Oral-facial cleft

Oral-facial cleft is a term encompassing a group of congenital conditions characterized by openings or splits in the upper lip, the roof of the mouth (palate), or both. These anomalies occur early in pregnancy when the facial structures that are developing separately do not fuse together properly. The most common types of oral-facial clefts are cleft lip, cleft palate, and cleft lip and palate, which can occur together or separately. The condition can vary in severity, from a small notch in the lip to a large opening from the lip up through the nose and a split in the palate.

Causes and Risk Factors

The exact cause of oral-facial clefts is not fully understood, but it is believed to be due to a combination of genetic and environmental factors. Risk factors may include family history of clefts, maternal smoking, diabetes, use of certain medications during pregnancy, and obesity. Additionally, some syndromes that have genetic bases also include oral-facial clefts as a feature.

Diagnosis

Oral-facial clefts are often diagnosed through prenatal ultrasound, though not all clefts are detected before birth. After birth, a physical examination can confirm the presence of a cleft. In some cases, further genetic testing may be recommended to determine if the cleft is part of a syndrome with additional health concerns.

Treatment

Treatment for oral-facial clefts typically involves a series of surgeries to close the cleft, improve the child's ability to eat, speak, hear, and breathe, and achieve a more typical facial appearance. The first surgery to repair a cleft lip usually occurs within the first few months of life, and cleft palate repair often happens before the child turns one year old. Additional surgeries and treatments, including dental and orthodontic care, speech therapy, and psychological support, may be needed as the child grows.

Prognosis

With early and comprehensive treatment, most children with oral-facial clefts can achieve normal appearance, speech, and eating. Ongoing care from a multidisciplinary team of specialists, including surgeons, dentists, orthodontists, speech therapists, and psychologists, is essential for the best outcomes.

Epidemiology

Oral-facial clefts are among the most common congenital anomalies worldwide, affecting approximately 1 in 700 births. The prevalence can vary significantly by geographic region, ethnic group, and socioeconomic status.

See Also

• Plastic surgery
• Pediatric surgery
• Orthodontics
• Speech therapy