Cleft Lip and Palate
Cleft lip and palate is a set of physical birth defects of the oral cavity that is estimated to occur in the United States at least once within every 1,000 births making them one of the most frequently occurring deformities.
Cleft Palate occurs along the hard part of the mouth’s roof, but it can also affect the soft upper portion of the back of the mouth. In cases of cleft palate, an opening is left from the mouth into the nasal cavity when the there is no proper fusion during gestation of the two plates of the roof of the mouth. This defect is generally the less-visible condition of the two cleft varieties; however, it can cause the upper lip to develop abnormally.
The cleft lip facial deformity is left when the lip is left with a split-like fissure where insufficient skin and tissue developed. Cleft lip’s impacts range from minimal effects – a small notch or scar for example – to severe symptoms that may have the appearance of a large opening leading into the nose. Cases of cleft lip are put into one of four categories based on the location of the defect and extent of facial coverage.
Clefts that are found on one side of the mouth and exclude the nose are called Unilateral Incomplete. If the cleft extends into the nostril, it is called Unilateral Complete. A Bilateral Complete cleft extends into the nose on both sides of the mouth. The mildest form of cleft lip is Microform Cleft that manifests as a small scar or notch on the lip tissue or a barely-visible scar that extends up the lip to the nose.
Males tend to have cleft deformities about twice as much as females. The birth defects – either individually or as a set – occur most of among children with Asian, Native American or Hispanic backgrounds. It is not known what makes certain people develop cleft lip and palate deformities but the cause is believed to be a mix of genetic and environmental causal factors. People who have cleft deformities are far more likely to pass the trait on to their children than those who do not exhibit physical symptoms. The use during pregnancy of hard drugs like cocaine or heroin, smoking and drinking alcohol are also believed to play a part in the development of cleft lip and palate. Other medications for acne and control of seizures can cause the appearance of cleft deformities.
Not only can cleft deformities trigger emotional issues related to the physical appearance of the cleft, other problems affecting speech, eating, hearing and teeth and gums can occur without corrective measures.
Cleft deformities are treated using a number of different techniques based on the extent of the defect. While some cases can be corrected relatively easily, most cases involve treatment throughout the childhood years that involves numerous surgeries.
Cleft lip surgery usually takes place within a few months of birth; however, treatment decisions can be affected by personal choice so not all cases are immediately addressed. If the defect is unilateral only one surgery may be needed but larger defects or those that occur bilaterally may require at least two surgeries. A special retainer is usually worn in the child’s mouth prior to cleft lip surgery to help close the gap inside the mouth. To correct cleft lip, incisions are made alongside the cleft and below the nose to allow the two sides to be joined together.
Cleft palate is remedied using an artificial palate that covers the opening in the roof of the mouth so that proper eating can occur until surgery can be undertaken after six-months-of-age. In the procedure, incisions are cut on either side of the opening and soft tissue is used from each side of the mouth to reconstruct the palate. Cleft palate is the more difficult of the two deformities to correct and usually requires several operations as the child grows.
Cleft lip and palate procedures can be very expensive; however, in general, the procedure is considered necessary by insurance companies and associated costs are covered. Additionally, several charities work with patient families to help with expenses related to the condition.