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Cleft lip and palate is a common congenital malformation that can lead to many disorders, incl. hearing loss, disorders of the skeletal and muscular system of the facial skull, and even disorders of emotional development. Fortunately, surgery is the solution to these problems. What are the causes of cleft lip and palate? How is the treatment going? What is the procedure?

Cleft lip and palateiscongenital malformation,which is caused by incorrect fusion or lack of connection between the parts forming the lip (cleft lip - hare's lip) or palate (cleft palate - the so-called wolf's mouth).

The formation of a cleft lip occurs during fetal development - between 4 and 7 weeks of pregnancy, and a cleft palate and between 5 and 12 weeks of pregnancy.

Cleft lip and palate - types of clefts

  • cleft lip

The cleft may cover one side (one-sided) and be partial (then there is a small gap in the continuity of the lip) or complete (then the cleft extends from the lip to the nose). It can also affect both sides of the lip (bilateral cleft).

  • cleft palate

There is a complete cleft, where the soft and hard palate are separated, and even the maxillary alveolar process, and an incomplete cleft, where the break occurs only in the canopy of the oral cavity (cleft soft palate).

  • cleft lip and palate

Includes one (one-sided) or both (two-sided) sides of the lip, base of the nose, gums and palate.

Cleft lip and palate - causes and risk factors

There is no one specific cause of cleft lip and palate. It is believed that genetic (possibly hereditary) and environmental factors contribute to the development of the defect.

According to research conducted by scientists in Denmark, the hereditary background of the cleft was present in 20-30 percent. cases of the families they studied.

However, it is not known how the cleft trait is inherited. Probably, this feature manifests itself when the tendency to its occurrence is inherited, and the fetus is additionally affected by harmful environmental factors:

  • vitamin deficiency (including folic acid) in a pregnant diet or their overdose (especially vitamin A)
  • reaching for stimulants during pregnancy (alcohol, nicotine, drugs)
  • ionizing radiation
  • having viral or bacterial diseases in the early stages of pregnancy (4-12 weeks), e.g. rubella

GOOD TO KNOW: Rubella during pregnancy causes serious defects in the fetus

  • pregnant disease, incl. diabetes, heart failure, kidney failure
  • taking certain medications during pregnancy
  • oxygen deficiency during fetal development

Sometimes clefts occur in collective genetic defects, such as in Patau syndrome, Edwards syndrome or Cri-du-chat syndrome.

Cleft lip and palate - treatment

Cleft lip and palate is a complex defect, therefore its treatment is multi-stage (usually takes several years) and requires the participation of many specialists.

The cleft lip may be operated the earliest, from the third month of life of an infant. During the procedure, the skin of the lip is sewn together. The shape of the baby's nose may also be corrected.

In the case of a cleft palate, the procedure can be performed from the age of 4 months, but it is usually waited until the child is one or two years old, when the upper jaw reaches normal growth. If the damage is significant, the procedure may be postponed until the child is 5 years old.

However, it is usually done before the child learns to speak. The cleft palate surgery involves making an incision in the mucous tissue of the palate in order to attract the edges of the cleft to you and sew them together. However, a complication after the procedure may be incomplete development of the palate and upper jaw.

Until the first operation, the baby is fed through the tube and then through a bottle with an individually selected nipple. Sometimes it is necessary to put on a special insert imitating the palate (the so-called palatine plate) to facilitate feeding.

After the first treatment, others are usually needed to further reconstruct the tissues at the cleft site. Then the child usually requires help:

  • plastic surgeon or maxillofacial surgeon who will perform the surgical correction of the face
  • audiologist as he may have some degree of hearing loss
  • dentist and orthodontist, as the cleft usually leads to malocclusion and maxillofacial defects. For example, when a cleft palate is repaired, the upper jaw and tooth arch may become too narrow. Some ofthe upper teeth can line up behind the lower teeth - this is called a "cross bite"
  • speech therapists and phoniatrists, so that the child learns to speak correctly. Children with a cleft palate find it difficult to pronounce the consonants correctly. In addition, their speech may be nasal in nature. Therapy may also be necessary after cleft surgery
  • psychologist

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