Causative & risk factors
The exact reason behind development of cleft lip and cleft palate is not known. It is believed to occur as a result of a genetic defect combined with an environmental trigger. These triggers include drinking, smoking or taking risky medications during pregnancy.
Cleft lip and palate are more common in Asian children and in those with a family history of this condition.
Clinical presentation
A cleft lip can appear as a small split in the lip or it may extend all the way up into the bottom of the nose. A cleft palate appears as a split in the roof of the mouth. Sometimes a submucous cleft palate may occur at the back of the mouth, which frequently goes unnoticed at birth.
Cleft lip and cleft palate can co-exist.
Babies with cleft palate find it very difficult to breast-feed. They are also susceptible to repeated ear infections. They suffer from speech problems such as a nasal speech.
Investigations
Diagnosis of a cleft lip or cleft palate can be made immediately at birth.
These babies can be diagnosed in-utero by an ultrasound examination.
Treatment
Surgical intervention is necessary to repair a cleft lip or cleft palate. Usually multiple procedures are required.
Cleft lip repair is usually performed between 1 and 4 months of age, whereas cleft palate repair is usually performed between 5 and 15 months of age. Additional surgeries are carried out after the child has completed 2 years of age.
