What are cleft lip and palate?

This cleft lip problem occurs when a baby is born with a cleft in the upper lip and/or palate. These orofacial fissures or clefts are among the most common congenital anomalies or malformations.

A baby can be born:

  • only with cleft lip
  • cleft palate only
  • or with both at the same time (cleft lip and palate).

This problem occurs when a baby is born with an opening (cleft) in the palate. The opening leaves a gap between the nose and the mouth.

This opening can:

  • occur at the back or back of the palate (the soft palate) or
  • extend to the front or front part of the palate, behind the gums (the hard palate)

Babies born with a cleft lip have a narrow opening or cleft in the upper lip. This occurs when the baby’s lip does not form properly early in pregnancy, causing a cleft.

In addition, the fissure can affect:

only on one side of the lip ( unilateral cleft lip ) It is the most common type.

Cracks vary in size:

  • Some are a mere notch in the lip ( incomplete cleft lip ).
  • Others extend from the lip to the nostrils, passing through the upper gums ( complete cleft lip ).

If the opening of the palate connects with the opening of the gums and lip, the baby has a cleft lip and palate.

Causes of cleft palate and cleft lip

During the period of gestation, normally the bones and skin of the baby’s upper jaw, nose, and mouth join together (or fuse) to form the palate and upper lip. It is the situation when the lip and/or palate do not fuse completely, the baby is born with a cleft or cleft in the lip and/or palate.

Doctors don’t always know why a baby has developed a cleft lip or palate, but they think some cases may be related to genetic (inherited) factors. Likewise, some environmental factors can increase the risk of a baby presenting this anomaly or congenital malformation (which is born with it), such as the following:

  1. taking certain medications (such as anti-seizure drugs) during pregnancy
  2. not getting an adequate amount of prenatal nutrients
  3. being exposed to some chemicals during pregnancy
  4. smoking tobacco, using drugs, and/or drinking alcohol during pregnancy

How are cleft lip and palate diagnosed?

Cleft lip and palate are usually found when a baby is born. Sometimes they are found on prenatal ultrasound scans. If a baby does not have a cleft lip, their cleft palate will be harder to see. Doctors usually detect a cleft palate when they look and feel inside the baby’s mouth during the first newborn exam.

How are cleft lip and palate treated? 

Cleft lip and palate can cause problems in the:

  • feeding
  • growth and development
  • ear infections and hearing
  • speech development

Therefore, it is important to correct the cleft lip and palate with surgery, operating on the child when he is still young.

Cleft lip repair

A plastic surgeon will first repair your baby’s cleft lip when he or she is about three months old. This is done through a type of operation called a cheiloplasty. It is done in a hospital while the baby is under general anesthesia.

The objectives of this operation are:

  • Close the crack.
  • Improve the shape of the nose and upper lip

Properly close the opening in between your nose and the mouth. 

If the cleft is wide, special procedures, such as lip bonding or nasoalveolar molding, may be needed to bring the lip parts closer together and improve the shape of the nose before the cleft lip is repaired. The operation that repairs the cleft lip usually leaves a small scar under the nose.

cleft palate repair

The Cleft palate is usually repaired with an operation called palatoplasty , which is usually done when the baby is 10 to 12 months old. The goals of palatoplasty are:

  1. Close the opening between the nose and the mouth.
  2. Help create a palate that works well and allows speech.
  3. Prevent solid and liquid food from escaping through the nose.

In palate repair operations, plastic surgeons:

  • They close the crack in layers.
  • They reorganize and repair the muscles of the soft palate so that they work better during speech.
  • Two incisions (cuts) are made on each side of the palate behind the gums to reduce stress during the operation.

This operation requires general anesthesia and takes approximately 2 to 3 hours. Most babies can go home 1 to 2 days after being admitted to the hospital. The stitches dissolve on their own.

Your child will need to be on a liquid diet for a week or two, and they may be on a soft diet for several more weeks before returning to their usual diet. Your child may be asked to wear special sleeves to prevent bending of the elbows. These sleeves are put on to prevent babies from putting their fingers or other hard objects in their mouths, which could reopen the repaired cleft.

Laurence Deleon

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