Definition

Cleft lip and palate are birth defects that affect the upper lip and the roof of the mouth.

Alternative Names
Cleft palate; craniofacial defect

Causes, incidence, and risk factors

There are many causes for of cleft lip and palate. Problems with genes passed down from one or both parents, drugs, viruses, or other toxins can all cause such birth defects. Cleft lip and palate may occur along with other syndromes or birth defects. A cleft lip and palate can affect the appearance of one's face, and may lead to problems with feeding and speech, as well as ear infections. Problems may range from a small notch in the lip to a complete groove that runs into the roof of the mouth and nose. These features may occur separately or together. Risk factors include a family history of cleft lip or palate and other birth defect. About 1 out of 2,500 people have a cleft palate.

Symptoms
A child may have one or more of these conditions at birth. A cleft lip may be just a small notch in the lip. It may also be a complete split in the lip that goes all the way to the base of the nose. A cleft palate can be on one or both sides of the roof of the mouth. It may go the full length of the palate. Other symptoms include:

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Misaligned teeth Change in nose shape (amount of distortion varies)

Problems that may be present because of a cleft lip or palate are:

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Failure to gain weight Feeding problems Flow of milk through nasal passages during feeding Misaligned teeth Poor growth Recurrent ear infections Speech difficulties

Signs and tests

A physical examination of the mouth, nose, and palate confirms a cleft lip or cleft palate. Medical tests may be done to rule out other possible health conditions.

Treatment
Surgery to close the cleft lip is often done at when the child is between 6 weeks and 9 months old. Surgery may be needed later in life the problem severely affects the nose area. Orofacial cleft; craniofacial birth defect repair; Cheiloplasty; Cleft rhinoplasty; Palatoplasty; Tip rhinoplasty Most times, cleft lip repair is done when the child is 6 to 12 weeks old. For cleft lip surgery, your child will have general anesthesia (asleep and not feeling pain). The surgeon will trim the tissues and sew the lip together. The stitches will be very small so that the scar is as small as possible. Most of the stitches will absorb into the tissue as the scar heals, so they will not have to be removed later. Most times, cleft palate repair is done when the child is older, between 9 months and 1 year old. This allows the palate to change as the baby grows. Doing the repair when the child is this age will help prevent further speech problems as the child develops. In cleft palate repair, your child will have general anesthesia (asleep and not feeling pain). Tissue from the roof of the mouth may be moved over to cover the soft palate. Sometimes a child will need more than 1 surgery to completely close the palate. During these procedures, the surgeon may also need to repair the tip of your child s nose. This surgery is called rhinoplasty. A cleft palate is usually closed within the first year of life so that the child's speech normally develops. Sometimes a prosthetic device is temporarily used to close the palate so the baby can feed and grow until surgery can be done. Continued follow-up may be needed with speech therapists and orthodontists.

Complications
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Dental cavities Displaced teeth Hearing loss Lip deformities Nasal deformities Recurrent ear infections Speech difficulties