Cleft Lip & Palate

In the United States, an average of 20 infants are born each day with cleft lip and palate. Most of these cases are caused by an interaction between environmental factors and genetics. An individual may be genetically susceptible for clefts and an environmental factor may trigger the development. A cleft develops in an embryo when space persists between parts that would normally touch and fuse together. This condition is hereditary and passes down through families.

Treatment

Providers in several fields of medicine may work to treat those with cleft lip and palate including otolaryngologists, dentists, orthodontists, speech pathologists, audiologists, plastic surgeons and geneticists, as well as nurses and mental health professionals. Coordinating a multidisciplinary treatment plan is important. The functional and cosmetic aspects can be treated successfully, but requires cooperation with the skilled medical team. There is no single treatment for this condition and each patient should have a plan based on their individual needs.

Complications

The major concerns with cleft lip and palate are the risk of aspiration, airway obstruction, and difficulties with feeding. The most common problem for children born with cleft lip and palate is insufficient weight gain. Many of these children are born with normal birth weight, but feeding can be difficult. Breastfeeding is usually not possible with this condition, and parents and healthcare providers may need to experiment to choose a method that works best for the individual.

Ear infections are also a common problem that should be monitored. Children with cleft lip and palate are predisposed to ear infections. Ventilation tubes are placed in the ear drum to prevent hearing loss. Hearing is tested after placement and is repeated often. Patients with open palates that are to be closed later have higher incidents of possible complications, such as eardrum perforation and otorrhea. Overall, each case is different and an individual approach is necessary.

Prevention

Research suggests that folic acid and multivitamins can play a significant role in prevention. Supplementation should begin before conception when the family is genetically predisposed.