Cleft Lip and Palate

Understanding Cleft Lip and Palate

Cleft lip and cleft palate are congenital conditions that occur when a baby's lip or mouth doesn't form properly during pregnancy. These conditions can affect feeding, speech, hearing, and dental development, but with proper treatment, children can lead healthy, normal lives.

Treatment typically involves a team approach with specialists including oral surgeons, plastic surgeons, orthodontists, speech therapists, and other healthcare professionals working together to provide comprehensive care.

Types of Cleft Conditions

Cleft Lip

A cleft lip occurs when the lip doesn't form completely during fetal development. This can range from a small notch in the lip to a complete separation that extends into the nose.

• Unilateral cleft lip (one side)
• Bilateral cleft lip (both sides)
• Complete or incomplete cleft
• May affect the nose and gum line

Cleft Palate

A cleft palate occurs when the roof of the mouth doesn't close completely during development. This can affect the hard palate, soft palate, or both.

• Hard palate cleft (front part of roof of mouth)
• Soft palate cleft (back part of roof of mouth)
• Complete or incomplete cleft
• May affect speech and feeding

Combined Conditions

Some children are born with both cleft lip and cleft palate, which may require more extensive treatment and multiple surgeries.

Causes and Risk Factors

Genetic Factors

While the exact cause is often unknown, genetic factors may play a role. Children with a family history of cleft lip or palate have a higher risk.

Environmental Factors

• Maternal smoking during pregnancy
• Alcohol consumption during pregnancy
• Certain medications taken during pregnancy
• Maternal diabetes
• Folic acid deficiency

Treatment Timeline

Early Treatment (Birth to 3 Months)

• Specialized feeding techniques
• Nasoalveolar molding (NAM) if needed
• Initial evaluation by cleft team
• Treatment planning

First Surgery (3-6 Months)

• Cleft lip repair surgery
• May include nose reconstruction
• Post-operative care and monitoring

Palate Surgery (9-18 Months)

• Cleft palate repair surgery
• Speech development support
• Continued monitoring

Ongoing Care (2-18 Years)

• Speech therapy
• Dental and orthodontic treatment
• Additional surgeries as needed
• Regular follow-up with cleft team

Surgical Procedures

Cleft Lip Repair

This surgery typically occurs between 3-6 months of age. The surgeon will:

• Close the gap in the lip
• Repair the muscle structure
• Improve the appearance of the nose
• Create a more normal lip contour

Cleft Palate Repair

This surgery usually occurs between 9-18 months of age. The procedure involves:

• Closing the gap in the palate
• Repairing the soft palate muscles
• Creating a functional palate for speech
• Improving feeding ability

Additional Surgeries

Some children may need additional procedures:

• Bone grafting for the gum line
• Nose revision surgery
• Speech surgery if needed
• Dental implant placement

Long-term Care and Support

Speech Therapy

Regular speech therapy helps children develop normal speech patterns and address any speech difficulties related to their cleft condition.

Dental and Orthodontic Care

Children with cleft lip and palate often need specialized dental and orthodontic treatment to address tooth alignment and jaw development issues.

Hearing Care

Regular hearing evaluations are important as children with cleft palate may be more prone to ear infections and hearing problems.

Psychological Support

Emotional support and counseling can help children and families cope with the challenges of living with cleft lip and palate.