What is Cleft Lip or Cleft Palate ?
Babies with Cleft Lip and Palate
Cleft Lip or Cleft Palate refers to the openings caused by the mutual unification of the structures during the development of the baby in the mother’s womb during the development of the facial part and the mouth and the related problems in the lip , nose , gums and palate. It is sometimes difficult to notice cleft palate. They can be seen together or separately. There are many different shapes of palate lip clefts.
What are The Types of Cleft Lips?
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Microform Slit:
In this type, there is a small notch on the lip.
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Incomplete (Unilateral or Bilateral):
These slits form slits where the base of the nose is not fully included.
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Complete (Unilateral or Bilateral):
These are slits that also cover the base of the nose.
What are The Types of Cleft Palate?
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Complete:
Conditions in which the soft and hard palate are affected together.
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Incomplete:
Clefts in which only the soft palate is affected.
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Bilateral Slits:
The condition of having clefts on both sides of the structure called the vomer.
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Submucous Cleft:
When viewed from the outside, there is no cleft, but the muscles do not join.
How are Palate Lip Clefts detected?
With a good examination at birth, the diagnosis can be made definite. However, it may be possible to catch lip clefts with ultrasound during pregnancy. Sometimes it can be difficult to diagnose in the very posterior cleft or hidden cleft of the soft palate. In this type of baby, nourishment comes from the nose while feeding, difficulty in sucking or not being able to suck at all is observed.
What are The Causes of Palate Lip Clefts ?
Cleft has no specific cause. A cause cannot be found in more than half of babies. In a small group, it can be seen together with other organs and structures. These are inherited. Also, a group of babies had a close distant family relative history. Consanguineous marriage can be a cause. Serious diseases in the first 1-2 months of pregnancy and some medications can be considered among the causes.
Do Palate Clefts Cause Speech Impairment ?
While lip clefts cause cosmetic, lip and nose problems; The most important problem that can be experienced in cleft palate is speech disorder. Immediately after birth, the most important issue is nutrition. Following and treatment of the middle ear and teeth after the operations becomes important. There may be tooth-jaw-face development problems. Problems are less with only cleft lip or only cleft palate, but differ.
Does The Cleft Palate Go Away by Itself?
Neither cleft lip nor cleft palate spontaneously pass or close. Only after birth may be narrowing of the cleft within months as the age progresses.
How is The Treatment of Cleft Lip and Palate ?
Both can be treated. The treatment is long-termed and the purpose is evaluated in 2 separate stages. First stage; It is the correction of visual problems and speech disorders, if any, before the child starts primary school. Second stage; In adulthood, the development of teeth, jaw and face is within natural limits and, if affected, both appearance and respiratory problems of the inside and outside of the nose are solved. These treatments are briefly grouped under 3 main headings: plastic surgery, orthodontic treatment and speech therapy.
At What Age can The Surgery be Done?
Lip clefts are operated on the baby’s health and development status between 2.5 months and 5 months. In this session, the cleft on the lip is closed and the nose is corrected. The gingival cleft is not touched in most cases. Palate clefts are often closed between 6 months and 9 months. Rarely, surgery is delayed to 1 year.
If The Treatment is Delayed…
Being late is mentioned in babies who are not operated before the age of 1 at the specified times after birth. As each year is delayed, surgeries become more difficult and success begins to decline. In addition, it becomes very difficult to correct the negative results of late and incomplete surgeries with subsequent surgeries.
Is There a Trace Left?
If the slits are closed with a suitable technique, the scar will be extremely less obvious. There may be very slight irregularities in the cleft line on the lip , and also a little asymmetry in the cleft side nose , wings and holes. A perfect result is often not possible. Revision or retouching operations may be required at later ages.
Before and after Cleft Lip Surgery
Before the cleft palate surgery to be performed, the most important point for parents; their babies are entrusted to teams of experts who constantly perform these surgeries and follow these babies with every problem. Each team must have a scientifically approved protocol. According to these applications, every point to be considered before and after cleft palate surgery is clear and explained in detail to the patient’s relatives.
Frequently Asked Questions About Cleft Lip and Cleft Palate
What is a cleft lip or cleft palate and how do they differ?
A cleft lip and a cleft palate are congenital facial deformities that develop during early pregnancy when a baby’s facial structures do not fuse completely. A cleft lip is a physical split or opening in the upper lip that can extend up into the nose. In contrast, a cleft palate is an opening or split specifically in the roof of the mouth (the palate), involving either the hard bony palate, the soft tissue palate, or both. A child can be born with one or both conditions simultaneously.
What are the primary causes and risk factors for cleft lip and palate?
The exact cause of cleft lip and cleft palate is often unknown, but most cases are linked to a combination of genetic and environmental factors. Risk factors during early pregnancy include a family history of facial clefts, maternal smoking, alcohol consumption, and taking certain prescription medications. Additionally, a lack of essential prenatal vitamins, particularly folic acid, or a maternal diagnosis of diabetes or obesity during gestation significantly increases the likelihood of these birth defects.
How does a cleft palate affect a baby’s ability to feed and swallow?
A cleft palate severely impacts a baby’s ability to feed because the opening between the mouth and nasal cavity prevents the infant from creating the suction required to nurse or drink from a standard bottle. Breast milk or formula can frequently enter the nasal passages, leading to coughing, choking, or nasal regurgitation. To ensure safe and adequate nutrition, parents must use specialized bottles and cross-cut nipples designed specifically for cleft palate infants.
Can cleft lip and cleft palate be detected before birth via ultrasound?
Yes, a cleft lip can frequently be detected before birth using a routine prenatal ultrasound, typically around the 18th to 22nd week of pregnancy when facial features are more pronounced. However, an isolated cleft palate is significantly more difficult to diagnose prenatally because the roof of the mouth is obscured inside the oral cavity on a standard two-dimensional ultrasound scan. A definitive diagnosis for an isolated cleft palate is usually made immediately upon physical examination at birth.
What is the ideal age and timeline for cleft repair surgeries?
Cleft repair requires a precise surgical timeline to support normal facial growth and speech development. Cleft lip repair surgery is typically performed early, within the baby’s first 3 to 6 months of life. Cleft palate repair surgery is generally scheduled between 9 and 18 months of age, before the child begins speaking, to minimize the risk of long-term speech difficulties. Follow-up surgeries, such as bone grafts or rhinoplasty, may continue into adolescence.
Do children with a cleft palate require ongoing speech therapy?
Yes, many children with a cleft palate require ongoing speech therapy even after a successful surgical repair. The physical opening alters muscle function in the roof of the mouth, which can cause air to escape through the nose during speech, resulting in a hypernasal or muffled voice. Regular evaluations by a speech-language pathologist help correct articulation errors, strengthen oral muscles, and ensure the child develops clear, age-appropriate communication skills.
Why are children with cleft palate highly prone to ear infections?
Children with a cleft palate are highly susceptible to recurrent ear infections and fluid accumulation because the malformed palate muscles fail to properly operate the Eustachian tubes. The Eustachian tubes drain fluid from the middle ear to the throat. When these tubes malfunction, fluid becomes trapped behind the eardrum, creating an ideal environment for bacterial growth. To prevent chronic infections and potential hearing loss, surgeons frequently insert tiny ventilation tubes (grommets) into the eardrums during cleft palate surgery.
