One of the most common congenital deformities affecting the face is a cleft lip, a cleft palate, or both. These facial irregularities occur during pregnancy when there is not enough tissue in the mouth or lip area for it to join together properly. This condition can be a genetically inherited or an isolated birth defect, but surgery can restore normal function and appearance. The severity of a cleft varies. It can be as severe as a large gap extending through the lip and gum into the nose or as minor as a small notch in the upper lip.
Several risk factors which may increase a baby’s likelihood of being born with this condition include:
- Family history of the condition
- Exposure to substances such as alcohol or smoking during pregnancy
- Sex – Males are more likely to be born with a cleft lip, and females are more likely to be born with a cleft palate
- Race – This condition is most common in children with Asian and American Indian heritage
- Obesity during pregnancy
Prenatal ultrasounds during pregnancy may sometimes reveal a cleft lip or palate, but it is very obvious during a physical examination once a baby is born. Aside from the aesthetic issues, children with a cleft lip or palate endure many other day-to-day problems.
Ear Infections and Hearing Loss
Children suffering from a cleft palate are more prone to fluid build-up in the middle ear; consequently, they are at a higher risk for ear infections, which can cause hearing loss if left untreated. Many children need special drainage tubes in the eardrums and must undergo annual hearing checks.
The presence of this condition increases the risk of cavities and often results in missing, extra, or displaced teeth, and extensive orthodontic treatment is required.
A cleft palate can make it difficult for children to eat and chew properly. The separation in the palate can cause liquids to enter the mouth and exit through the nasal passage if consumed at an upward or sideways angle. A prosthetic palate can be worn to make eating easier until the corrective surgery is performed.
Children with either of these conditions often experience difficulty carrying their voices and pronouncing words, and it is common for their voices to take on a nasal sound.
How is a Cleft Lip or Palate Treated?
The great news is that children with a cleft lip or palate can gain many functions through surgery, therapy, or both, thereby making many of the problems mentioned above treatable. Children frequently undergo a series of surgeries as they age and develop to guide the lip and palate into their proper, fully developed positions.
When repairing a cleft palate, the first surgery performed usually occurs during infancy, between 6 months and 12 months of age. The surgeon will enter the mouth to close the gap or hole that has failed to develop, reconnect the palate muscles, and sometimes elongate the palate. Usually, a second surgical procedure is performed when the child is between 8-12 years of age, which involves placing a bone graft into the palate.
Treatment for a cleft lip aims to close the separation and restore balance and function to the upper lip. The initial procedure is usually performed when the patient is 1-4 months of age. Additional surgeries may be needed to monitor the lip’s growth and development starting at age two and continuing into the later teen years. Further treatment, such as hearing aids or speech therapy, may be recommended as well.
Dr. Marashi’s extensive knowledge of oral and maxillofacial surgery and training in both dentistry and general medicine makes him especially qualified to repair cleft lip and palate deformities. If you are in need of a consultation to repair this facial defect, please contact one of our office locations in Pineville or Steele Creek, Charlotte, NC.