Cleft Lip and Cleft Palate

Cleft lip is a congenital condition where there’s a split or open section of the upper lip. This opening can occur at any point along the top lip and can extend as high as the nose.

Cleft palate is where a defect exists in the hard or the soft palate at the roof of the mouth. This leaves an opening between the mouth and the nasal cavity. The cleft lip and the cleft palate can occur together or on their own.

Who needs Cleft lip and Cleft palate treatment?

Babies born with a cleft lip or cleft palate may have difficulties eating (both from the breast and a bottle). They may also have trouble speaking, and they often have fluid behind their eardrum that can affect hearing. Most cases of cleft lip and cleft palate are noticed right away at birth and don’t require special tests for diagnosis

When to see a specialist?

A cleft lip and cleft palate are usually noticed at birth, and your doctor may start coordinating care at that time. If your baby has signs and symptoms of a submucous cleft palate, make an appointment with your child’s doctor.

Procedures

• Cleft lip repair- Cleft lip surgery performed within the first 3 to 6 months of age. To repair the cleft lip the surgeon makes incisions on both sides of the cleft to close the separation in the lip and creates flaps of tissue. The flaps are then stitched together, including the lip muscles. The repair should create a more normal lip appearance, structure and function. Initial nasal repair, if needed, is usually done at the same time.

• Cleft palate repair- Cleft palate surgery performed by the age of 12 months, or earlier if possible. To repair the cleft palate the surgeon makes incisions on both sides of the cleft and repositions the tissue and muscles. The repair is then stitched closed. Various procedures may be used to close the separation and rebuild the roof of the mouth (hard and soft palate), depending on your child’s situation.

• Ear tube surgery- For children with cleft palate, ear tubes may be placed to reduce the risk of chronic ear fluid, which can lead to hearing loss. Ear tube surgery involves placing tiny bobbin-shaped tubes in the eardrum to create an opening to prevent fluid buildup.

• Surgery to reconstruct appearance – Additional surgeries may be needed to improve the appearance of the mouth, lip and nose.

Recovery

After the surgery, most babies are in hospital for 1 to 2 days. Arrangements may be made for you to stay with them during this time. Your child will have a slight scar, but the surgeon will try to line up the scar with the natural lines of the lip, to make it less noticeable and in case of cleft palate the scar from cleft palate repair will be inside the mouth. The stitches will be removed after a few days or may dissolve on their own.

Risks

• Possible cleft surgery risks include:

• Bleeding

• Damage to deeper structures – such as nerves, blood vessels, muscles and auditory canal can occur and may be temporary or permanent

• Infection

• Irregular healing of scars including shortening, thickening or overgrowth

• Poor healing of incisions

• Possibility of revisional surgery

• Residual irregularities and asymmetries in the lip or nose

• Respiratory problems after surgery

Benefits of Cleft lip and Cleft palate treatment?

Surgery to correct a cleft lip or palate helps your child’s lips and mouth function properly and lowers the risk of certain health conditions.

Frequently Asked Questions

1. What is Cleft lip and Cleft palate?

   Cleft lip and cleft palate are openings or splits in the upper lip, the roof of the mouth (palate) or both. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby don’t close completely.

2. How are cleft lip and cleft palate treatment performed?

   To repair the cleft lip the surgeon makes incisions on both sides of the cleft to close the separation in the lip and creates flaps of tissue. The flaps are then stitched together, including the lip muscles. The repair should create a more normal lip appearance, structure and function. Initial nasal repair, if needed, is usually done at the same time.

   To repair the cleft palate the surgeon makes incisions on both sides of the cleft and repositions the tissue and muscles. The repair is then stitched closed. Various procedures may be used to close the separation and rebuild the roof of the mouth (hard and soft palate), depending on your child’s situation.

3. Is Cleft lip and Cleft palate treatment painful?

   Your child is under general anesthesia, so they won’t feel pain. They’ll be uncomfortable after the pain medication wears off.

4. How long does Cleft lip and Cleft palate treatment take?

   The operation usually takes about 2 hours. Most children are in hospital for 1 to 3 days, and again arrangements may be made for you to stay with them.

5. What are the risks of Cleft lip and Cleft palate treatment?

   There are several risks include Bleeding, Infection, respiratory problems, Poor healing of incisions, Residual irregularities and asymmetries in the lip or nose etc.