Cleft Lip & Cleft Palate
It is a congenital deformity affecting both males and females. A baby may have a cleft lip, cleft palate or both cleft lip and palate. A cleft is a birth defect that prevents fusion of lip and or palate segments causing a visible defect in the lip, gums and or palate with difficulty in feeding in the beginning and speech defect later in the life.
Cleft lips are classified as:
- microform cleft- it presents as a small notch in the vermillion of the upper lip.
- unilateral incomplete cleft- presents as partial cleft of the lip extending through the white roll to the skin of the upper lip
- Unilateral complete- complete cleft lip involves the upper lip completely and extends to the gum and alveolus of the upper jaw.
- Bilateral complete- this is a complete cleft lip on both sides.
Cleft palates are classified as:
- sub mucous cleft palate- it is presented as bifid uvula with underlying muscle abnormality
- Unilateral Incomplete cleft palate- the cleft involves soft and hard palate on one side without involving the alveolus
- Bilateral incomplete or horseshoe shape cleft- it is a “U” shaped defect of the soft and hard palate without the alveolus
- Unilateral complete cleft palate- it is complete cleft of soft and hard palate extending to the alveolus and associated with cleft Cleo
- Bilateral complete cleft palate- complete cleft of lip and palate on both the sides
Management of cleft lip and palate
Treatment of a child born with cleft lip and palate involves a multidisciplinary team approach with following key team members
- Plastic and craniofacial surgeon
- Dentist and oral surgeon
- Speech therapist
The international protocol for management of Cleft lip and palate, for a successful outcome, is as follows-
- Counseling by Plastic surgeon
- Feeding advice
3 months of age–
- Cleft Lip repair
- Grommet Insertion in the Ear drums
8-12 months of age–
- Cleft Palate repair depending upon the type of cleft palate and health of child
2 years of age–
- Speech assessment by Speech therapist
5 years of age–
- Surgery for Lip and Nose touch up if necessary
- Speech assessment including nasoendoscopy
6 years of age–
- Initial Dental and Orthodontist consultation
7-11 years of age–
- Orthodontics/ braces
- Alveolar bone grafting for the cleft in Gums
18 years + of age–
- Jaw Surgery if required
It is a congenital deformity affecting both males and females. A baby may have a cleft lip, cleft palate or both cleft lip and palate.