What is Cleft Lip
Written by Mystic on Saturday, May 10, 2008
Cleft Lip
What is other name :
Hare lip.
Introduction :
One or two off centre splits in the upper lip that may involve the palate (roof of the mouth).
Types :
Can vary from a barely noticeable notch in the upper lip, to a complete wide split of the upper lip and full length of the palate.
Cause :
From four to seven weeks after conception in the womb, each of us has a double cleft lip; and from the fifth to twelfth weeks, each of us has a cleft palate. For virtually everyone, these clefts of the lip and palate close naturally before we are born. Closure does not occur naturally in late pregnancy or after birth.
Incidence :
In about one person in 800, the clefts in the lip and palate do not close naturally before birth.
Investigations :
Sophisticated x-rays and CT scans of the face and skull will be undertaken before any surgical repair to accurately gauge the extent of the problem.
Screening :
May sometimes be detected late in pregnancy by an ultrasound scan of the foetus.
Treatment :
These children need special medical, dental and speech therapy treatment, especially during their early development. The aims of the team of specialists treating these people are threefold. Firstly, and most importantly, to ensure that the developing child has good speech through to adult life. Secondly, to enhance facial attractiveness; and thirdly, to produce the best possible jaw function and dental bite. The reason for good speech having the highest priority during treatment is that no matter how facially attractive a person may be, if that person cannot speak clearly and well, his/her social and personal development will be severely restricted. Directly related to good speech is good hearing. Most children with a cleft palate need careful monitoring to ensure their hearing is adequate. It is important that these children maintain good general health, and particularly to avoid infections or surgery to their tonsils and adenoids. Surgical repair of the cleft lip is normally done between two and six months after birth. Infants with a double cleft lip must have special dental treatment to reshape their upper jaw prior to surgical repair of the lip. The dental treatment starts immediately after birth, and requires a high degree of cooperation from the parents. This period is very emotional and demanding for the parents, but becomes most rewarding after the lip repair is done. The palate repair is normally done at about one year of age, and this is the critical operation for the child's speech. Most children with a cleft palate have an upper jaw which does not grow is well as the lower jaw, thus special dental and orthodontic care is necessary until the child has finished growing, to ensure the jaws and teeth develop in the correct relationship to each other. The vital periods for correct specialist care are when the adult teeth appear at seven or eight years, and during the rapid growth stage between 11 and 13 years. The ability to bite, chew and smile effectively are essential for both comfort and appearance. An attractive face and clear speech are added benefits of good care.
Outcome :
Modern surgery now makes it possible to correct poor speech in people who have a cleft palate, no matter how old they are. Older patients who have a poor bite because of a too small or too large upper or lower jaw can also be helped by this surgical technique. Cleft palate and lip are no longer the gross social stigmas of earlier years.
Further information:
Parents and children can benefit from the assistance offered by support groups such as Cleft-Pals that exist in most capital cities.
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