A cleft lip or palate is one of the most common birth defects because, during early pregnancy, the separate areas of a child’s face develop independently and then join together. If the two sections on the right and left don’t meet properly, the result is a cleft. If a separation only appears on the upper lip, then it is a cleft lip.
A completely formed lip is necessary in the human body because it needs to be able to move to suck in air and form proper sounds during speech. Possessing a normal facial appearance is also crucial for a child’s self-esteem. A cleft and cleft lip varies, but it typically appears as an opening in the lip between the mouth and nose, and can range from a slight notch to a complete separation. A cleft on only one side is a unilateral cleft, while one on both sides is termed a bilateral cleft.
Sometimes, a cleft in the gum may occur in association with the cleft lip. As with cleft lips, a cleft in the gum can range from being a small, visible notch to being a complete division of the left and right parts. If there is a defect in the roof of the mouth, then this is termed a cleft palate.
The roof of the mouth is called the palate, and it is made of bone and muscle before being covered with the skin that forms the inside of the mouth. You can feel the palate by touching the roof of your mouth with your tongue. It plays an important role in separating the nasal cavity from the mouth, while also allowing humans to speak by stopping air from blowing out through the nose instead of the mouth. It further prevents foods and liquids from slipping up into the nose.
Similar to a cleft lip, a cleft palate occurs in early pregnancy when the separate sides of the face develop and then join. When someone says a child has a cleft palate, it means there is a hole in the opening of the roof of the mouth, typically in the back (soft palate) but also in the front (hard palate). The severity of a cleft palate ranges from a small opening in the back of the mouth to an almost complete separation in the roof of the mouth. Both can be quite dangerous as it means food and liquids can slip into the nose and airway.
Sometimes a baby born with a cleft palate will also have a small chin, which makes breathing difficult. The condition is often called Pierre Robin sequence and is a combination that needs to be fixed for the child’s health. Children can be born with a cleft lip and palate at the same time.
It’s not uncommon for babies to be born with a cleft defect, since they occur in around 1 out of every 800 babies. Children born with any kind of cleft condition typically need to see multiple professionals to manage problems associate with feeding, speaking, hearing, and psychological development because the early years are crucial to health and wellness. In most cases, surgery is recommended to correct the problem. Surgeries completed by experienced, qualified oral and maxillofacial surgeons like Dr. Adamous and Dr. Sonnichsen often produce positive results and outcomes for both the child and parents.
Cleft Lip Treatment
Cleft lip surgery is typically completed when a child reaches ten years old. The goal is to close the separation in the mouth, restore the function of the muscles, and also produce a normal mouth shape. Sometimes a nostril deformity can be addressed during the procedure, or it might require another surgery.
Cleft Palate Treatment
A cleft palate is typically treated with a safe surgery when the child is between 7-18 months old. Each individual will be different, so sometimes children will require the procedure later in life.
The major goals of surgery are to:
- Close the gap or hole between the roof of the mouth and the nose
- Reconnect the muscles that make the palate work
- Make the repaired palate long enough so that it can perform its function properly
There are different techniques surgeons use to accomplish these goals, so the techniques should be discussed between the surgeon and parents prior to surgery to find the right fit.
If a child has a cleft hard palate, then the repair can be done between the ages of 8-12, when the cuspid teeth have started to develop and emerge. In most cases, the procedure involves moving a piece of bone from the hip to the mouth and then closing the gap between the gum tissues. This seals the palate and separates the nose and mouth from one another. This procedure can also be performed on teenagers and adults, or done in combination with corrective jaw surgery.
What Can Be Expected After The Surgery?
After the palate is fixed, children tend to have an easier time swallowing food and liquids. Unfortunately, 1/5 children might have a portion of the repair split, which can cause the minor leakage of fluid into the nose. For larger holes, called fistulas, it can once again disrupt eating and speaking. Surgery is once again performed to repair the palate to ensure each child is able to develop as fully functional as possible following the procedure.