In simple terms, a cleft is separation of the parts of the lip or roof of the mouth.
A cleft lip is a separation of the two sides of the lip and often includes the bones of the maxilla (upper jaw) and the upper gum (alveolar ridge).
The palate is the roof of the mouth. The front part contains bone and is hard (hard palate); the back part does not contain bone and is soft (soft palate). A cleft palate is an opening in the roof of the mouth.
Normally, the lips and roof of the mouth come together during the early weeks of a baby's development in the womb. If a fetus has a cleft, an ultrasound can detect it early on in the pregnancy.
Because the lip and palate develop separately, it is possible for a child to have only a cleft lip, only a cleft palate, or both a cleft lip and cleft palate.
Unilateral Cleft Lip
A cleft lip can occur with or without a cleft palate. When it occurs on one side of the face, it's referred to as a unilateral cleft.
Bilateral Cleft Lip
When a cleft occurs on both sides of the mouth, it's referred to as a bilateral cleft. This is less common than unilateral clefts.
Cleft Palate
A cleft palate does not mean that the palate is "missing" ... It means that the two sides of the palate did not join together (fuse) as the unborn baby was developing.
Complications
cleft lip and palate
Unrepaired clefts
What happens to children born with clefts if they do not receive corrective surgery?
Difficulty feeding
One of the most immediate concerns after birth is feeding. A cleft lip makes it hard for the baby to make a good seal around the nipple. A cleft palate makes it hard to create suction. Without proper education for the nursing mother or a specialized feeding bottle, the baby may not get enough milk, making it vulnerable to other health conditions associated with malnutrition.
Ear infections / Hearing Loss
Babies with cleft palates are especially at risk of developing middle ear fluid and hearing loss. These problems require management by ear and hearing specialists. Many children in developing countries never receive this care.
Dental Problems
A cleft of the lip, gum, and/or palate in the front of the mouth can produce a variety of dental problems. These may involve the number, size, shape, and position of both the baby teeth and the permanent teeth. The teeth in the area of the cleft may be displaced, resulting in their erupting into abnormal positions.
Compromised Speech
When there is a cleft palate, there is a space between the nasal cavity and the mouth.This means that the child cannot build up air pressure in the mouth because air escapes out of the nose, and that there is less tissue on the roof of the mouth for the tongue to touch. Both of these problems can make it difficult for the child to learn how to make some sounds. Without surgery and speech therapy, their speech will be affected for their entire life.
Fewer Educational / Work Opportunities
Children with clefts may face social, emotional and behavioral problems due to differences in appearance. It is not uncommon for parents to keep these children at home, away from the judgements of their neighbors. Consequently, the children are isolated, with little or no access to school and socialization. Finding employment later in life can be close to impossible for adults with unrepaired cleft lips and palates.
Low Self-Esteem
Bullying, withdrawal, embarrassment, low self-esteem, anxiety – the emotional scars of cleft are far deeper than the physical. The minds of children born with clefts are bright and smart, and they are fully aware that their appearance is not normal. During adolescence, this awareness can be crippling.
FACES has repaired over 600 clefts and provided over 1,000 speech therapy sessions.
Follow-up Care
How we work
Process
Patient Evalutions
All patients are evaluated by a US Board Certified Facial Plastic Surgeon. The FACES surgeons host preliminary virtual evaluations and refers good surgical candidates to local pediatricians for further evaluation and pre-surgical work-up.
Hospital Partnership
The FACES Foundation has partnered with Hospital Belén of Lambayeque for 15 years. The hospital provides compassionate and competent medical professionals with specialties in pharmacy, nursing, laboratory, pediatrics, and social services.
Follow-up Care
Children who are born with both a cleft lip and a cleft palate need multiple surgeries. The FACES Surgical Team follows patients throughout their medical journey. This is why we return to the same town year after year. When necessary, patients are provided with speech therapy and referred to orthodontics.
