Cleft Lip & Palate

Cleft Lip & Palate

During early pregnancy, separate areas of the face develop individually and may not properly join together. This separation is referred to as a cleft.

A completely formed lip is important for normal facial appearance, sucking, and forming certain sounds made during speech. A cleft lip is a condition that creates an opening in the upper lip between the mouth and nose. It looks as though there is a split in the lip. It can range from a slight notch in the colored portion of the lip to a complete separation in one or both sides of the lip extending up and into the nose. A cleft on one side is called a unilateral cleft, and a bilateral cleft is separation occurs on both sides.


Cleft Palate

Cleft lip and palate diagramThe palate is bone and muscle that makes up the roof of your mouth. It is covered by thin, wet skin that is the red covering inside the mouth. The palate plays an important role during speech and in eating. The palate prevents air from blowing out of your nose instead of your mouth and prevents food and liquids from going up the nose.

Similar to a cleft lip, a cleft palate occurs in early pregnancy. A cleft palate occurs when there is an opening in the rood of the mouth. The back of the palate is called the soft palate while the front is known as the hard palate. A cleft palate can range from just an opening at the back of the soft palate to nearly a complete separation of the roof of the mouth (soft and hard palate).

As a result of the lip and palate developing separately, it is possible for a child to be born with a cleft lip, palate, or both. These defects occur in about one out of every 800 babies. Babies with a cleft palate may have a small chin and difficulties with breathing easily. This condition may be called Pierre Robin sequence.

Children born with either or both of these conditions usually need the skills of several professionals to manage the problems associated with the defect such as feeding, speech, hearing and psychological development. In most cases, surgery is recommended. Oral and maxillofacial surgeons can product effective and positive results for children with this condition.


Cleft Lip Treatment

Cleft lip surgery is usually performed when the child is around 10 years old. The goal of surgery is to close the separation, restore muscle function, and provide a normal shape to the mouth. The nostril deformity may be improved as a result of the procedure or may require a subsequent surgery.


Cleft Palate Treatment

A cleft is initially treated with surgery safely when the child is between 7 to 18 months old. This depends upon the individual child and his/her own situation, such as associated health problems.


The Major Goals Of Surgery Are To:

  1. Close the gap or hole between the roof of the mouth and the nose.
  2. Reconnect the muscles that make the palate work.
  3. Make the repaired palate long enough so that the palate can perform its function properly.

There are many different techniques that surgeons will use to accomplish these goals. The choice of these techniques may vary between surgeons and should be discussed between the parents and the surgeon prior to surgery.

The cleft hard palate is generally repaired between the ages of 8 and 12 when cuspid teeth begin to develop. The procedure involves placement of bone from the hip into the bony defect, and closure of the communication from the nose to the gum tissue in three layers. It may also be performed in teenagers and adults as an individual procedure or combined with corrective jaw surgery.


What Can Be Expected After The Surgery?

After the palate has been fixed, children will immediately have an easier time swallowing food and liquids. However, in about one out of every five children, the repair will split, causing a new hole to form between the nose and mouth. This hole is referred to as a “fistula,” and may need further surgery to correct. If small, this hole may result in only an occasional minor leakage of fluids into the nose. However, if the hole is large, it can cause significant eating problems and how the child speaks.