Cleft lip

Cleft Lip

A cleft lip is a congenital deformity caused by abnormal facial development during gestation. It is characterized by a split or opening in the upper lip that can vary in size from a small notch to a large gap that extends up into the nose. This condition can occur on one or both sides of the lip and is often associated with a cleft palate, which is an opening in the roof of the mouth.

Epidemiology

Cleft lip is one of the most common congenital deformities, affecting approximately 1 in 700 live births worldwide. The incidence varies by geographic region, ethnicity, and socioeconomic status. It is more prevalent in Asian and Native American populations and less common in African populations.

Etiology

The exact cause of cleft lip is not fully understood, but it is believed to result from a combination of genetic and environmental factors. Genetic predisposition plays a significant role, with several genes implicated in the development of the condition. Environmental factors such as maternal smoking, alcohol use, and certain medications during pregnancy can increase the risk of a child being born with a cleft lip.

Pathophysiology

Cleft lip occurs when the tissue that forms the lip does not completely join before birth. During normal fetal development, the tissues and cells from each side of the head grow toward the center and join to form the face. If this process is disrupted, a cleft can occur.

Clinical Presentation

The clinical presentation of a cleft lip can vary widely. It may present as a small notch in the lip or as a large gap that extends into the nose. In some cases, the cleft may be unilateral (one side) or bilateral (both sides). Associated symptoms can include feeding difficulties, speech problems, ear infections, and dental issues.

Diagnosis

Cleft lip is typically diagnosed at birth through physical examination. Prenatal ultrasound can sometimes detect cleft lip before birth, allowing for early intervention planning.

Management

The management of cleft lip involves a multidisciplinary approach, including plastic surgeons, orthodontists, speech therapists, and otolaryngologists. Surgical repair is the primary treatment and is usually performed when the child is around 3 to 6 months old. Additional surgeries may be required as the child grows.

Prognosis

With appropriate treatment, most children with cleft lip can achieve normal appearance and function. Early intervention and comprehensive care are crucial for optimal outcomes.

Prevention

While not all cases of cleft lip can be prevented, certain measures can reduce the risk. These include adequate prenatal care, avoiding harmful substances during pregnancy, and genetic counseling for at-risk families.

Also see

• Cleft palate
• Congenital disorder
• Plastic surgery
• Speech therapy