Cleft lip and palate

Cleft Lip and Palate: Causes, Symptoms, and Treatment Options

What is Cleft Lip and Palate? Basic Information

Cleft lip and palate are congenital craniofacial anomalies. They occur when there is an incomplete closure of the upper lip or palate in newborns. This condition typically develops during the prenatal period and leads to various deformities in the baby’s oral and facial structures. This condition is not merely an aesthetic issue; it can also affect feeding, speech, and respiratory functions.

Frequency of Cleft Lip and Palate Cases

The frequency of cleft lip and palate cases can vary based on regional and genetic factors. In Turkey, about 1 in every 700 births results in a cleft lip or palate anomaly. This rate can differ globally, with certain populations in Asia and America experiencing higher frequencies.

How Do Cleft Lip and Palate Develop?

The formation of cleft lip and palate begins during the embryonic period. This anomaly arises when there is a disruption in the fusion of the baby’s facial structures during the early stages of pregnancy.

The Mechanism of Cleft Formation During Pregnancy

Lip formation occurs between the 4th and 7th weeks of embryo development, while the palate forms between the 6th and 9th weeks. Any disruption in the fusion process during these critical periods can result in the formation of a cleft lip or palate. In normal development, the baby’s upper lip and palate close as a whole, but when this fusion fails, clefts appear.

The Role of Genetic Factors

Genetic predisposition plays a significant role in the formation of cleft lip and palate. A family history of such anomalies can increase the risk for future children. While single-gene mutations are rare, the interaction of polygenic and environmental factors is influential in the emergence of this condition.

Environmental Influences and Risk Factors

Certain environmental factors during pregnancy can increase the risk of cleft formation. Smoking, poor nutrition, alcohol consumption, and the use of specific medications are among these risk factors. Folate deficiency is also a contributing factor.

Types of Cleft Lip and Palate

Cleft lip and palate can present in different forms. In some babies, only the lip is affected, while in others, both the lip and palate may be involved.

What is a Complete Cleft Lip and Palate?

A complete cleft is an opening that extends from the upper lip to the nasal cavity. This indicates that both the lip and palate have not fully closed. It typically appears as a noticeable gap in the middle of the face.

Differences Between Partial Cleft Lip and Palate

A partial cleft lip refers to a condition where only a portion of the lip tissue is open. In cases of partial cleft lip, the gap is usually limited to the lip and does not extend into the nasal cavity. Similarly, a partial cleft palate is confined to a limited area of the palate.

Distinguishing Between Unilateral and Bilateral Clefts

Clefts can be unilateral or bilateral. A unilateral cleft lip occurs on one side of the face, while a bilateral cleft affects both sides. Bilateral clefts often require more complex surgical intervention.

How is Cleft Lip and Palate Diagnosed?

Cleft lip and palate can be diagnosed both before and after birth using various methods. Modern technology allows these anomalies to be detected even during pregnancy.

Prenatal Diagnosis Through Ultrasound

Ultrasound examinations during pregnancy allow for the early detection of congenital anomalies like cleft lip and palate. Detailed ultrasounds, especially in the second trimester, can reveal potential issues with the baby’s facial structure.

Physical Examination After Birth

If the condition is not detected during the prenatal period, a physical examination immediately after birth can confirm the diagnosis of cleft lip and palate. The presence of an open area in the lip or palate is often noticeable at first glance in a newborn.

The Use of Additional Imaging Methods

In cases of cleft palate, particularly when internal structures are involved, additional imaging methods may be used to gather more detailed information. These techniques are crucial for surgical planning.

Symptoms of Cleft Lip and Palate

Cleft lip and palate cases manifest with physical symptoms that are evident from birth.

Physical Symptoms in Newborns

The most obvious physical symptom is the presence of an open area in the lip or palate. Some babies may also exhibit deformities in the nasal structure. A cleft in the palate can cause air and fluids to pass into the nasal cavity from the mouth.

Feeding and Sucking Difficulties

Babies with a cleft palate may experience difficulties with sucking because their reflexes are not fully developed. This can result in feeding issues, and affected babies may struggle to gain weight. This situation often necessitates the use of special feeding devices.

Effects on Speech and Language Development

Cleft lip and palate can lead to problems with speech and language development. Palatal clefts, in particular, can interfere with the proper production of sounds. In such cases, speech therapy becomes essential.

Treatment Options for Cleft Lip and Palate

The treatment process requires a multidisciplinary approach. Surgical intervention, orthodontic treatments, and speech therapy are the main components of this process.

Surgical Intervention: When and How Should it Be Done?

Surgical intervention for cleft lip and palate is usually performed within the first 12 to 18 months of the baby’s life. The aim is to correct both aesthetic and functional issues. Lip surgery is typically performed within the first few months, while palate surgery is delayed until a later stage.

Postoperative Process and Recovery

The recovery process after surgery varies for each baby. Postoperative care, including pain management, suture care, and monitoring feeding patterns, is essential.

The Importance of Orthodontic Treatments

Orthodontic problems are common in children with cleft lip and palate. Therefore, early orthodontic treatments are vital to ensure proper alignment of the teeth.

Preoperative Preparation for Cleft Lip and Palate Surgery

Before cleft lip and palate surgery, both the child and family undergo a preparation process that requires physical as well as emotional support.