Cleft Lip and Palate


cleft-palate_afterOur doctors are associated with the cleft lip and palate team at Children’s Clinics for Rehabilitative Services.

Cleft lip and palate surgery is done to correct a physical defect caused by a cleft lip or cleft palate, which may occur once in every 800 – 1000 live births.  During early pregnancy, separate areas of the face develop individually and then join together, including the left and right sides of the roof of the mouth and lips.  If some parts do not join properly, the result is a cleft.  If a separation occurs in the upper lip, the child is said to have a cleft lip.  If the separation occurs on the palate (roof of the mouth), the child is said to have a cleft palate.  A completely formed lip and palate is not only important for a normal facial appearance, but also for eating and development of normal speech.

cleft-lip-01a

A cleft lip may be just a small notch in the lip or it may also be a complete split in the lip that goes all the way to the base of the nose.  The cleft can involve one side or both sides of the lip.  A cleft palate can be on one or both sides of the upper jaw and roof of the mouth.  It may go the full length of the palate.

A child may have one or both of these conditions at birth.  A cleft lip may require multiple surgeries depending on the extent of the repair needed.  The initial surgery is usually performed by the time a baby is 3 months old.
 

Reparative Surgery

The surgery to repair the palate usually occurs when the baby is between 6 and 12 months old. The initial surgery creates a functional palate, reduces the chances that fluid will develop in the middle ears, and aids in the proper development of the teeth and facial bones.  Repair of the cleft in the portion of the upper jaw where teeth are formed and erupt is performed between the ages of 9 and 12.

As a member of a team of healthcare specialists, our oral surgeons play an important role in the carefully orchestrated, multiple-stage correctional program for cleft lip and palate patients.  The main goal of cleft lip and palate treatment is to close the gaps between the lip and the palate, helping to restore the jaw and facial structures, leading to normal function and appearance.

Our surgeons become involved after the initial repair of the lip and palate. We are integrally involved during the time that jaws and teeth develop (age 5 – 20).  We perform surgery to close the cleft in the area where teeth develop and erupt, and graft bone in the area to provide support to the jaw and the teeth.  When the jaws do not grow in a coordinated fashion, we perform reconstructive jaw surgery after growth is complete.

Care and treatment must consider function, appearance, nutrition, speech, hearing and emotional and psychological development.