogn\u00e0tica si existeix una discrep\u00e0ncia significativa entre els maxil\u00b7lars.<\/p>\n\n\n\n

Quin paper exerceix l’equip multidisciplinari en el tractament?<\/h2>\n\n\n\n

El tractament del llavi lepor\u00ed i la fenedura palatal \u00e9s un dels exemples m\u00e9s clars de la necessitat d’un abordatge multidisciplinari coordinat a llarg termini.<\/p>\n\n\n\n

L’equip habitual inclou el cirurgi\u00e0 maxil\u00b7lofacial o pl\u00e0stic (responsable de les intervencions quir\u00fargiques), al ortodontista (que guia el desenvolupament dels maxil\u00b7lars i prepara el terreny per a les cirurgies), al logopeda (fonamental per al desenvolupament de la parla i la correcci\u00f3 de la resson\u00e0ncia nasal caracter\u00edstica d’aquests pacients), a l’otorrinolaring\u00f2leg (per l’alta incid\u00e8ncia de problemes auditius associats) i al psic\u00f2leg, que acompanya tant al nen com a la fam\u00edlia al llarg d’un proc\u00e9s de tractament que s’est\u00e9n durant anys.<\/p>\n\n\n\n

La coordinaci\u00f3 entre tots aquests especialistes, idealment en unitats espec\u00edfiques amb experi\u00e8ncia acumulada en aquesta patologia, \u00e9s un dels factors que m\u00e9s influeix en el resultat final.<\/p>\n\n\n\n

Quins resultats es poden esperar amb el tractament actual?<\/h2>\n\n\n\n

Els avan\u00e7os en les t\u00e8cniques quir\u00fargiques, en la planificaci\u00f3 ortod\u00f2ntica prequir\u00fargica i en l’abordatge multidisciplinari coordinat han millorat de forma molt significativa els resultats funcionals i est\u00e8tics en les \u00faltimes d\u00e8cades.<\/p>\n\n\n\n

La gran majoria dels pacients tractats en unitats especialitzades aconsegueixen un desenvolupament de la parla dins de par\u00e0metres normals, una funci\u00f3 masticat\u00f2ria adequada i un resultat est\u00e8tic que els permet fer una vida completament normal.<\/p>\n\n\n\n

L’\u00e8xit a llarg termini dep\u00e8n en gran manera del compliment del calendari quir\u00fargic, del seguiment continuat durant tota la inf\u00e0ncia i adolesc\u00e8ncia, i de l’experi\u00e8ncia espec\u00edfica de l’equip tractant en aquesta patologia concreta, que requereix un volum de casos suficient per a mantenir la per\u00edcia t\u00e8cnica necess\u00e0ria.<\/p>\n\n\n\n

Si has rebut un diagn\u00f2stic de llavi lepor\u00ed o fenedura palatal durant l’embar\u00e0s o en n\u00e9ixer el teu beb\u00e8, cerca un equip multidisciplinari amb experi\u00e8ncia espec\u00edfica en aquesta patologia. L’acompanyament des del primer moment marca una difer\u00e8ncia real en tot el proc\u00e9s.<\/p>\n","protected":false},"excerpt":{"rendered":"

El llavi lepor\u00ed i la fenedura palatina s\u00f3n les malformacions cong\u00e8nites craniofacials m\u00e9s freq\u00fcents. Es produeixen durant les primeres setmanes de gestaci\u00f3, quan les estructures que formen el llavi superior i el paladar no es fusionen correctament. Encara que el […]<\/p>\n","protected":false},"author":3,"featured_media":7355,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[35],"tags":[],"class_list":["post-7363","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-odontopediatria-2"],"yoast_head":"\nLlavi lepor\u00ed i la fenedura palatina: abordatge - Cl\u00ednica Belodonte<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.belodonte.es\/labio-leporino-paladar-hendido-abordaje\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Llavi lepor\u00ed i la fenedura palatina: abordatge - Cl\u00ednica Belodonte\" \/>\n<meta property=\"og:description\" content=\"El llavi lepor\u00ed i la fenedura palatina s\u00f3n les malformacions cong\u00e8nites craniofacials m\u00e9s freq\u00fcents. 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