Cleft Lip and Palate
What is the cause of cleft lip and palate?
Mostly, the cause is unknown. Clefts can run in families and be associated
with other problems. Some drugs taken during pregnancy are known to cause
clefts. Clefts occur once in every 700 to 1000 births, making it a common
birth defect.
Do babies with clefts have other problems?
Most children with clefts do not have other birth defects. Most are normal
in intelligence and abilities. Children with clefts do have a higher incidence
of a problem called serous otitis media-fluid in the ear. If untreated,
frequent ear infections and even hearing loss can result. Many children
with clefts have abnormalities of the teeth-this can range form crooked
teeth to extra or missing teeth.
What is the treatment for cleft lip and palate?
Children with clefts benefit from specialized team care. Cleft teams consist
of specialists in Plastic Surgery, Otolaryngology, Pediatrics, Oral and
Maxillofacial Surgery, Genetics, Dentistry, Speech, Pathology, Audiology,
Nursing, and Psychology. These teams work with the child's own pediatrician
to provide the best care possible. Excellent care is also available outside
of cleft teams, but requires more coordination of various specialists by
the parents. Most surgeons repair cleft lip when the baby is 6 to 10 weeks
old. Most surgeons repair cleft palate at 6 to 12 months of age. The exact
age for repair will depend on the size and health of the child and the surgeon's
preference.Some children with cleft palate will require a second operation
on the palate to help get better speech. This happens in about 20% of cases,
and cannot be predicted at the time of the original palate surgery. Many
children with clefts involving the gun line will benefit from an operation
to put extra bone in the gum. This is called an alveolar bone graft. This
allows the permanent teeth to come in better. This operation is done sometime
between the ages of 6 and 10, depending on how fast the permanent teeth
are developing. Children with clefts of the lip may need or want touch up
operations to improve the appearance of the scars. As teenagers, some need
nasal surgery to improve breathing or appearance. In some children with
clefts, the jaws are not in good alignment. In these cases, surgery can
be done to align the bite.
