Cleft Palate

Cleft Palate

A cleft palate is a congenital deformity that occurs when the roof of the mouth (palate) does not completely close during fetal development, leaving an opening (cleft) that can extend into the nasal cavity. This condition can affect the hard palate, the soft palate, or both, and is often associated with a cleft lip.

Epidemiology

Cleft palate is one of the most common congenital malformations, with an incidence of approximately 1 in 700 live births worldwide. The prevalence can vary based on geographic location, ethnicity, and socioeconomic status. It is more common in certain populations, such as Asians and Native Americans, and less common in African populations.

Etiology

The exact cause of cleft palate is not fully understood, but it is believed to result from a combination of genetic and environmental factors. Risk factors include:

• Genetic predisposition
• Maternal smoking or alcohol use during pregnancy
• Maternal diabetes
• Certain medications taken during pregnancy, such as anticonvulsants

Embryology

The development of the palate occurs between the sixth and ninth weeks of gestation. The primary palate forms first, followed by the secondary palate. A cleft palate results when the palatal shelves fail to fuse properly.

Clinical Presentation

A cleft palate can present with a variety of symptoms, including:

• Difficulty feeding
• Nasal regurgitation of food
• Speech difficulties
• Ear infections and hearing loss

Diagnosis

Cleft palate is typically diagnosed at birth through physical examination. Prenatal diagnosis is possible with ultrasound and fetal MRI in some cases.

Treatment

The management of cleft palate involves a multidisciplinary approach, including:

• Surgical repair, typically performed between 6 and 18 months of age
• Speech therapy
• Orthodontic treatment
• Audiological management

Surgical Techniques

Several surgical techniques are used to repair a cleft palate, including:

• Palatoplasty
• Furlow double-opposing Z-plasty
• Von Langenbeck technique

Complications

Potential complications of cleft palate repair include:

• Fistula formation
• Velopharyngeal insufficiency
• Dental anomalies

Prognosis

With appropriate treatment, most children with a cleft palate can achieve normal speech and feeding abilities. However, ongoing care and monitoring are often necessary.

See Also

• Cleft lip
• Congenital disorder
• Speech therapy

References

• "Cleft Palate." National Institute of Dental and Craniofacial Research.
• "Cleft Lip and Palate." World Health Organization.

External Links

• Cleft Palate Foundation
• Mayo Clinic: Cleft Palate