Cleft Lip and Cleft Palate
From Holoprosencephaly
Cleft Lip / Cleft Palate Definition
Clefts of the lip and/or palate are structural malformations that occur during embryonic development. Cleft lip (CL) is a failure of the lip, gum tissue and bone to fuse at midline beneath the nose. Cleft lip occurs in varying degrees. This may be a unilateral notch without nasal involvement, a unilateral cleft between the upper lip and one nostril or a bilateral cleft between both nostrils and the upper lip.
CL may occur with or without Cleft Palate (CP). Cleft Palate is a failure of the sides of the hard and/or the soft palates to fuse at midline in the roof of the mouth. Complications are dependent on the degree of deformity.
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Problems associated with Cleft Lip / Cleft Palate
The most immediate problem is feeding difficulty. CL and/or CP compromise the ability to suck. Under supervision of a medical professional, bottle fed infants must use specialized nipples for safe and effective feeding. They should be held upright while feeding to prevent nasal regurgitations and burped frequently.
Some infants may require temporary oral gastric tubes or nasogastric tubes and some may have gastric tubes placed surgically if they are unable to bottle feed.
Treatment for Cleft Lip / Cleft Palate
Treatment of CL and/or CP is usually directed toward surgical closure of the clefts. Closure of the lip is completed prior to the palate defect (if present). This usually this occurs between 6 and 12 weeks of age. Closure of the palate usually occurs after the age of 18 months.
Prognosis
Prognosis is dependent upon the success of anatomic closure/repair and other health complications present. Problems may include feeding difficulties related to impaired muscle function, dental issues related to improper tooth alignment, ear infections related to ineffective function of the eustachian tubes and respiratory infections related to aspiration.
Management
Management should be guided by an interdisciplinary team of specialists including the pediatrician, surgeon, dentist, otolaryngolist and speech therapist.
Links to resources:
http://www.widesmiles.org http://www.cleftline.org http://www.craniofacial.net/institute.htm
If you have any concerns, please don't hesitate to discuss your concerns with your child's doctor(s).
For information about dealing with other potential health problems, treatments and medications, please visit our Miscellaneous Health Information category.
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