Cleft lip and palate
Key points
- Cleft lip and palate are congenital abnormalities (present at birth) that affect the upper lip and the hard and soft palate of the mouth.
- Cleft lip and palate are facial may occur in association with other syndromes or birth defects.
- A physical examination of the mouth, nose and palate confirms the presence of cleft lip or cleft palate.
- Treatment of cleft lip and palate requires a team approach and involves several specialties, including plastic surgeons, orthodontics, speech therapists and others.
Definition
Cleft lip and palate are congenital abnormalities (present at birth) that affect the upper lip and the hard and soft palate of the mouth. Features range from a small notch in the lip to a complete fissure (groove) extending into the roof of the mouth and nose. These features may occur separately or together.
Causes, incidence, and risk factors
Cleft lip and palate are facial may occur in association with other syndromes or birth defects. There are numerous causes for these birth defects, including mutant genes inherited from one or both parents and teratogens (drugs, viruses, or other toxins that can cause abnormalities in a developing fetus).
As well as being disfiguring, these abnormalities can cause feeding difficulties, problems with speech development, and ear infections.
Risk factors include a family history of cleft lip or palate and presence of another birth defect. The incidence of cleft lip and palate varies with different races; approximately 1 out of 1,000 Caucasians are affected. The incidence of cleft palate alone is 1 out of 2,500 people.
Symptoms
- Separation of the lip alone
- Separation of the palate
- Separation of the lip and palate
- Varying amounts of nasal distortion
- Recurrent ear infections
- Failure to gain weight
- Nasal regurgitations during bottle feeding
- Growth retardation
- Misaligned teeth
- Poor speech
- Feeding problems
Signs and tests
A physical examination of the mouth, nose and palate confirms the presence of cleft lip or cleft palate. Diagnostic testing may be performed to determine or rule out the presence of other abnormalities.
Treatment
Treatment of cleft lip and palate requires a team approach and involves several specialties, including plastic surgeons, orthodontics, speech therapists and others. Treatment may extend over a period of several years.
Surgery to close the cleft lip is usually performed at 3-9 months of age. Later surgery may be needed if there is extensive nasal involvement.
A cleft palate is usually closed within the first year of life to enhance normal speech development. Until surgery, a prosthetic device is often fitted over the palate for feeding.
Continued follow-up may be needed with speech therapists and orthodontists.
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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