Cleft Palate/Cleft Lip

An oral-facial cleft is an opening in a structure around the mouth and face. Clefts may occur in the lip, the roof of the mouth (hard palate) or the tissue in the back of the mouth (soft palate).

A cleft lip can range in severity from a simple notch in the upper lip to a complete opening in the lip extending into the floor of the nostril. The upper gum may be involved. Clefts can occur on one or both sides, and with or without involvement of the palate. More than 70 percent of babies with cleft lip also have cleft palate.

Cleft palate (whether alone or part of cleft lip/palate) can involve the soft palate only or extend forward through the hardpalate. One or both sides of the palate can be affected.

Causes
The causes of cleft lip/palate are not well understood. Studies suggest that a number of genes, as well as environmental factors, such as drugs (including antiseizure drugs), infections, maternal illnesses, maternal alcohol use and, possibly, deficiency of B vitamin folic acid may be involved.

Prevention
While little is known about how to prevent oral-facial clefts, a 1995 study suggested that taking multivitamins containing folic acid before conception and during the first two months of pregnancy may help prevent cleft lip/palate and isolated cleft palate.

Treatment
Surgery often is used to correct cleft lip/palate and isolated cleft palate. The timing and type of surgery depend on a number of factors, including the preference of the individual surgeon, the general health of the baby and the nature of the cleft. Most surgeons agree that cleft lip should, in most cases, be repaired by about three months of age. Cleft palate repair is generally timed to restore the partition between the nose and mouth as early as possible (often between 9 and 18 months). Additional surgical procedures often are needed as the child grows.

Children with oral-facial clefts usually are treated by a team of specialists so that all aspects of treatment can be coordinated. Most teams include a pediatrician, a plastic surgeon, dental specialists,an otolaryngologist (ear, nose and throat specialist), a speech-language pathologist, an audiologist (hearing specialist), a geneticist and a psychologist and social worker.

Source: March of Dimes Foundation Last Updated: December 03, 2007