Understanding And Treating Clefts

Birth defects are relatively uncommon, with only 3 or 4 out of 100 infants being born with one. When defects do occur, orofacial clefts, more commonly referred to as cleft lip, cleft nose, and cleft palate, are some of the most common birth defects.  A cleft lip, with or without a cleft palate, is more common than a cleft palate alone. A cleft lip can be minor, or the cleft can go all the way into the nose. Here is what you should know about these specific defects.

How Does A Cleft Defect Develop?

When an embryo is about four or five weeks old, the face begins forming. Over the course of the next several weeks, the sides of the face will grow together, fusing down the middle of the forehead, nose, lips, and chin. Unfortunately, this fusing process doesn't always go as it should and a cleft develops. A cleft is a split in the lips, nose, and/or palate.

What Causes A Cleft To Develop?

Maternal smoking during pregnancy is believed to be a cause as more children with cleft defects are born to women who smoked. Diabetes and obesity appear to play a role as well. Additionally, certain medications, such as those that prevent seizures, taken during early pregnancy may play a role. But as with many birth defects, the exact cause of a cleft defect isn't known. It is believed to be a combination of genes along with other contributing factors.

How Is A Cleft Treated?

Surgery is the only way a cleft lip, with or without a cleft palate and/or cleft nose, and a cleft palate can be treated. A superficial cleft lip is the easiest to treat and has the least amount of complications. Unfortunately, a cleft lip often involves the nose. A cleft palate, with or without a cleft lip, often has nasal interaction as well.

Surgery usually begins when the infant is just a few months old. Feeding can be difficult with severe cleft defects, especially with a cleft palate that is severe or occurs with a cleft nose. Therefore, it is best to begin surgical repair as soon as the baby is able to withstand general anesthesia.

Most children will require multiple surgeries to fully repair the cleft defect(s). This is because as the child grows, so will their face. Their nose will change significantly as they age; in fact, the nose never really stops growing completely. In addition to repairing the splits, the child may require other surgeries, such as a cleft rhinoplasty. More commonly called a "nose job," a cleft rhinoplasty attempts to build the child's nose without the usual framework. Some plastic surgeons advocate for delaying nasal repair until the child is older as this will retain the original tissue and avoid scar tissue if a second cleft rhinoplasty is required, but regardless, the child will need at least one corrective nose surgery. If your child has an orofacial cleft, talk with a clinic, like Cleft NY, that offers treatments for orofacial clefts.