A cleft lip or cleft palate is a condition in which parts of the lip and/or palate (the roof of the mouth) do not develop properly early in a pregnancy. Since an infant’s lips and the palate develop separately, it is possible for a child to be born with a cleft lip only, cleft palate only or both. Consequently, the conditions can be categorized into three general categories:
- Cleft lip without a cleft palate
- Cleft palate without a cleft lip
- Both cleft lip and cleft palate
The condition can occur on one side of the mouth (known as unilateral clefting) or on both sides (known as bilateral clefting).
Diagnosis & Treatment
Surgical Treatment for Cleft Lip
A cleft lip is usually repaired when the baby is between 3 to 6 months old. An orthodontic appliance may be used before and after the lip repair surgery to help align the lip and nose. A child with a very wide opening may need to have a temporary procedure that brings the parts of the lip closer together before the full lip repair is done.
The goal of the surgery is to bring together the separation in the lip so that the lips work and look normal. Incisions are made on both sides of the cleft to create ﬂaps of tissue that are then drawn together and stitched to close the opening. Surgery is performed in the hospital under general anesthesia.
Surgical Treatment for Cleft Palate
A cleft palate is usually repaired between 9 and 12 months of age. The plastic surgeon carefully puts the tissue and muscles in a better position so that the opening beteween the nose and mouth is closed and the roof of the mouth is rebuilt. Incisions are made on both sides of the opening and specialized ﬂap techniques are used to reposition the muscles and the palate. The repair is then stitched closed, usually in the middle of the roof of the mouth, so that normal feeding and speech development can occur and growth can continue throughout the child’s life. Surgery for cleft palate is performed under general anesthesia. Children are observed overnight in the hospital and remain there until they are comfortable and can drink sufficient fluids, which is usually a night or two.
The goal of surgery is to create a palate that works well for feeding and for speech. Most children will have good speech after palate repair. Some children, however, may need further surgery on the muscles of the palate or the muscles of the throat to achieve normal speech.
The surgeon makes every attempt to see that the scars after a cleft repair are minimized by hiding them in the normal contours of the upper lip and nose. Over time, the scars will fade and your child’s ability to grow and function normally will continue to improve.
As a child grows, secondary plastic surgery procedures to improve function and appearance may be required. Your child's surgeon will talk with you about the timing and nature of these surgeries.
The results of surgery for cleft lip and palate are usually excellent both aesthetically and functionally. Children born with these conditions have a good quality of life and a normal life expectancy.
Learn more about the condition’s diagnosis before birth and general treatment by a multidisciplinary team of professionals in the Institute for Fetal Health pages.