Cleft Lip/Palate

What is a Cleft Lip/Palate?

A cleft can include just the lip or just the palate or both. There are also many variations possible: unilateral, bilateral, complete, or incomplete. Cleft lip and palate have several variations but things to expect is deformities of the lip components, flattening of the nose  on the cleft side, dental irregularities and/or thinning of the lip.

The cause of clefts is not completely understood, but most likely, it is related to genetics with a combination of environmental expression. There are certain environmental and drug exposures which are associated with an increase risk including but not limited to Dilantin (phenytoin), vitamin A derivatives, and possibly botanical estrogens, as well as other environmental pollutants.

Repair of Cleft Lip and Palate

Timing for repairing a cleft lip and palate vary depending on the clinical presentation. However, most cleft repair can usually begin at a very young age.

This can be a long process that begins very early in the child’s life and progresses to adulthood. Expected timeline for certain repairs:

  • Cleft lip can be repaired in the first weeks of life.
  • Cleft palate is usually repaired between 6 to 9 months of age, with the goal being to repair the palate before speech develops. Sometimes, additional palate intervention is needed around age 4 or 5, because about 20% of children with cleft palate will have hyper-nasal speech that can be addressed through surgery.
  • Clefts of the dental ridge (alveolar cleft) can be repaired as early as age 6.
  • Nose surgery (rhinoplasty) may be helpful at age 16 or 17, once growth has stopped.