Cleft lip and palate: causes and treatment

One of the most common birth defects in newborns is a cleft lip and cleft palate.
Which requires urgent surgical treatment in most cases and a number of reasons are involved in its occurrence, what are the reasons and surgical methods available to correct the cleft lip and palate in Turkey and more in this article.

 

 

These openings occur as a result of the failure of the facial tissues and lips of the fetuses to fuse properly, and this leads to their birth with openings in the upper lip known as the rabbit's lip and the upper mouth.
This is called orofacial clefts and appear from birth.

 

Having a baby with a bunny lip is a great fear for the mother, especially as it causes difficulties in feeding.
But it is good that these deformities can be repaired and the clefts of the jaw and the cleft of the upper lip can be closed.
The defect of the cleft lip and cleft palate can be corrected through a series of surgeries with the aim of restoring the normal function and shape of the mouth and trying to restore the usual features with the least amount of effects.

 

Lip formation begins in fetuses during the fourth to seventh week of pregnancy. During the process of growth and differentiation, there is a group of cells that grow and divide on both sides to participate in the formation of the face of the newborn.

The union of tissues helps to give contours.
Failure to do so causes a congenital defect called the cleft lip. A cleft lip may be small, or it may be large and extend into the nose.

While the throat develops, or what is known as frenulum, in the period between the sixth week of the ninth week of pregnancy, a cleft palate occurs for the same reason, which is the failure of the fusion of the tissues of the throat in the roof of the mouth between the right and left sides, and this cleft may be in the front or back part, or both.

The presence of openings and clefts in the upper lip or palate of the infant can be noticed immediately after birth.

It is called the rabbit because it resembles the shape of the lips of a rabbit, and it has several images, including:

•  Cleft in the upper lip on one side or on both sides and the shape of the lip resembles the mouth of a rabbit.
• The incision extends from the top of the lip to the gums and top of the palate, and may reach the bottom of the nose so that both the nasal cavity and the mouth are open to each other.
• The roof of the palate should be cleft, but without any apparent congenital defects.
• In a few cases, the opening may be in the soft tissue of the palate, i.e. in the posterior lining of the inner oral cavity.
  This condition is not detected and diagnosed until other symptoms begin.

What are the symptoms of cleft lip and cleft palate?

Babies born with a cleft lip or cleft palate have many problems.
In addition to their abnormal appearance, the openings in the upper lip and palate cause the following:

• Difficulty breastfeeding and eating at an older age.
• Recurrent ear and nose infections.
• Ear closure with wax as a result of repeated inflammation, which affects the development of hearing.
• Teeth not growing properly, in addition to being more susceptible to tartar and tooth deviation.
• Difficulty pronouncing words as well as the sound of nasal talking as the child gets older.

 

A cleft palate is caused by the failure of partial or complete fusion of the central facial tissues into the throat or lips, leading to an opening in them.

The cause of cleft lip and cleft lip is unknown and there is no clear cause for it to date.
Many doctors believe that there are several factors involved in women giving birth to fetuses with cleft lip and cleft palate.

 

It is likely that a combination of genetic and environmental factors are involved in causing cleft lip and palate.
Where it is believed that some practices carried out by the pregnant woman may activate certain genes, which in turn leads to the failure of the union of the central bond in the fetus's palate and lip.

Among these behaviors:

Smoking, using certain medications, drinking alcohol, or being exposed to harmful radiation.

But most likely there is a genetic aspect that may be the father or the mother.
Perhaps heredity is independent and does not involve any symptoms of another syndrome, and it may be a combination of genetic problems.
These genes must be stimulated by different environmental conditions, which are called risk factors.

 

There are several factors that can increase the likelihood of having children with cleft lip or cleft palate, including:

1. Pregnant women are exposed to harmful substances such as cigarettes, alcohol and medicines.
   The chance of getting clefts of the lip and palate increases in women who smoke and who drink alcohol.
2. Family heredity. Having a family history of cleft lip and cleft palate in both parents, whether in the father or mother’s family, increases the possibility of passing on the cleft palate gene to the child.
3. Having chronic diabetes or noticing that a pregnant woman suffers from diabetes before she becomes pregnant increases the chance of fetal abnormalities.
   As the diabetic woman is more likely to give birth to a fetus with cleft lip and cleft palate than others.
4. Women diagnosed with epilepsy or depression and using their medications continuously, as some of these medications must be discontinued because they may cause abnormalities if they are taken during the first three months of pregnancy.
5. Obese women.
   It was found that there is an association between the birth of children with a birth defect such as the upper cleft lip and cleft palate, and the fact that the mothers have serious obesity.

 

 

When a child is born with a cleft palate or cleft lip, this creates anxiety in the parents and they become fearful that their children may have the same birth defect.
The possibility of a recurrence of the mouth and throat defect at a later time cannot be ruled out, but the incidence of this is low and ranges from 2 to 8%.

It is difficult to prevent the occurrence of cleft lip and cleft palate, but a set of tips can be adhered to that will reduce the risk of deformation of the lip and palate, including:

 

• If you think you are pregnant or planning to become pregnant in the future, it is best to seek medical advice.
  Getting a genetic test and checking your blood sugar and body mass index can help you avoid various risk factors and try to control them.
• If you have epilepsy, you should regulate your medications and ask that they be changed to medications that are less dangerous to the fetus.
  This is not only important and protects against cleft lip and palate, but also reduces the chance of many birth defects.
• You should take the necessary vitamins before and during your pregnancy.
  Folic acid is essential and important to protect against deformities of the face and spine.
• Stop smoking and drinking alcohol.

 

Abnormal clefts of the lip and palate are noticed after the birth of the fetus.
The upper lip is shaped like a furrow or cleft lip, and there may be openings in the palate.
Ultrasound imaging of fetuses in the uterus helps diagnose abnormalities inside the uterus, and no special examinations are required.

 

Doctors usually schedule an ultrasound scan for abnormalities during the second half of a woman's pregnancy, during which the baby is diagnosed with a cleft lip.
Where the doctor notes that there is a defect and inequality between the two halves of the upper lip.
It is easy to identify and diagnose a cleft lip by ultrasound, but a cleft palate may be delayed for longer periods and difficult to see, especially if it is in the inner part of the palate.

 

If your current child is not the first of your children diagnosed with cleft lip and cleft palate, your doctor may ask you to test a semen sample to rule out a combination of known genetic syndromes.
He may also suggest a genetic test if you want to become pregnant in the future.

 

Oral and palate malformations are confirmed by the routine examination of newborns.
Then the child is presented to a specialist doctor in order to find out the available treatment methods for cleft lip and palate and to answer the parents' questions.

 

 

The treatment of the cleft lip and cleft palate is complex and includes several aspects, the most important of which is helping children to breastfeed and eat, reducing hearing problems and recurrent infections, improving their appearance, and bringing the shape of their faces closer to normal.

The newborn may not be able to breastfeed from his mother like other infants, and special bottles must be used to feed them, especially those with cracks in the throat.

 

Many doctors and specialists are involved in the treatment of cleft lip and cleft palate. Children need a medical staff that includes doctors and specialists who work together to treat the best of them:

• Ear, Nose and Throat Doctors.
• Oral and oral surgeons.
• specialists Orthodontics for misalignment of the teeth To treat jaw and dental problems associated with clefts of the lip and palate.
• Pediatric surgery.
• Speech and hearing therapists.
• genetics experts.
• Psychologists and social workers.

 

The surgical procedure followed varies depending on the condition of the infant.
The appropriate age for cleft lip surgery also varies, some of them need quick surgery and some may wait until they reach the age of 18 months.

 

Surgical correction is necessary to reshape the face as it improves breathing, nutrition, hearing and other basic functions.

 

Correction of the cleft lip and cleft palate occurs in the following sequence:

 

1. Closing the cleft lip during the first six months.
2. Correction of cleft palate within a maximum period of 12 months, preferably as soon as possible.
3. Subsequent surgeries according to the child's need during his development and into adulthood.

Dealing with complications of cleft lip