Cleft Lip and Palate

What Is A Cleft Lip?

Early on in pregnancy, a baby’s face begins to develop from several embryological processes. Many genetic and environmental factors influence this complex orchestration of events, but in about 1/700 people, a cleft may occur. This means that somewhere along the way, those facial processes were unable to properly fuse. This may range from a small split on part of the upper lip to a large, wide split extending into the nose.

There are several classification systems, and literature abounds regarding this issue, but the critical element is that the lip muscle remains in two parts. This affects smiling, sucking, and forming certain sounds during speech.

What About A Cleft Palate?

When a cleft extends into the nose, many times it also affects the gums. This may also present with a range from just a small notch on the gums to a wide split extending all the way back on the roof of the mouth, the palate. The palate functions in proper speech and eating. Similar to the lip repair, the palate muscle must be properly repaired and connected so that the oral cavity is sealed from the nasal cavity during function.

Properly addressing cleft lip and palate issues involves a team approach. This includes appropriate members to help the child develop proper speech, ear function, dental development, and even social issues to name a few.

Cleft Lip Treatment

Cleft lip surgery is usually performed when the baby is about 3 months old. This allows

adequate time for the baby to be thriving from a nutritional standpoint. Goals of the surgery include executing perfect alignment of the lip elements and anastomosis of the muscle. This also improves the nasal deformity. Sometimes (usually when addressing wider clefts) this surgery is performed in two phases, which improves the esthetic result for both lip and nose.

Cleft Palate Treatment

Cleft palate surgery is usually performed when the child is about 1 year of age. This balances the need to allow sufficient growth of the upper jaw and the child’s speech development. Usually ear tubes are placed by an otolaryngologist at the same time as the palate repair.

The cleft hard palate may be repaired anywhere from when the child is 7 to 12 years of age. The development of the child’s cuspid is a major component in this decision.

What Should Be Expected After Surgery

After your baby’s cleft surgery, he/she may be fussy for a few days even up to a week. Interestingly, having a cleft lip and/or palate is “normal” for the baby, so when it is repaired, we are changing what is normal for them. Your cleft surgeon, Dr. Gaal, will be with you step by step along the way. This long-term relationship initiates from when the cleft is diagnosed all the way into adulthood. That is because we understand it is not just about a one-time surgical intervention. Cleft care is about occlusion (dental bite) and growth of your child over time, and we partner in this together.