A cleft lip and a cleft palate are both birth defects that can occur when an infant’s lip or mouth doesn’t form correctly during pregnancy. A cleft lip can form between the fourth and seventh week of pregnancy. During pregnancy, body tissues grow toward the center of the face and join. Clefting happens when there isn’t enough tissue in the mouth or lip area to form that area, and the present tissue doesn’t join together properly. Cleft palates are usually formed between the sixth and ninth weeks of pregnancy, and occur when the tissue that creates the roof of the mouth doesn’t completely join. Both of these conditions can cause problem for infants, making it more difficult for them to feed and speak clearly. They can also cause ear infections, issues with hearing, and problems with their teeth. The CDC estimates that each year, about 2,650 babies are born with a cleft palate and about 4,440 babies are born with a cleft lip. Together, these conditions are referred to as orofacial clefts.
The causes of orofacial clefts are largely unknown. In some cases it may be caused by changes in the infant’s genes. This can combine with other factors, such as certain things the mother can come into contact with during pregnancy. What the mother eats and drinks can also have an effect, as well as certain medications.
Orofacial clefts can often be diagnosed during pregnancy by having a routine ultrasound. For the most part they are easily diagnosed after the baby is born. However, there are certain types of cleft palate that may not be diagnosed until later in life.
Surgery for cleft lips is usually done when the child is ten months old. During surgery we will close the separation, restore muscle function, and provide a normal shape for the child’s mouth. We can also attempt to improve nostril deformity. Cleft palates are treated with surgery when the child is between 7 and 18 months old. The specific age depends on the individual child and his or her specific needs. During surgery, our goals are to close to the gap or hole between the roof of the mouth and nose; reconnect the muscles that make the palate work; and make the repaired palate long enough so that the palate can function properly. There are many techniques that we can employ to achieve a successful surgery. We’ll discuss all options with parents before surgery. Cleft hard palates are usually repaired between ages 8 and 12: the procedure involves placement of bone from the hip into the bony defect as well as the closure of the communication from the nose to the gum tissue in three layers. After surgery, children will have an easier time eating. Sometimes a portion of the repair can split. Small splits may not require further attention, but if the split is large then the child may need further surgery. For more information, or to schedule an appoint, please contact us online or call us.