General Cleft Lip and Palate
Rainbow Babies & Children’s Hospital is one of the nation’s most respected children’s hospitals. Our internationally renowned craniofacial team has a wide range of experience in treating all forms of cleft lip and palate. It is one of the most common problems we treat, because it is one of the most common congenital anomalies in children. In fact, clefts of the lip and palate occur in approximately one in 700 births.
What are cleft lip and palate?
Cleft lip and palate are incomplete formations of the upper lip and roof of the mouth. This causes a gap or defect to occur in the affected area, involving skin, muscle and oral lining. There is often an associated deformity of the nose on the affected side.
Cleft lip
A
cleft lip can be on one (unilateral) or both (bilateral) sides of the upper lip. This can occur alone or in association with a cleft palate. Similarly, a cleft palate may occur in isolation, without a corresponding deformity of the upper lip.
There are several types of cleft lip:
- Forme fruste unilateral cleft lip: a subtle cleft on one side of the upper lip, which may appear as a small indentation
- Incomplete unilateral cleft lip: a cleft on one side of the upper lip, which does not extend into the nose
- Complete unilateral cleft lip: a cleft on one side of the upper lip, which extends into the nose
- Incomplete bilateral cleft lip: clefts on both sides of the upper lip, not extending to the nose
- Complete bilateral cleft lip: clefts on both sides of the upper lip, extending into the nose
Cleft palate
In
cleft palate, the inside of the nose and mouth are not separated. This leaves an opening in the roof of the mouth. A cleft palate affects speech because the muscles at the back of the palate, which are needed for normal speech, are not formed properly.
What causes cleft lip and palate?
Various familial and environmental factors may contribute to clefting. Most infants with cleft lip and/or palate are healthy children who have no other birth anomalies. However, children with clefts may have other medical problems.
How is it treated?
Treating a cleft lip or palate is a lengthy process. It begins when the child is an infant and continues through adulthood. Treatment can include orthodontics, surgery, speech therapy, and more.
Recent advancements in pre-surgical treatments, such as nasoalveolar molding (reshaping the gums, lip and nostrils before surgery) have reduced the need for surgeries as the child grows. However, it is crucial for a newborn with a cleft lip and palate to see a plastic surgeon within the first few weeks of life.
At Rainbow Babies & Children’s Hospital, we work with you to create an individual treatment plan that is right for your child. Our goal is to help your child look and feel as normal as possible when he or she enters school. LINK to patient galleries
Timeline
| Age |
Treatment |
1 - 3 weeks
|
Plastic surgery evaluation |
| |
Considerations:
- Presurgical orthopedics (Pediatric dentistry)
- Ear tubes (Otolaryngology)
|
3 - 6 months
|
Cleft lip repair
|
| |
Ear tubes (Otolaryngology) |
11 - 12 months
|
Cleft palate repair
|
18 months
|
Speech evaluation (Speech therapy)
|
2 1/2 - 3 years
|
Craniofacial Clinic
- once your child begins repeating phrases,
he/she will have annual visits with entire team
|
3 - 4 1/2 years
|
Secondary speech management (If necessary)
|
| 5 - 6 years |
Lip/Nose revision (If necessary)
|
8 years
|
Alveolar bone grafting (If necessary)
|
14+ years
|
Monitor midfacial growth
|
While this timeline gives you a good idea of when your child should be treating the various stages and symptoms of cleft lip and palate, every child is unique, and should be assessed by a qualified doctor. If you would like to make an appointment to have your child evaluated by our team of specialists, contact us.