What are Cleft Lip and Cleft Lip and Palate?
A cleft lip (cheiloschisis) is a type of orofacial birth defect. Normally, between the 4th and 7th week of pregnancy, the lips form. A cleft, which means split or separation, can range from a small notch in the upper lip to a long notch that reaches the nose. It can occur on one or both sides of the lip, or in the middle of the lip (although the last is extremely rare).
An “isolated cleft lip”, where only the upper lip is affected without palate involvement, accounts for 20 percent of all cleft cases. The Centers for Disease Control estimates that each year “4,437 babies are born with a cleft lip with or without cleft palate. Cleft lip is more common than cleft palate. Isolated orofacial clefts, or clefts that occur with no other birth defects, are one of the most common birth defects in the United States. About 70% of all orofacial clefts are isolated clefts” (CDC).
What is a Cleft Lip/Palate?
A cleft lip and palate occurs when the palate and lip do not close properly between the 6th and 9th weeks of pregnancy. This means the roof of the mouth is open either partially or completely so that there is no actual separation between the nose and mouth. In some cases, the palate (roof of the mouth) has not closed, but the opening is covered by soft tissue.
This obviously creates great difficulty in eating and drinking, in some cases breathing, and, later on, speech and tooth development.
About one in 1,000 babies are born with cleft lip/palate and these cases account for approximately 50 percent of all clefts. Cleft lip/palate is more common among Asian and certain American Indians. The lowest rates are among African Americans. Boys are more often born with cleft lip/palate deformities than girls, and up to 13 percent of cases present with other birth defects. At this point, research continues to try to figure out why these incidents happen.
An isolated cleft palate affects the palate or roof of the mouth only, not the lip, and about 2,000 babies every year. A submucous cleft palate – where the palate is open, but covered by soft tissue – accounts for one in 1,200 births. Isolated clefts account for about 30 percent of all cleft cases and occur more in female babies.
It is not known why clefts of any kind occur. Research continues, but it is generally thought that a cleft is an inherited characteristic from either or both parents, could be the result of poor early pregnancy health or exposure to alcohol or cocaine, or the result of a genetic syndrome. “Cleft lip/palate is a part of more than 400 syndromes…. Approximately 30 percent of cleft deformities are associated with a syndrome, so a thorough medical evaluation and genetic counseling is recommended for cleft patients” (AAO-HNS).
Treatment for Cleft Lip/Palate
The extent of treatment required depends on the severity of the cleft. Usually, clefts are treated with surgery, and can involve several specialists over the course of the surgical and follow-up treatment. Surgery to repair a cleft lip usually happens between 10 and 12 weeks, while a cleft palate surgery is scheduled between 9 and 18 months.
Ongoing therapy may include the involvement of speech, hearing, growth, dental and psychological development evaluations and treatments.
If you and your child are facing the prospect of cleft lip or cleft palate surgery, the American Society of Plastic Surgeons has some great information about the procedure and what you can expect and questions you should ask: Cleft Lip and Palate Repair.
Darlene Oakley is a freelance writer for EmpowHER.com.
Facts about Cleft Lip and Cleft Palate. Centers for Disease Control. Web. Feb 21, 2012. http://www.cdc.gov/ncbddd/birthdefects/CleftLip.html
Fact Sheet: Cleft Lip and Cleft Palate. American Academy of Otolaryngology-Head and Neck Surgery. Web. Feb 21, 2012. http://www.entnet.org/HealthInformation/cleftLipPalate.cfm
Cleft Lip and Palate Repair. American Society of Plastic Surgeons. Web. Feb 21, 2012. http://www.plasticsurgery.org/reconstructive-procedures/cleft-lip-and-palate.html#content