Cleft lip and cleft palate pathophysiology
A cleft lip contains an opening in the upper lip that may extend into the nose which may be on one side, both sides, or in the middle. A cleft palate is the condition in which the roof of the mouth contains an opening into the nose. Problem related to these disorders are feeding problems, speech problems, hearing problems, and frequent ear infections. If the cleft does not affect the palate structure of the mouth it is referred to as cleft lip. It is due to the failure of fusion of the maxillary and medial nasal processes. Cleft palate is a condition in which the two plates of the skull that form the hard palate are not completely joined. Development of the upper lip is characterized by fusion of the maxillary prominences with the lateral and medial nasal prominences. This process starts during the fourth week of gestation and is completed by the seventh week. Failure of mesenchymal migration to unite one or both of the maxillary prominences with the medial nasal prominences results in a unilateral or bilateral cleft of the lip, respectively. Classification includes: Cleft lip or palate, Isolated unilateral cleft lip, Isolated cleft palate, Midline clefts of the nose or lip.
Cleft lip and cleft palate Statistics
The percentage of patients encountered with Cleft lip and cleft palate in Ireland is 7.23% lower cleft lip and cleft palate and 10.79% for upper cleft lip and cleft palate. Estimated annual number of cases for Cleft palate without cleft lip is 2,651 and Cleft lip with or without cleft palate is 4,437.
Cleft lip and palate is usually treated with surgery. The initial surgery is usually performed by the time a baby is 3 months old. Repair of a cleft palate often requires multiple surgeries over the course of 18 years. The first surgery to repair the palate usually occurs when the baby is between 6 and 12 months old. The initial surgery creates a functional palate, reduces the chances that fluid will develop in the middle ears, and aids in the proper development of the teeth and facial bones. Children with a cleft palate may also need a bone graft when they are about 8 years old to fill in the upper gum line so that it can support permanent teeth and stabilize the upper jaw. Other treatments may be needed to treat associated symptoms, such as speech therapy or dental care.
Cleft lip and cleft palate ongoing research
Some of the ongoing research studies on Cleft lip and cleft palate in Ireland are In utero exposure to valproate increases the risk of isolated cleft palate, Are photographs a suitable alternative to dental study casts when assessing primary surgical outcome in children born with unilateral cleft lip and palate?