Cleft Palate and Cleft Lip
June 25, 2021 | Farah Jassawalla

Cleft Palate and Cleft Lip

What is a cleft palate?

A cleft palate forms when the tissues that make up the roof of the mouth do not join properly in the early developmental stage of the baby during pregnancy. It can involve any of the following two portions of the mouth:

1.    Hard palate: It is the front bony portion of the roof of the mouth.

2.    Soft palate: It is the back portion composed of soft tissues.

Types of cleft palate:

      Complete cleft palate: a cleft involving both the palates, hard and soft.

      Incomplete cleft palate: a cleft involving the soft palate only.

      Submucous cleft palate: a cleft covered by mucous membrane.

What is a cleft lip?

A cleft lip is a split in the upper lip, appearing as a separation in the skin. The lip formation takes place during the fourth and seventh weeks of pregnancy. Before birth, many tissues join together to develop facial features, for example, the lips and mouth. In some cases, the tissues that make up the lips do not join completely. This results in a malformation called the cleft lip.

Types of cleft lip:

      Forme fruste unilateral cleft lip: occurs on one side of the upper lip.

      Incomplete unilateral cleft lip: does not extend into the nose from the upper lip.

      Complete unilateral cleft lip: extends into the nose from the upper lip.

      Incomplete bilateral cleft lip: cleft present on both sides of the upper lip but does not extend into the nose.

      Complete bilateral cleft lip: extends into the nose and is present on both sides of the upper lip.

Prevalence of orofacial defects (cleft palate and cleft lip)

Cleft palate and cleft lip are also called orofacial defects and can be present at the same time. It is also possible to have a cleft palate without cleft lip or cleft lip without cleft palate. Studies have found that almost 7000 children are affected by orofacial defects almost every year. It is considered the 4th most common birth defect in the U.S.

Cleft palate is more common in girls than in boys. However, compared with girls, twice as many boys have a cleft lip, both with and without a cleft palate.

Causes of cleft lip and cleft palate

In most cases, a definite cause has not been discovered yet. However, doctors believe that this may be due to the interaction of genetic and environmental factors.

Physiologically, these birth defects are caused by the incomplete fusion of tissues involved in the formation of your lips and your mouth. Other factors that contribute to the formation of cleft lip and cleft palate during pregnancy are mentioned below:

      Consuming medications like anti seizures, anti-cancer, drugs for acne, arthritis, etc

      Smoking during pregnancy

      Drinking alcohol

      Substance abuse

      Diabetes

      Deficiency of folic acid

      Exposure to certain chemicals

Problems associated with cleft lip and cleft palate

      Difficulty in speaking

      Difficulty feeding

      Shortness of breath

      Vision problems

      Eating problems

      Hearing loss

      Malformed teeth

Diagnosis of cleft lip and cleft palate

It can be diagnosed during pregnancy as well as after birth in two ways:

      Prenatal ultrasound: this ultrasound uses high-frequency sound waves to get a clear image of the baby inside the womb.

      Physical examination: done after birth, confirming the presence of the defect.

Treatment of cleft lip and cleft palate

Treatment involves surgeries to close the separation and to reconstruct the features of the face;

      For cleft palate: surgery is performed within 1 year after childbirth.

      For cleft lip: surgery is performed when the child is 6 to 18 months old.

Additional surgeries may be performed to improve the appearance of the lip and nose, close openings between the mouth and nose, help in breathing, and stabilize and straighten the jaw. Contact Shifa4U online for further information.

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Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.