An oral-facial cleft is a birth defect. A cleft lip is an opening in the upper lip, usually just below the nose. A cleft palate is an opening in the roof of the mouth (hard palate) or in the soft tissue at the back of the mouth (soft palate). In the majority of cases, a cleft lip and cleft palate occur together.
All fetuses have an opening in the lip and palate during early pregnancy. In normal fetal development, these openings close during pregnancy. Failure of one or both of these openings to close results in an oral-facial cleft. The exact cause is not known. Cleft lip occurs alone or in combination with cleft palate in approximately 1 in 750 white births, and cleft palate occurs in approximately 1 in 2,500 white births.
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors for oral-facial clefts include:
The major symptom of a cleft lip and/or cleft palate is a visible opening in the lip or palate. Other symptoms can occur as a result of an oral-facial cleft include:
A doctor can diagnose cleft lip or cleft palate by examining the newborn baby. A newborn with an oral-facial cleft may be referred to a team of medical specialists soon after birth. Rarely, a partial or “submucous” cleft palate may not be diagnosed for several months or even years.
Cleft lip and palate are sometimes associated with other medical conditions. Your doctor should be able to tell you whether or not your child’s clefting is part of a “syndrome.” Some syndromes may require treatment in addition to taking care of a cleft lip or palate.
Prenatal diagnosis (diagnosis prior to birth) can also be accomplished using ultrasound examination. Cleft lip is more easily diagnosed via prenatal ultrasound than cleft palate is. Diagnosis can be made as early as 18 weeks of pregnancy. Prenatal diagnosis gives the parents and the medical team the advantage of advanced planning for the baby’s care.
Treatments may include:
The main treatment is surgery to close the opening in a lip and/or palate. Additional surgical treatment for oral-facial clefts may include:
Other treatments may include:
Pregnant women and women who are likely to become pregnant can do the following to help prevent oral-facial clefts in their unborn children:
RESOURCES:
Cleft Lip and Palate Association
http://www.clapa.com/
Cleft Palate Foundation
http://www.cleftline.org/
CANADIAN RESOURCES:
About Kids Health
http://www.aboutkidshealth.ca/
Women's Health Matters
http://www.womenshealthmatters.ca/
References:
Behrman RE, Jensen HB, Nelson WE, Kleigman RM. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.
Berkow R. The Merck Manual of Medical Information . New York, NY: Pocket; 2000.
Berkow R, Beers MH, Fletcher AJ. The Merck Manual of Medical Information—Home Edition. 2nd ed. New York, NY: Simon and Schuster, Inc; 2003.
Cleft lip and palate. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/cleftlipandpalate.html . Updated June 2009. Accessed July 9, 2009.
Cummings CW. Cummings: Otolaryngology: Head & Neck Surgery. 4th ed. St. Louis, MO: Mosby; 2005.
Last reviewed September 2009 by J. Thomas Megerian, MD, PhD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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