The Cleft Lip and Palate

 

Cleft Lip and Palate are among the most common congenital deformities, affecting an estimated one in 700 to 800 newborns worldwide.

A variety of factors influence the development of cleft lip and palate, which happens very early in pregnancy. Researchers continue to study the causes, but no one knows for sure why clefts happen.

Some cases are associated with other deformities are called syndromes.

A cleft lip is a congenital facial deformity that occurs when one (unilateral) or both sides (bilateral cleft lip) of the upper lip fail to fuse. In unilateral cases there may be a partial or total assimetry of the nose.

In bilateral cases the nose is symmetrical, but is small with the tip almost attached to the lip. A cleft palate is also a congenital deformity It is found when of one or both sides of the roof of the mouth fail to fuse (unilateral or bilateral cleft palate).

The severity of cleft lip and cleft palate can range from a slight notch in the lip to a wide cavity in the upper lip, upper gum, and/or palate, extending into the nasal cavity.

There may be other variations, combinations and presentations, but they are the most common.

Unilateral Cleft Lip	Incomplete	Complete
Bilateral Cleft Lip	Incomplete	Complete
Cleft Palate	Incomplete	Complete

Kids with cleft palates are often persistently malnourished and underweight because the roofs of their mouths are not closed, making breast feeding and eating difficult. Some children with cleft lips suffer nutritional problems as well because the gap in their lip makes it difficult to suck. They also suffer dental and middle ear problems. Children with clefts not treated early and adequately are frequently shunned, denied an education and social integration because of their appearance and speech impediments.

Performing cleft surgery when the patient is young is critical to allow for normal speech development. A cleft lip is typically repaired when a baby is three months old and have reached a weight and conditions appropriate to enter surgery are better, including the nose repair and hard palate closed at same time, The cleft palate is generally repaired within the first 6 to 12 months, or even sooner following the Britanic protocol by Dr. Brian Sommerlad.

The treatment of cleft lip and palate It must be evaluated by multidisciplinary team such us Pediatrician, Plastic Surgeon, Otolaryngologist, Geneticist, Anesthesiologist, Nurse, Psychologist, Nutritionist, Orthodontics, Pediatric Dentistry, Speech Therapist, among others.

There is always the possibility of additional or complimentary surgery that can be performed from two years old.

Patients who arrived at any age from one year can receive complete surgical treatment for cleft lip and palate at the same time.

As the child begins to speak must be in contact with speech pathologists or speech therapists to receive appropriate management.

The orthodontics or Pediatric Dentistry is needed to complete the treatment of defects in the entire area. Usually in most cases the surgery is needed from the 8 or 9 years old to do a bone graft to enable them to improve conditions for the dental rehabilitation

The Rhynoplasty and orthognatic surgery is needed from 15 years old for complete program of rehabilitation.

Psychological support is provided from the beginning to help further the acceptance and integration into society of those affected.