CLEFT LIP AND PALATE: CAUSES, DIAGNOSIS, EFFECTS, AND TREATMENT

The cleft lip and the cleft palate – collectively called the orofacial clefts – are the facial and oral malformations of the foetus during the developmental stages of pregnancy (4-9 weeks). A cleft lip is a physical separation, opening, or split between the two sides of the upper lip. This separation can appear as a minor slit or gap in the upper lip or can go beyond the mouth to the base of the nose. A cleft palate is an opening in the roof of the mouth. It can occur in the bony front part of the roof of the mouth, otherwise referred to as the hard palate, or in the softback part of the roof of the mouth called the soft palate.

Cleft lip and palate can occur on one side or simultaneously on both sides of the lips. This signifies that having a cleft lip does not necessarily mean a cleft palate must be present, too, since the cleft lip and palate are formed separately in a baby’s life while in the womb.

What are the causes?

The causes of orofacial clefts are relatively unknown in most cases. However, studies suggest that heredity and genetic factor could play a role, such as a higher possibility of occurring in children with parents or relatives that have had the same issue. Other potential causes include drug intake, past health issues, smoking history, exposure to viruses and chemicals within the environment of a pregnant woman. Diabetic women and smokers also tend to have babies with orofacial clefts than those who don’t.

How is it formed?

As said previously, orofacial clefts are formed in-utero, that is, while the baby is still in the mother’s womb. In-utero, the lip forms between the fourth and seventh weeks of pregnancy, while the roof of the mouth (palate) forms between the sixth and ninth weeks of pregnancy.

As a baby develops during pregnancy, body tissues and special cells from each side of the head grow toward the center of the face, where they join together to make the face whole. This tissue joining forms the facial features, like the lips, mouth, nose, etcetera. A cleft lip happens when the tissue that makes up the lip does not join completely before birth resulting in an opening in the upper lip. This gap in the lip can be a small slit or an ample space that goes through the lip into the nose. It can occur on one or both sides of the lip or in the middle of the lip or alongside a cleft palate.

A cleft palate happens if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. For some babies, both the front and back parts of the palate are open. For other babies, only part of the palate is affected.

Diagnosis

Being a physical malformation, a cleft lip or palate can be easily identified at different stages of life; however, it is best evaluated and diagnosed by a medical practitioner. Equally, clefts can be diagnosed using prenatal ultrasound in an unborn child.

Effects of Cleft

There are several physical health problems associated with cleft lip or palate. Children with clefts are at the risk of having eating problems, dental and speech problems, middle ear fluid, and hearing loss. They can also have other accompanying physical malformations, some of which may be internal, for example, a heart defect. It is based on this that a medical practitioner best makes the evaluation and diagnosis.
Moreover, cleft lip or palate can also have psychological effects on a child, which can lead to low self-esteem, depression, social withdrawal, etc.

Treatment

orofacial clefts

Thankfully, orofacial clefts can be managed and reconstructed. Services and treatment for children with orofacial clefts vary depending on the severity of the clefts; the child’s age and needs; the presence of associated syndromes or other congenital disabilities, or both. Reconstructive surgery to repair a cleft lip usually occurs in the first few months of life – recommended within the first 12 months – while surgery to repair a cleft palate is recommended within the first 18 months or earlier. Some children may need additional surgical procedures as they get older. Surgical repair can improve the look and appearance of a child’s face and might also improve breathing, hearing, and speech and language development. Children born with orofacial clefts might need other types of treatments and services, such as special dental and orthodontic care or speech therapy.

At The Good Shepherd Specialist Hospital, we have a team of healthcare professionals experienced in treating children with cleft lip and palate. With our partnership with Smile Train, our orofacial left surgeries are entirely FREE. We have been in collaboration with Smile Train for over five years, and since then, we have put on smiles on the faces of over a hundred children and mothers. You can also click here to know more about this partnership.

If you know anyone with this condition, kindly inform us or reach out to us via any of our contact channels.

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