Birth Defects Other Cleft Palate

Cleft palate is an incomplete development of the lip and/or the roof of the mouth. Cleft palate and lip can affect breathing, feeding and speech. Orofacial clefts are among the most common birth defects, and they can occur alone or as part of a syndrome.

Cleft palate was once commonly called “harelip,” but that term has been dropped in recent years because it is considered pejorative.

Causes of Cleft Lip and Cleft Palate

Orofacial clefts are congenital defects that occur during fetal development, when the lip or palate does not form completely. Clefts develop within the first five to nine weeks of fetal development. The lip and palate form separately, but close to one another in time.

Orofacial clefts may develop as single birth defects, but are also common components of defects in several syndromes, including:

  • Amniotic band syndrome
  • Trisomy 13 (Patau syndrome)
  • Velocardiofacial syndrome.

Orofacial clefts are caused by an interaction of genetic and environmental factors. Exposure to toxins that cause birth defects can contribute to orofacial cleft risk. These include:

  • Alcohol
  • Illicit or prescription drugs
  • Viruses.

Types of Orofacial Clefts

A cleft is a separation in a body structure. Clefts are usually broken into two categories:

  • Cleft lip is a congenital split between the two sides of the lip, and is visible from the outside.
  • Cleft palate is a congenital opening in the roof of the mouth, and may be identifiable only by looking inside the mouth.

Submucous clefts are covered by the mucous membrane of the roof of the mouth, so they are more difficult to see. These clefts may affect the soft or hard palate, and symptoms may include:

  • Bifid (split) uvula
  • Difficulty feeding
  • Hypernasal speech
  • A light-colored line down the midline of the palate.

Clefts present on a continuum of severity. Mild cases can appear as a notch on the lip, whereas more severe cases may extend all the way up to the nose, through the lip, gum and to the roof of the mouth. These more severe cases may occur with malformations of the nose or teeth.

Clefts can occur in different combinations. An infant can have a cleft palate alone, or a cleft lip with or without cleft palate.

Cleft Palate and Lip Treatment

Orofacial clefts require surgical repair. In severe cases, several surgeries may be required to reconstruct the lip and/or palate. Surgical closure of the cleft improves both function and outward appearance.

Depending on the affected structures, various specialists such as otolaryngologists or plastic surgeons may collaborate on the treatment.

Taking folic acid supplements during pregnancy can help to prevent orofacial clefts, as well as other birth defects. Talk to your doctor for more information on prenatal health.

Resources

Cleft Palate Foundation. (n.d.). Submucous cleft palate. Retrieved April 29, 2010, from: http://www.cleftline.org/publications/submucous.

Mayo Clinic. (n.d.). Cleft lip and cleft palate.Retrieved April 29, 2010, from: http://www.mayoclinic.com/health/cleft-palate/DS00738.

Medline Plus. (n.d.). Cleft lip and palate.Retrieved April 29, 2010, from: http://www.nlm.nih.gov/medlineplus/ency/article/001051.htm.

Utah Department of Health. (n.d.). Orofacial clefts at a glance. Retrieved April 29, 2010, from: http://health.utah.gov/birthdefect/defects/orofacial.html.