Cleft lip and cleft palate

Diagnosis

The majority of cleft lip and cleft palate instances are identified at birth and don’t need any additional testing to be diagnosed. More often than not, cleft lip and cleft palate can be noticed during an ultrasound before the infant is even born.

Ultrasound before birth

During a prenatal ultrasound, sound waves are used to produce images of the growing fetus. A doctor may notice a variation in the face structures after reviewing the images.

Beginning about the 13th week of pregnancy, ultrasonography can identify cleft lip. Accurately diagnosing a cleft lip may get simpler as the fetus continues to develop. When a cleft palate develops alone, ultrasonography imaging is more challenging.

Your doctor might suggest a treatment to remove a sample of amniotic fluid from your uterus (amniocentesis) if a prenatal ultrasound reveals a cleft. The fluid test could reveal a genetic condition that could lead to other birth abnormalities in the fetus. However, cleft lip and cleft palate most frequently have no recognized etiology.

Treatment

The goals of treatment for cleft lip and cleft palate are to improve the child’s ability to eat, speak and to hear normally and to achieve a normal facial appearance.

Care for children with cleft lip and cleft palate often involves a team of doctors and experts, including:

• Cleft repair specialists in surgery, including plastic surgeons or ENTs
• Surgeons who specialize in oral surgery
• Ear, nose and throat doctors (ENTs)
• Pediatricians
• Pediatric dentists
• Orthodontists
• Genetic counselors
• Social workers
• Psychologists
• Nurses
• Hearing specialists
• Speech therapists

Surgery is used to correct the defect, and therapies are used to treat any associated diseases.

Surgery

The type of surgery required to treat cleft lip and palate depends on your child’s specific circumstances. Your doctor can advise additional procedures to enhance speech or the aesthetics of the lip and nose after the initial cleft repair.

Surgery is normally carried out in the following order:

• Cleft lip repair: done during 3 to 6 months from birth
• Cleft palate repair: done when the child has reached the 12th month or if possible, even earlier
• Follow-up surgeries: done during 2nd year and late teenage years

A hospital is where cleft lip and palate surgery is performed. A general anesthesia will be administered to your child so they won’t be conscious or in discomfort during the procedure. Repairing cleft lip and palate, reconstructing the afflicted areas, and preventing or treating associated problems all need a variety of surgical techniques and procedures.

Procedures often comprise:

• Cleft lip repair. The surgeon will make incisions on the two sides of the cleft in order to close the separation of the lip by creating flaps of tissue. The lip muscles and the flaps are further stitched together. A more typical lip appearance, structure, and function should result after the repair. If necessary, the initial nasal repair is typically done concurrently.
• Cleft palate repair. Depending on the circumstances surrounding your child, different methods may be utilized to repair the hard and soft palate and heal the divide. The surgeon repositions the tissue and muscles by making incisions on both sides of the cleft. After that, the repair is sewn shut.
• Ear tube surgery. Ear tubes may be inserted in children with cleft palates to lessen the possibility of chronic ear fluid, which can cause hearing loss. The goal of ear tube surgery is to create an aperture in the eardrum that will prevent fluid collection.
• Surgery to reconstruct appearance. It can be necessary to have more procedures to enhance the appearance of the mouth, lip, and nose.

Your child’s appearance, quality of life, and capacity for eating, breathing, and speaking can all be dramatically enhanced by surgery. Bleeding, infection, slow healing, broadening or elevation of scars, and temporary or permanent harm to nerves, blood vessels, or other tissues are all potential dangers associated with surgery.