What is Cleft Lip? The lip forms between the fourth and seventh weeks of pregnancy. As a baby develops during pregnancy, body tissue and special cells from each side of the head grow toward the center of the face and join together to make the face. This joining of tissue forms the facial features, like the lips and mouth.
Cleft lip is formed in the top of the lip as either a small gap or an indentation in the lip partial or incomplete cleftor it continues into the nose complete cleft.
Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP). A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. Of all the babies born with birth defects, approximately one-third display anomalies of the head and face [Gorlin et al., ] including cleft lip, cleft palate, small or absent facial and skull bones and improperly formed nose, eyes, ears, and teeth. Craniofacial disorders are a primary cause of infant mortality and have serious lifetime functional, esthetic, and social consequences that are devastating to both . Dec 02, · The American Cleft Palate-Craniofacial Association (ACPA) is an international, non-profit medical society of health care professionals from 30 disciplines and 40 countries who treat and/or research birth defects of the head and face.
Lip cleft can occur as a one-sided unilateral or two-sided bilateral condition. It is due to the failure of fusion of the maxillary and medial nasal processes formation of the primary palate.
Unilateral incomplete Unilateral complete Bilateral complete A mild form of a cleft lip is a microform cleft. The soft palate is in these cases cleft as well.
In most cases, cleft lip is also present. Cleft palate occurs in about one in live births worldwide. When cleft palate occurs, the uvula is usually split. It occurs due to the failure of fusion of the lateral palatine processes, the nasal septum, or the median palatine processes formation of the secondary palate.
The hole in the roof of the mouth caused by a cleft connects the mouth directly to the inside of the nose. The top shows the nose, the lips are colored pink. For clarity the images depict a toothless infant. Incomplete cleft palate Unilateral complete lip and palate Bilateral complete lip and palate A result of an open connection between the mouth and inside the nose is called velopharyngeal inadequacy VPI.
Because of the gap, air leaks into the nasal cavity resulting in a hypernasal voice resonance and nasal emissions while talking. Adolescents may face psychosocial challenges but can find professional help if problems arise.
There is research dedicated to the psychosocial development of individuals with cleft palate. Self-concept may be adversely affected by the presence of a cleft lip or cleft palate, particularly among girls. However, as they grow older and their social interactions increase, children with clefts tend to report more dissatisfaction with peer relationships and higher levels of social anxiety.
Experts conclude that this is probably due to the associated stigma of visible deformities and possible speech impediments. Children who are judged as attractive tend to be perceived as more intelligent, exhibit more positive social behaviors, and are treated more positively than children with cleft lip or cleft palate.
It has been reported that elevated stress levels in mothers correlated with reduced social skills in their children. A cleft lip or cleft palate may affect the behavior of preschoolers.
Experts suggest that parents discuss with their children ways to handle negative social situations related to their cleft lip or cleft palate.
A child who is entering school should learn the proper and age-appropriate terms related to the cleft. The ability to confidently explain the condition to others may limit feelings of awkwardness and embarrassment and reduce negative social experiences.
An adolescent with cleft lip or cleft palate will deal with the typical challenges faced by most of their peers including issues related to self-esteem, dating and social acceptance. Adolescent boys typically deal with issues relating to withdrawal, attention, thought, and internalizing problems, and may possibly develop anxiousness-depression and aggressive behaviors.
Individuals with cleft lip or cleft palate often deal with threats to their quality of life for multiple reasons including: Complications A baby being fed using a customized bottle. The upright sitting position allows gravity to help the baby swallow the milk more easily Cleft may cause problems with feeding, ear disease, speech and socialization.
Due to lack of suction, an infant with a cleft may have trouble feeding. An infant with a cleft palate will have greater success feeding in a more upright position. Gravity feeding can be accomplished by using specialized equipment, such as the Haberman Feederor by using a combination of nipples and bottle inserts like the one shown, is commonly used with other infants.
A large hole, crosscut, or slit in the nipple, a protruding nipple and rhythmically squeezing the bottle insert can result in controllable flow to the infant without the stigma caused by specialized equipment. Individuals with cleft also face many middle ear infections which may eventually lead to hearing loss.
The Eustachian tubes and external ear canals may be angled or tortuous, leading to food or other contamination of a part of the body that is normally self-cleaning. Hearing is related to learning to speak.
Babies with palatal clefts may have compromised hearing and therefore, if the baby cannot hear, it cannot try to mimic the sounds of speech.
Thus, even before expressive language acquisition, the baby with the cleft palate is at risk for receptive language acquisition. Because the lips and palate are both used in pronunciation, individuals with cleft usually need the aid of a speech therapist.
Cause The development of the face is coordinated by complex morphogenetic events and rapid proliferative expansion, and is thus highly susceptible to environmental and genetic factors, rationalising the high incidence of facial malformations. During the first six to eight weeks of pregnancy, the shape of the embryo's head is formed.
Five primitive tissue lobes grow:Our research suggests that folic acid also helps prevent facial clefts, another common birth defect.” In the United States, about one in every babies is born with cleft lip and/or palate.
“Folic acid deficiency causes facial clefts in laboratory animals, so we had a good reason to focus on folic acid in our clefts study,” said Wilcox. Dr. Shin's areas of research include tissue engineering, biomaterials & biomimetrics, craniofacial anomalies, cleft lip and palate, and health care service and policy.
His current research topic is the effect of mandibular advancement on velopharyngeal closure and speech performance. Background Cleft lip and palate (CLP) are the most common craniofacial birth impairment and one of the most common congenital impairments in humans.
Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. They happen early during pregnancy.
They happen early during pregnancy. A baby can have a cleft lip, a cleft palate, or both. A cleft lip or palate is the most common facial birth defect.
Up to babies are born in the United States each year with this problem. Clefts occur more often . Clefts of the mouth and face affect up to 1 in people, making it one of the most common birth defects.
Sometimes the cleft is just a small indentation of a person's lip, while in other cases the cleft splits deeply into the lip, upper palate and even the nose.