CLEFT LIP AND CLEFT PALATE

What is a cleft lip and palate?

Early in the development of the human fetus, the lips and roof of the mouth meet and fuse along the midline. Sometimes this fusion does not completely occur. An incomplete fusion of the lip is called a cleft lip. An incomplete fusion of the roof of the mouth is called a cleft palate. The appearance of a child with a cleft lip or palate can be shocking to the unprepared parent.

Lack of complete fusion of the lip and roof of the mouth can interfere with normal growth and function of the mid face and mouth. Problems with facial growth can develop. Problems with speech and oral competence are also frequent.

Both cleft lip and cleft palate are repaired surgically. Usually, the surgical results are quite pleasing in appearance and function.

A child and family with cleft lip or cleft palate will be cared for by a team of specialists including: pediatrician, plastic surgeon, orthodontist, dentist, speech and language specialist, hearing specialist, otolaryngologist, psychologist, genetic counselor and nurse.

I want to have my baby operated on as soon as possible, is that feasible?
For a child with cleft lip and palate, the parents have to understand that he or she will undergo a series of operations in his or her lifetime. This is to achieve as normal looking facial and oral anatomy as possible. As the child grows, revisions are frequently needed to attain symmetry and balance of facial structures.

The first surgery is done when the child’s health permits that he is ready to undergo general anesthesia. The rule of ten’s makes it easy to remember these guidelines: 10 pounds of weight, hemoglobin of 10 gm and usually at 10 weeks of age. The first operation is usually correction of the cleft lip. Cleft palate surgery is done when the child is a little older and always before onset of speech. Other surgeries that can be done as needed are alveoloplasties (repair of the gums and teeth), bone grafting, revision of cleft lip, and correction of the nose deformity.

A pediatrician who will help the surgeon and anesthesiologist determine his readiness to undergo an operation will closely manage your child. The pediatrician will also investigate the presence of other congenital anomalies or birth defects.