A cleft lip is a congenital abnormality of the upper lip of newborn infants.  This defect may involve the lip, skin, muscle, gums, and even bone. A complete cleft extends into the nose whereas with an incomplete cleft some tissue remains to separate the nose and mouth. A cleft lip may involve one or both sides of the upper lip. A cleft palate is an abnormal separation of the 2 halves of the upper part of the mouth. A sub mucosal cleft palate may be hidden below intact mucosa. A cleft palate may involve the soft and/or hard palate and represents an abnormal division of the underlying muscle and bone. An untreated cleft palate or cleft lip may result in breathing and feeding difficulties.  Surgical repair is typically performed before one year of age.

What is a cleft lip? 

A cleft lip is a congenital abnormality of the upper lip.  There is incomplete formation of skin, gums, muscle, and/or bone that results in a visible defect.

What is a cleft palate?

A cleft palate is an abnormal division of the roof of the mouth.  This may involve the hard front surface, the back soft surface, and the underlying muscle and bone.  In some cases the defect is hidden by the surface mucosa of the roof of the mouth.

Can a child have both cleft lip and cleft palate? 

Yes.  The child may have one or both. When cleft lip affects both sides, there is an 86% chance of having left palette also.  When left of that is on one side only, cleft palate is present in about 68% of cases. 

How common are cleft lip and cleft palate?

One or both of these defects occurs in approximately one out of 700 births.  These defects seem to be slightly more common in Asians than other ethnic groups.

What causes cleft lip and cleft palate?

• In most cases the cause is not known. 
• About 1/3 children with these defects have a family member with a similar defect .
• Children who are born to mothers who smoke during pregnancy are twice as likely to develop one of these defects. 
• The defect results from incomplete fusion of the palette or lip during fetal development. 

How are cleft lip and cleft palate diagnosed?

• Both of these defects can be seen on prenatal ultrasounds. 
• After birth of the diagnoses of cleft lip is typically obvious. 
• The roof of the mouth can be examined with a finger.
• An oral exam with a tongue depressor may reveal a uvula with two heads (a bifid uvula). 
• Other anomalies of the face, heart, and/or extremities may be associated with a cleft lip or palate. 

How are cleft lip and cleft palate treated? 

• Shortly after birth it must be determined if the infant has problems with breathing or feeding. 
• Some infants require a special nipple that aids with feeding. 
• Some infants may require a feeding tube.  

Surgery

• Ultimately these defects will require surgical repair.
• The best time for cleft lip repair varies from 2-6 months of age. 
• Cleft palate repair is typically performed before one year of age to avoid difficulties with speech.  

Other anomalies

All infants with cleft lip and cleft palate should be investigated for other abnormalities.  These should be treated as needed. 

Dr. Tummy's view 

Surgical correction of these defects has come a long way in recent years.  In most children, the defect is hardly noticeable after surgical repair. 

 Photo credit - WikiMedia Commons Raj d0509 on 2006 March 6

Bookmark with: