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A Guide to Cleft Palate

A Guide on Cleft Palate

Curious about cleft palate or looking for the best course of treatment? Read our guide on cleft palate and discover more about this common craniofacial anomaly. 

What is a Cleft Palate?

Cleft palate and cleft lip are openings or splits in the upper lip, roof of the mouth (palate), or both. Cleft lip and cleft palate are among the most common birth defects, and usually occur as isolated incidents. However, they can be associated with other inherited genetic conditions or syndromes.

Types of Cleft Lip and Palates

There are a few different types of cleft defects, each affecting different areas to varying degrees. These types of defects fall under two umbrella categories — unilateral and bilateral.

Unilateral Defects

These defects are the most common type of cleft, affecting one side of the lip or palate:

  • Incomplete Unilateral Cleft Lip
    • A notching of the lip that does not extend into the nose

  • Incomplete Unilateral Cleft Lip and Palate
    • A notching of the lip that does not extend into the nose, accompanied by a cleft palate

  • Complete Unilateral Cleft Lip and Palate 
    • An opening that extends from one side of the lip into the nose and palate

Bilateral Defects 

These defects affect both sides of the lip and/or palate, forming two clefts:

  • Incomplete Bilateral Cleft Lip and Palate
    • A notching of both sides of the lip that does not extend into the nose

  • Complete Bilateral Cleft Lip and Palate
    • An opening that extends from both sides of the lip into both nostrils

Causes of Cleft Lip and Palates

Cleft lip and cleft palate usually occur when tissues in the baby's face and mouth don't fuse properly in the womb. Typically, these tissues fuse together in the second and third months of pregnancy, but that fusion only partly or never takes place in babies with cleft lip and palate. Medical experts and researchers think that most causes of this birth defect are from genetic factors — in many babies, a definite cause is never found.

​​In addition to genetics, there are several syndromes commonly associated with cleft lip and palate:

  • Van der Woude syndrome
  • Stickler syndrome
  • Pierre Robin sequence or syndrome
  • Hemifacial microsomia
  • Goldenhar syndrome
  • Downs syndrome
  • DiGeorge syndrome
  • Oro-mandibular limb hypoplasia syndrome
  • Opitz syndrome

Cleft Lip and Palate Surgery

To fix cleft lip and palate, surgery is usually required. There are several different types of procedures available depending on the severity of the deformity:

Nasoalveolar Molding

Nasoalveolar molding is a procedure performed by an orthodontist who specializes in treating craniofacial deformities. Patients receiving this treatment are usually between 1-3 months old. This surgery gradually brings the palate and lip together and provides symmetry of the nose. 

Cleft Lip Repair

Cleft lip surgery repairs the separation of the lip only. There are a variety of techniques to do this repair, the most common being a rotation advancement repair. For this surgery, a plastic surgeon will make an incision on each side of the cleft from the lip to the nostril. The two sides of the lip are then sutured together, using tissue from the area to rearrange and close the lip as needed. 

Cleft lip repair surgery also realigns the muscle of the upper lip to provide normal lip function. A primary nasal repair is often done during cleft lip repair. This procedure involves realigning some of the nasal area to achieve a more normal configuration.

Cleft Palate Repair

Cleft palate surgery fixes the roof of the mouth, also known as the palate, so the patient can eat and talk normally. This surgery is a more complicated procedure compared to cleft lip surgery, and yields the best results when the child is around 1 year of age. 

There are a few different procedures that are used to repair the cleft palate, each of which close the palate in three different layers — the inner layer that forms the nasal lining, the middle layer consisting of the muscles at the back of the palate, and the final layer including the oral mucosa. Cleft palate repair also realigns the palatal muscles. This puts the muscles in a normal position that allows for proper function of the palate while talking and eating.

Other additional surgeries or treatments patients may need include:

Let Parris Orthodontics Fix Your Smile

Ar Parris Orthodontics, we treat each patient the way we would want to be treated - with love, kindness, and respect. We recommend starting with an initial orthodontic evaluation, and our pediatric orthodontist can get you started. Interested in getting the smile you’ve always dreamed of? Contact us today and schedule your evaluation!

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Posted by Bill Parris at 4:09 PM
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