Cleft Lip and Palate
Cleft lip (a separation in the upper lip) and cleft palate (a split of the roof of the mouth) are the most common types of craniofacial malformations. The condition affects approximately one of every 700 babies born in the U.S. each year. Clefts can occur on one side (unilateral) or on both sides (bilateral) of the lip and palate. Because the lip and the palate develop separately, it is possible for the child to have a cleft lip, a cleft palate, or both cleft lip and cleft palate.
Our Team Approach
Gillette’s Center for Craniofacial Services offers a comprehensive approach to treating cleft lip, cleft palate and associated symptoms. Our team of specialists include craniofacial surgeons, neurosurgeons, plastic surgeons, orthodontists, dentists and nurse practitioners. We meet with the child’s family, often before the baby leaves the hospital, to discuss treatments and feeding techniques that support proper nutrition and growth.
Case study: Unilateral cleft lip (link to photo and content from current site)
Case study: Unilateral cleft lip and palette (link to photo and content from current site)
Causes
In the early stages of pregnancy, separate areas of a baby’s face develop individually and then join together. When facial parts do not join properly, the result is a cleft, or split, in the lip and/or palate.
Though know one knows exactly what causes clefts, some specialists believe that both genetic (inherited) and environmental factors (such as vitamin deficiencies) play a role. Children of a parent with a cleft have a 4- to 6-percent chance of also having clefts. Some ethnicities have a higher incidence of clefts, including Asians and some groups of Native Americans.
Associated Complications
Up to 13 percent of children born with clefts may have other health complications, including:
- Dental problems – missing or improperly positioned teeth in the cleft area
- Speech and language delays
- Greater risk of ear infections and secondary hearing loss
- Feeding problems during infancy
Treatment
Children born with a cleft require several different types of treatments, including surgery and presurgical orthopaedics. As they grow and develop, children may also need dental care, orthodontics and speech therapy.
Presurgical Treatment
Before babies undergo surgery to correct a cleft lip or palate, our physicians recommend they wear an OrthoCleft Retainer®. The appliance brings gum segments together to reduce the gap in the mouth, stretch the lip muscles and give the nose a more even shape. It also helps improve sucking and eating abilities. Babies wear an OrthoCleft Retainer® from one week old until their first surgery – typically at 3 months of age. Such early use typically results in better surgical outcomes and fewer reconstructive surgeries during childhood.
Surgery
Surgery can successfully close a cleft and repair associated problems with the lip and nose. Cleft lip repair typically takes place at 3 months of age, and only requires one surgery. Cleft palate repair is more extensive, occurring between 9 and 18 months of age. Some children with cleft palates need additional surgeries to help improve speech, improve the appearance of the lip and nose, or assist with breathing. These can take place anywhere between 18 months and four years of age.
Speech Therapy
Some children with cleft lips or cleft palate develop speech more slowly than their peers. Words may sound nasal, and they may have difficulty pronouncing some consonant sounds. Our speech and language therapists work with children to improve speech after cleft repair surgery.
Information and Referrals
For more information about cleft lip and palate, call Gillette’s Center for Craniofacial Services at 651-602-3277 or 800-719-4040 (toll-free).
To refer a patient, call 651-229-3944 or 800-719-4040 (toll-free).
