Cleft Lip/Palate

document-openDefinition:

Cleft lip is a characterized by a gap or hole in the lip. Cleft palate is a hole or gap in the upper palate or roof of the mouth.

Description:

The depth and extent of the hole or gap in cleft lip and palate can vary. Sometimes the bones of the upper jaw can be affected. They can occur on one side (unilateral) or both sided (bilateral). The cleft is created during development of the baby during pregnancy. During early pregnancy, the roof of the mouth and palate are expected to fuse together, and when they do not, a cleft is created.  Since the palate and lip develop separately, it is possible to have a cleft lip, cleft palate, or both. Sometimes a cleft of the palate is covered by a thin layer of skin and cannot be readily observed (submucosal cleft).

Causes:

Most clefts are thought to be caused by a combination of genetics and environmental factors. Sometimes, they occur as part of a syndrome that may cause other problems as well.

Diagnosing this disorder:

In the case of readily observable clefts, they are often discovered during prenatal ultrasounds (when available) or at birth. In the case of submucosal clefts (below the skin), they may not be discovered until later in infancy or childhood, depending on the symptoms that the individual may have that would prompt a professional to palpate (feel) the upper palate. A submucosal cleft is sometimes, but not always, associated with a bifurcated uvula. The uvula is the fleshy extension that hangs down at the back of the throat. When it is bifurcated, it appears to spit into two.

Implications for communication and swallowing:

Children with cleft lip and or palate may have difficulty with feeding due to problems achieving adequate suction. They may have swallowing problems such as milk going from the mouth into the nose. They may also have difficulty with forming sounds and delays in development of language skills. They sometimes have difficulty with the resonance (sound) of vocal quality and/or velopharyngeal insufficiency or dysfunction (VPI or VPD).  If the cleft lip and/or palate is part of a syndrome, there may be more significant language and learning difficulties.

Treatment:

Depending on the exact type of cleft and the type of symptoms, the medical team may recommend surgical repair of the cleft. This sometimes requires more than one surgery. When swallowing and/or communication are affected, the child should be under the care of a speech-language pathologist. Many children with cleft lip and/or palate can gain functional swallowing and communication skills when provided good medical care and therapy.

Resources:

Books for kids:

First Place – A story book helping kids to understand cleft palate & cleft lip [Paperback]

Kate Gaynor (Author), Eva Byrne (Illustrator)

Books for Parents:

A Parent’s Guide to Cleft Lip and Palate by Karlind Moller, Clark Starr and Sylvia Johnson (Feb 23, 1990)

Your Cleft-Affected Child: The Complete Book of Information, Resources, and Hope by Carrie T. Gruman-Trinkner and Blaise Winter (Oct 12, 2001)

Websites/Support:

http://www.cleftline.org

http://www.clapa.com/parents

http://www.mayoclinic.com/health/cleft-palate/DS00738/DSECTION=coping-and-support

References:

Cleft Lip and Palate. (n.d.). Retrieved from http://www.asha.org/public/speech/disorders/CleftLip.htm

Cleft Palate Foundation. Parents & Individuals. (n.d.). Retrieved from http://www.cleftline.org/parents-individuals

A.D.A.M. Medical Encyclopedia.

Cleft Lip and palate. (2011, May 1). Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002046

 

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