Cleft Lip and Cleft Palate are common congenital malformations (birth defects), also known as oral clefts or orofacial clefts. Birth defects are health conditions that are present at birth and they change the shape or function of one or more body parts. During the development of lip and palate in early pregnancy period, incomplete fusion of upper lip and palate leads to the formation of cleft lip and palate in a child.
A child can have a cleft lip, a cleft palate or both because development of lips and palate occur at different times during gestation. Children with these birth defects have difficulty in feeding and talking. They are also prone to ear infections, hearing loss, and dental problems.
Cleft lip and cleft palate are common birth defects and happen very early in the pregnancy. Asian population have highest frequency, often 1 in 500 or higher. Cleft lip with or without cleft palate is more common in males than in females. Isolated cleft palate is more common in females whereas males have more severe defects.
Cleft lip is an opening in the upper lip due to incomplete formation of the upper lip before birth. It may be unilateral or bilateral (on both sides of lip).
Cleft palate is an opening of the hard palate or soft palate (roof of the mouth) due to its incomplete fusion. It may also be unilateral or bilateral.
Cleft lip and Cleft palate can be easily identified at birth as these may appear as:
Children with the cleft lip and palate deformities face several problems such as:
Certain other birth defects that may be associated with cleft lip and palate are - Common cardiac defects, Pyloric stenosis (narrowing of stomach as it connects to the small intestine), Club foot, and Scoliosis.
Definite aetiology of cleft lip and palate is still unknown but heredity is the most important factor. Environmental factors also play an important role.
Other possible causes of CLP are:
Most of the children are diagnosed with cleft lip or cleft palate after birth. The diagnosis of cleft lip at birth is obvious whereas to rule out cleft palate, direct illuminated examination of the infant's hard and soft palate is done. Palpation of hard and soft palate is also done to ensure that a partial cleft is not missed. Prenatal ultrasound may demonstrate deformities like cleft lip and palate.
Following measures can be taken to reduce the risk factors of birth defects:
Treatment of cleft lip and palate is mostly surgical. Cleft lip surgery is usually done before 12 months of age, and cleft palate surgery is done before 18 months. Surgeries help in improving the facial appearance of the child along with eating, breathing and speech improvement. Children may need several years of multiple surgeries for a satisfactory outcome. Dental and orthodontic care (braces), speech therapist, hearing specialist, plastic surgeon, ENT specialist, oral surgeon, prosthodontist, psychologist, and a nurse coordinator need to work as a team along with parents’ cooperation for the successful treatment of a child with CLP. Most children with clefts lead a healthy life post treatment.