Cleft Lip and Palate: A-to-Z Guide from Diagnosis to Treatment to Prevention

Introduction to cleft lip and palate:

If parents think of adults they have known with repaired cleft lips, they might not be aware that surgical techniques and results have improved over recent years.

What is it?

Clefts are gaps in the developing lip and/or palate(roof of the mouth). They may be small notches or large open spaces. They occur because of problems during prenatal development. The two sides of the developing face fail to meet and join properly.

Who gets it?

People might have cleft lip and palate for genetic reasons, because of a medical syndrome (such as fragile X syndrome), or because of exposure to drugs or toxins during development.

Cleft lip with or without cleft palate is more common than cleft palate alone. These conditions happen in all ethnic groups, but are most common in Asians.

What are the symptoms?

The cleft may be just a tiny notch in the lip or a defect where the barrier between the mouth and nose is missing. The cleft may be on one side of the face, both sides, or in the middle. Sometimes the bone of the palate is cleft, but the overlying tissue in the mouth is intact.

The most urgent problem with clefts is potential feeding difficulties. Speech development, dental problems, and ear infections are later potential problems.

Is it contagious?

No

How long does it?

Clefts last until corrected.

How is it diagnosed?

The diagnosis is made on physical examination. Sometimes a partial cleft in the mouth is only noticed by feeling the palate.

How is it treated?

Special nipples, squeezable bottles, or temporary appliances may be used to assist in feeding.

Surgical repair is the core of treatment. Often a team of healthcare providers will work together to care for children with clefts. The team might include a plastic surgeon, an ENT surgeon, an orthodontist, a speech therapist, nurses, social workers, psychologists, psychiatrists, and a pediatrician and pediatric dentist.

How can cleft lip and palate be prevented?

Often clefts cannot be prevented. Avoiding prenatal exposure to drugs and toxins may prevent some clefts.