During early pregnancy separate areas of a child’s face develop individually and then join together, including the left and right sides of the roof of the mouth and lips. However, if the sections don’t meet the result is a cleft. If the separation occurs in the upper lip, the child is said to have a cleft lip.
A completely formed lip is important not only for a normal facial appearance but also for sucking and to form certain sounds made during speech etc.
A cleft lip is a condition that creates an opening in the upper lip between the mouth and nose. It looks as though there is a split in the lip. It can range from a slight notch in the colored portion of the lip to complete separation in one or both sides of the lip extending up and into the nose. A cleft on one side is called a unilateral cleft. If a cleft occurs on both sides, it is called a bilateral cleft where for single side is called as unilateral cleft.
A cleft in the gum may occur in association with a cleft lip. This may range from a small notch in the gum to a complete division of the gum into separate parts. A similar defect in the roof of the mouth is called a cleft palate.
The palate is the roof of your mouth. It is made of bone and muscle and is covered by a thin, wet skin that forms the covering inside the mouth. You can feel your own palate by running your tongue over the top of your mouth. Its purpose is to separate your nasal cavity from your mouth. The palate has an extremely important role during speech because when you talk it prevents air from blowing out of your nose instead of your mouth. The palate is also very important when eating; it prevents food and liquids from going up into the nose.
As in cleft lip, a cleft palate occurs in early pregnancy when separate areas of the face develop individually and do not join together properly. A cleft palate occurs when there is an opening in the roof of the mouth. The back of the palate is called the soft palate and the front is known as the hard palate. A cleft palate can range from just an opening at the back of the soft palate to a nearly complete separation of the roof of the mouth (soft and hard palate).
Sometimes a baby with a cleft palate may have a small chin and a few babies with this combination may have difficulties breathing easily. This condition may be called Pierre Robin sequence. There are many syndromes known to be associated with cleft deformities in different forms.
Since the lip and palate develop separately, it is possible for a child to be born with a cleft lip, palate or both. Cleft defects occur in about 1 out of every 800 babies, this figure again varies geographically and statewise.
Children born with one or both of these conditions usually need the skills of several professionals from different fields to manage the problems associated with the defect such as feeding, speech, hearing, and psychological development. In most cases, surgery is recommended. When surgery is done by an experienced, qualified oral and maxillofacial surgeon, well at Medlife Dr. Shyam Sheth is chief operating surgeon who does all oral and maxillofacial surgeries and has already done more than 4500 cleft surgeries.
Cleft lip surgery is usually performed when the child is about 3-4 months old. The goal of surgery is to close the separation, restore muscle function, and provide a normal shape to the mouth. The nostril deformity may be improved as a result of the procedure, or may require a subsequent surgery in later stage of the patient.
A cleft palate is initially treated with surgery safely when the child is between 12 to 18 months old. This depends upon the individual child and his/her own situation. For example, if the child has other associated health problems, it is likely that the surgery will be delayed. There are many syndromes and conditions that hamper the surgical procedures for some of the patients.
1. Close the gap or hole between the roof of the mouth and the nose
2. Reconnect the muscles that make the palate work
3. Make the repaired palate long enough so that it can perform its function properly
4. To make separation between nasal cavity and mouth.
There are many different techniques that surgeons will use to accomplish these goals. The choice of techniques may vary between surgeons and should be discussed between the parents and the surgeon prior to surgery. Our team counsels and plan the surgical procedures and the same is communicated to their parents or guardians.
After the palate has been fixed children will immediately have an easier time swallowing food and liquids. After surgery patient will have speech improvement based on the age group, but can be improved to much extent by consulting speech therapist to undergo speech therapy.