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Cleft Palate

Cleft palate is a disorder in which there’s a split or opening (a cleft) in the roof of the mouth (the palate). Cleft palate is congenital, meaning it is present from birth. Cleft palate commonly occurs with another condition, cleft lip, which is an abnormal split in the upper lip. Both cleft lip and cleft palate are due to the failure of certain tissues of the mouth and face to fuse properly during pregnancy.

Cleft palate is one of the most common congenital disorders worldwide. It is usually recognized at birth and treated surgically. People with cleft palate may need one surgery, or multiple surgeries over the course of their childhood, to repair their palate and to make sure all other structures such as their jaw, throat, and ears are developing properly.

Symptoms

A child born with cleft palate may also be born with cleft lip, and the most obvious symptom of this would be a split in the upper lip. If there is no cleft lip, cleft palate can be seen by looking at the roof of a baby’s mouth. Besides these symptoms, other symptoms of cleft palate include:

  • Difficulty feeding
  • High-pitched, strange sounding voice
  • Frequent ear infections
  • Hearing loss
  • Abnormal teeth
  • Self-consciousness or social anxiety
  • Sadness or emotional problems

Symptoms like self-consciousness, emotional problems, and hearing loss typically develop in children who have longer-standing cleft palate. If cleft palate treatment is started early in infancy, some of these symptoms may not develop.

Causes

Cleft palate is not caused by a single thing. Instead, it is caused by a combination of genes and environmental factors. It is not possible to say exactly which factor led to cleft palate in each babies’ case, but some factors can predispose to it. These factors include things from teratogens – substances that damage foetuses in the womb – to some maternal conditions – like diabetes.

Reference Articles

Risk Factors

There are several risk factors that increase the likelihood of cleft palate, including:

  • Certain ethnic groups – People of Asian and Amerindian ancestry have the highest rates and risk of cleft palate globally. Caucasians and Latinos have intermediate rates, and people of African ancestry have the lowest rates globally.
  • Exposure to teratogens – Substances like cigarette smoke, alcohol, heroin, cocaine, anti-seizure medicines, and some pesticides, can all be toxic or teratogenic, and increase the risk of cleft palate.
  • Family history – Babies have a higher risk of being born with cleft palate if a family member of theirs had cleft palate in the past.
  • Maternal health problems – Some maternal health conditions, like diabetes, anaemia, and high blood pressure, increase the risk of cleft palate in a growing foetus.
  • Some genetic syndromes – Cleft palate sometimes co-occurs with other abnormalities in people with genetic syndromes. These abnormalities can include polydactyly (extra fingers) in Patau syndrome or micrognathia (an abnormally small jaw) in Pierre Robin syndrome.

Diagnosis

Cleft palate is often diagnosed at birth when a doctor does a physical examination, opens the mouth, and sees the cleft. Sometimes cleft palate may be diagnosed before birth, with ultrasound scans of the pregnant mom’s abdomen.

Treatment

The treatment for cleft palate is palate surgery, and this is usually done from 6 – 12 months old. Cleft palate can require additional surgeries which are staged for later periods in a child’s development. These surgeries can include pharyngoplasty (a type of throat surgery) around age 3 – 6 years, and jaw surgeries in teenagerhood.

Alongside surgery, children born with cleft palate usually see other medical and behavioural specialists, including speech therapists, orthodontists, audiologists, and psychologists. These specialists help to improve the educational, physical, and emotional development of children born with cleft palate.

 
 
 

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