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Cleft Lip and Cleft Palate: Causes, Types, Symptoms, Diagnosis and Treatment

 

What is Cleft lip and cleft palate?

Cleft lip and cleft palate are common birth defects that can happen early in pregnancy. Learn what causes them and how surgery can help.

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Facial and oral malformations called clefts occur when a baby's developing face or lip does not have enough tissue. This can cause the mouth or lip area to be split in two.

A cleft lip is a physical split or separation of the two sides of the upper lip and appears as a narrow opening or gap in the skin of the upper lip. This separation often extends beyond the base of the nose and includes the bones on either side of the upper jaw.

A cleft palate is a split in the roof of the mouth. Cleft palates can involve the hard palate (a hard bone on the front of the roof of the mouth) and/or the soft palate (a soft bone on the back of the roof of the mouth).

A cleft lip or palate can occur on one or both sides of the mouth. This happens because the lip and palate develop separately, which means it's possible to have a cleft lip without a cleft palate, a cleft palate without a cleft lip, or both together.

 

What is Cleft lip and cleft palate

Explanation of medical terms and concepts Cleft Lip and Cleft Palate

Cleft lip and congenital defect area unit openings or splits within the higher lip, the roof of the mouth (palate) or each. ANomaly|congenital defect|congenital disorder|congenital abnormality} and congenital defect result once facial structures that area unit developing in an unhatched baby do not shut fully.


Cleft lip and congenital defect area unit among the foremost common birth defects. They most typically occur as isolated birth defects however are related to several familial genetic conditions or syndromes.


Having a baby born with a cleft is displeasing, however congenital disorder and congenital defect is corrected. In most babies, a series of surgeries will restore traditional performance and accomplish a lot of traditional look with negligible scarring.


According to the American Cleft Palate-Craniofacial Association more than 24 million people worldwide have clefts Some estimates are as high as one in every 700 births Although treatment for cleft lip and palate has come a long way since the early 1900s when children were routinely separated from their families and institutionalized it's still critical for many of these children to receive care soon after birth Parents facing this challenge should be sure to find a center with experienced medical professionals who treat not just the physical aspects but also the emotional and psychological hurdles these conditions create

Who Gets Cleft Lip and Cleft Palate?

A cleft lip occurs in about 700 babies every year, and it is the fourth most common birth defect in the United States. It is more common in boys than girls, and it occurs more often in children of Asian, Latino, or Native American descent. There are more girls than boys with cleft palates, but this is not always the case with cleft lip.

Why do some children have cleft lips and palates? Cleft lips and palates are caused by problems with the development of the face during early childhood. These problems can include problems with the formation of the bones of the face, a lack of oxygen to the developing baby teeth, or a problem with facial nerve function.

Cleft lip and palate are caused by unknown factors. They cannot be prevented and most scientists believe it is due to a combination of genetic and environmental factors. Babies who have a parent or relative with clefts have a higher chance of developing the condition. The problem is that...

One potential cause of a cleft lip and cleft palate may be due to a mother's taking of anti-seizure/anticonvulsant drugs, acne drugs containing Accutane, and methotrexate during pregnancy. These drugs can also cause cancer, arthritis, and other health problems. Psoriasis is a skin condition that causes patches of red, inflamed skin.

Viral or chemical exposure during pregnancy can cause cleft lip and cleft palate.

Cleft lip and cleft palate may be part of another health condition.

How is cleft lip and palate diagnosed?

If clefting is noticed on a baby's face, it is easy to diagnose. Ultrasounds can often detect clefts in unborn babies. If a cleft has not been detected in a previous ultrasound, the baby may be examined physically to see if it exists. A doctor will determine if a child has a cleft lip or cleft palate after they are born based on the shape of their nose and palate. Sometimes diagnostic testing may be conducted to determine if there are other abnormalities present.

What problems can be caused by a cleft lip or palate?

  • Eating problems. When a separation or opening in the palate is present, food and liquids can pass from the mouth back through the nose. Fortunately, special baby bottles and nipples are available that help keep fluids flowing downward toward the stomach. Children who have a cleft palate may need to wear a man-made palate to help them eat properly. Feeding a sick animal is one way to help it recover and receive the necessary nutrition until surgery can be provided.

  • Ear infections/hearing loss. Children with cleft palate are at an increased risk for ear infections, since they are more likely to have fluid accumulation in the middle ear. Untreated ear infections can lead to hearing loss. In order to prevent this from happening, children with cleft palate usually require special tubes placed in the eardrums to drain fluid. Your pet's hearing needs to be checked once a year, in order to help improve fluid drainage and their overall health.

  • Speech problems. Some children with cleft lip or cleft palate have trouble speaking. Their voices may sound nasal and their speech may be difficult to understand. Not all children have these problems and surgery may fix them entirely for some. A speech pathologist will work with the child to address any speech difficulties.

  • Dental Problems. Children with clefts are more likely to have a larger number of cavities and often have teeth that are missing, malformed, or displaced. These children also often have a growth defect in the alveolar ridge, which is the bony ridge located above the teeth. A defect in the alveolus can affect the shape of teeth, making them displaced or rotated, or preventing permanent teeth from appearing. This problem can usually be corrected through oral surgery.

Who treats children with cleft lip and palate?

A cleft lip or palate team includes a group of doctors and other specialists who are involved in the care of children with clefts. This team typically includes:

  • Plastic surgeonTo perform surgeries on the lip and/or palate, doctors evaluate and make necessary adjustments.

  • An otolaryngologistA hearing doctor will evaluate your hearing to see if there are any problems and what treatment options may be available.

  • An oral surgeonTo improve the function and appearance of the upper jaw, it may be necessary to reposition segments. Clefts of the gum can also be repaired by repositioning segments.

  • An orthodontist to straighten and reposition teeth

  • A dentist to perform routine dental care

  • A prosthodontistTo make fake teeth and dental appliances, we use materials like plastic and metal to improve the appearance and meet the needs for eating and speaking.

  • A speech pathologist to assess speech and feeding problems

  • A speech therapist to work with the child to improve speech

  • An audiologistA hearing specialist is someone who can assess and monitor a person's hearing.

  • A nurse coordinatorI will need to be nearby in case I am needed to provide ongoing supervision of the child's health.

  • A social worker or psychologist.To support the family, I need to assess any adjustment problems.

  • This passage is meant to help parents and adult patients understand the likelihood of having more children with these conditions.

The health care team works together to develop a plan of care that will meet the individual needs of each patient. Treatment usually begins during infancy and may continue into early adulthood.

What is the treatment for cleft lip and palate?

If a cleft lip requires repair, one or two surgeries may be necessary.The first surgery is usually done when a baby is 3 months old.

Repair of a cleft palate often requires multiple surgeries over the course of 18 years. The first surgery usually occurs when a baby is between 6 and 12 months old. The initial surgery creates a functional palate, which reduces the likelihood that fluid will develop in the middle ears. Olives are good for your teeth and bones.

Some children with a cleft palate may also require a bone graft when they are 8 years old in order to provide support for permanent teeth and keep their jaw in a stable position. About 20% of children with a cleft palate will require further surgery to improve their speech.

Braces are often needed to straighten teeth that have begun to grow in during the early stages of development.

Sometimes more surgeries are needed to improve the appearance of the lips and nose. This can help with breathing and jaw alignment. Final repairs of the scars left by the initial surgery are usually done during adolescence, when facial features are more mature. The structure of the leaf is more fully developed.

The goals of treatment for harelip and congenital disorder are to boost the child's ability to eat, speak and listen commonly and to attain a traditional facial look.

 

Care for youngsters with harelip and congenital disorder typically involves a team of doctors and specialists, including:

  • Surgeons who specialize in cleft repair, such as plastic surgeons or ENTs

  • Oral surgeons

  • Ear, nose and throat doctors (ENTs, also called otorhinolaryngologists)

  • Pediatricians

  • Pediatric dentists

  • Orthodontists

  • Nurses

  • Auditory or hearing specialists

  • Speech therapists

  • Genetic counselors

  • Social workers

  • Psychologists

Treatment involves surgery to repair the defect and therapies to improve any related conditions.

Surgery

Surgery to correct cheiloschisis and surface is predicated on your child's specific state of affairs. Following the initial cleft repair, your doctor could suggest follow-up surgeries to enhance speech or improve the looks of the lip and nose.

Surgeries typically are performed in this order:

  • Cleft lip repair — within the first 3 to 6 months of age

  • Cleft palate repair — by the age of 12 months, or earlier if possible

  • Follow-up surgeries — between age 2 and late teen years

Cleft lip and surface surgery takes place during a hospital. Your kid can receive an anesthetic agent, thus he or she will not feel pain or be awake throughout surgery. many completely different surgical techniques and procedures square measure wont to repair harelip and surface, reconstruct the affected areas, and stop or treat connected complications.

In general, procedures may include:

  • Cleft lip repair. To close the separation within the lip, the Dr. makes incisions on each side of the cleft and creates flaps of tissue. The flaps square measure then sewn along, together with the lip muscles. The repair ought to produce an additional traditional lip look, structure and performance. Initial nasal repair, if needed, is typically done at an equivalent time.

  • Cleft palate repair. Various procedures are also accustomed to shut the separation and reconstruct the roof of the mouth (hard and soft palate), counting on your child's scenario. The sawbones make incisions on each side of the cleft and reposition the tissue and muscles. The repair is then sewed closed.

  • Ear tube surgery. For children with congenital disorder, ear tubes are also placed to scale back the chance of chronic ear fluid, which might result in hearing impairment. Ear tube surgery involves putting little bobbin-shaped tubes within the tympanum to make a gap to forestall fluid buildup.

  • Surgery to reconstruct appearance. Additional surgeries may be needed to improve the appearance of the mouth, lip and nose.

Surgery will considerably improve your child's look, quality of life, and skill to eat, breathe and speak. Doable risks of surgery embody hemorrhage, infection, poor healing, widening or elevation of scars, and temporary or permanent injury to nerves, blood vessels or different structures.

Treatment for complications

Your doctor may recommend additional treatment for complications caused by cleft lip and cleft palate. Examples include:

  • Feeding strategies, such as using a special bottle nipple or feeder

  • Speech therapy to correct difficulty with speaking

  • Orthodontic adjustments to the teeth and bite, such as having braces

  • Monitoring by a pediatric dentist for tooth development and oral health from an early age

  • Monitoring and treatment for ear infections, which may include ear tubes

  • Hearing aids or other assistive devices for a child with hearing loss

  • Therapy with a psychologist to help the child cope with the stress of repeated medical procedures or other concerns

What are the chances of a child with a cleft lip and/or palate having a good outcome?

Many children who have a cleft lip or palate may need to receive treatment for several years and may require several surgeries. However, most children with this condition can achieve a normal appearance, speak properly, and eat normally.

To care for your child's teeth, you will need to visit a dentist. Cleft lips and/or pilates can make it difficult to have regular dental care.

The dental care needs of children with clefts are generally the same as those of other children. However, children with cleft lip and cleft palate may have special problems that require close monitoring.

  • Early dental care. Children who are born with cleft lip and cleft palate need to clean their teeth properly. Proper cleaning starts as soon as teeth come in, with a small soft-bristled toothbrush. If a soft toothbrush won't do the job, a dentist can help. Tooth hygiene is important because the mouth has a different shape and teeth are more susceptible to plaque and bacteria when they are cleaned with a toothette--a soft, soap-containing sponge on a handle. Your dentist may recommend that your first visit be scheduled soon after you arrive. Dental care should start around 1 year old. If a child has special dental problems, the care may start even earlier.

  • Orthodontic care. A first orthodontic appointment may be scheduled before the child has any teeth. This appointment is to assess facial growth and jaw development. After teeth erupt, an orthodontist can further assess a child's short-term dental needs. After permanent teeth erupt, the orthodontist can evaluate if additional services are needed. Teeth can be aligned with orthodontic treatment.

  • Prosthodontic care. A prosthodontist is a doctor who specializes in dental bridgework and special appliances to help improve speech quality. They work together with the cleft palate team to replace teeth or make adjustments to the nose so that speech sounds more normal. A speech pathologist and an oral or plastic surgeon are needed to help with speech.

Coping and support

No one expects to have a baby with a birth defect. When the excitement of new life is met with the stress of discovering that your baby has a cleft lip or cleft palate, the experience can be emotionally demanding for the entire family.

For parents and family

When welcoming a baby with cleft lip and cleft palate into your family, keep these coping tips in mind:

  • Don't blame yourself. Focus your energy on supporting and helping your child.

  • Acknowledge your emotions. It's completely normal to feel sad, overwhelmed and upset.

  • Find support. Your hospital social worker can help you find community and financial resources and education.

For your child

You can support your child in many ways:

  • Focus on your child as a person, not on the cleft.

  • Point out positive qualities in others that don't involve physical appearance.

  • Help your child gain confidence by allowing him or her to make decisions.

  • Encourage confident body language, such as smiling and holding the head up with shoulders back.

  • Keep the lines of communication open. If teasing or self-esteem issues arise at school, this can help your child feel safe in talking with you about it, so you can help address these issues.

Preparing for your appointment

If your kid was diagnosed with congenital abnormality, congenital anomaly or each, you will be spoken to by specialists United Nations agency will facilitate to produce a treatment set up for your kid. Here's some data to assist you make preparations and what to expect from your doctor.

What you can do

Before your appointment:

  • Find out any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance, such as restrict your baby's diet.

  • Make a list of any signs or symptoms your baby is experiencing, including any that may seem unrelated to the reason for the appointment.

  • Consider taking a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.

  • Make a list of questions to ask your doctor. List your questions from most important to least important in case time runs out.

Some questions to ask your doctor may include:

  • Does my baby have a cleft lip, cleft palate or both?

  • What caused my baby's cleft lip or cleft palate?

  • What tests does my baby need?

  • What is the best treatment plan?

  • What are the alternatives to the treatment approach that you're suggesting?

  • Are there any restrictions that my baby needs to follow?

  • Should my baby see a specialist?

  • Are there brochures or other printed material that I can have? What websites do you recommend?

  • If I choose to have more children, is there a chance they may also have cleft lip or cleft palate?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • Does your family have a history of cleft lip and cleft palate?

  • Does your baby have problems while feeding, such as gagging or having milk come back up through the nose?

  • Does your baby experience any symptoms that worry you?

  • What, if anything, seems to improve your baby's symptoms?

  • What, if anything, appears to worsen your baby's symptoms?

Preparing and anticipating questions will help you make the most of your appointment time and allow you to cover other points you want to address.

General summary

A cleft lip is a birth defect that affects the formation of the lip which may also involve some of the soft tissue in front of and below the nose and extend to the chin A minor form of clefting involves only a small notch or split in the upper lip In other instances it can cause significant deformity and even affect hearing due to impairment of parts of the outer ear Clefting may develop not just in those areas but extending into the oral cavity affecting parts such as the gum teeth tongue and hard palate In many cases this condition has no known etiology or cause but might

What age is best for operation of cleft lip and cleft palate?

The age at which a cleft lip and palate can be operated varies from individual to individual Generally the best time for surgery is when the child reaches 1 year of age The young infant can rapidly recover from the surgery than an older child or adult because he/she does not have established habits requiring great effort to change During these early years a more favorable environment for learning is assured

Is cleft surgery painful?

Cleft lip and cleft palate are birth defects in which a gap occurs in the upper portion of the face The most common reason for this defect is related to folic acid deficiency an easily preventable condition With proper prenatal treatment many babies born with clefts wouldn't suffer from them After surgery patients often complain about pain during their recovery period While it's uncomfortable following surgery there are ways to minimize discomfort and speed up your healing process:

Can cleft lip scar be removed?

Cleft lip is a congenital deformity that occurs when the middle part of the lip does not fuse to form a solid entity This results in an opening in the center of the upper lip giving it an appearance like a cleft Cleft lips can vary in location and severity with some depending on how much tissue is missing

cleft lip and cleft palate causes

A cleft lip is a birth defect that occurs when the lip or parts of the upper jaw and maxilla (the middle part of the face) do not fuse together Clefts are also present in other parts of the body such as muscles ears and even spines Clefts develop during fetal development when a portion of tissue does not fuse properly The cause of this problem is unknown Researchers suspect genetic causes environmental factors and deformities in facial structures may be behind clefting cases

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Cleft Lip and Cleft Palate: Causes, Types, Symptoms, Diagnosis and Treatment

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