Cleft Palate

By: Peyton Borel

Cleft Lip and Cleft Palate

Cleft lip and cleft palate are facial and oral malformations that occur very early in pregnancy while the baby is developing inside the mother. Clefting results when there is not enough tissue in the mouth or lip area, and the tissue that is available does not join together properly.

What is it?

A cleft lip is a physical split or separation of the two sides of the upper lip and appears as a narrow opening or gap in the skin of the upper lip. This separation often extends beyond the base of the nose and includes the bones of the upper jaw and/or upper gum.

A cleft palate is a split or opening in the roof of the mouth. A cleft palate can involve the hard palate (the bony front portion of the roof of the mouth), and/or the soft palate (the soft back portion of the roof of the mouth)

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Cleft lip and cleft palate can occur on one or both sides of the mouth. Because the lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate, a cleft palate without a cleft lip, or both together.
Cleft lip, with or without cleft palate, affects one in 700 babies annually, and is the fourth most common birth defect in the U.S. Clefts occur more often in children of Asian, Latino, or Native American descent. Compared with girls, twice as many boys have a cleft lip, both with and without a cleft palate. However, compared with boys, twice as many girls have cleft palate without a cleft lip.

History

No one really knows who discovered the cleft lip/palate because it has been around forever. Spartans and Romans would even kill the children as they were considered to harbour evil spirits.

Signs and Symptoms

A child may have one or more birth defects.

A cleft lip may be just a small notch in the lip. It may also be a complete split in the lip that goes all the way to the base of the nose.

A cleft palate can be on one or both sides of the roof of the mouth. It may go the full length of the palate.

Other symptoms include:

  • Change in nose shape (how much the shape changes varies)
  • Poorly aligned teeth

Problems that may be present because of a cleft lip or palate are:

  • Failure to gain weight
  • Feeding problems
  • Flow of milk through nasal passages during feeding
  • Poor growth
  • Repeated ear infections
  • Speech difficulties

How does it happen?

No one knows why a particular baby has cleft lip or cleft palate. Sometimes the condition runs in families. This means that a person with cleft lip or cleft palate may have a relative with the same thing. Other times, cleft palate is part of a syndrome, meaning there are birth defects in other body parts, too. Sometimes a cleft may be related to what happened during a mother's pregnancy, like a medication she may have taken, a lack of certain vitamins, or exposure to cigarette smoke. Most of the time, however, the cause of the cleft is unknown.

Treatment

A cleft lip may require one or two surgeries depending on the extent of the repair needed. The initial surgery is usually performed by the time a baby is 3 months old. Repair of a cleft palate often requires multiple surgeries over the course of 18 years. The first surgery to repair the palate usually occurs when the baby is between 6 and 12 months old.