Cleft Lip and Palate

September 14, 2005
S. Anthony Wolfe, MD

,
Carolyn De La Cruz, MD

Cleft lip and palate is a common congenital facial malformation that occurs once in about every 750 births among Caucasians.

Cleft lip and palate is a common congenital facial malformation that occurs once in about every 750 births among Caucasians.

Figures 1A and 1B show a baby boy with a complete right-sided cleft of the lip, alveolus, and palate. Figures 2A and 2B show a baby girl with complete bilateral cleft of the lip, alveolus, and palate.

S. Anthony Wolfe, MD, Carolyn de la Cruz, MD, and Martha Mejia, DDS, of the Miami Children's Hospital in Florida, report that both of these patients were treated presurgically with maxillary orthopedics (Figure 2C) that aligned and brought together the maxillary segments. This made it possible to close the cleft of the alveolus (gingivoperiosteoplasty) and the anterior palate; it also allowed closure of the lip and correction of the cleft lip nasal deformity.

Both children underwent surgery when they were 6 months old. Figures 1C and 1D show the boy about 6 months after the operation. Figures 2D and 2E show the girl 3 months after her surgery. The remaining palatal cleft will be closed in both when they reach 18 months.

The goal is completion of all reconstructive surgery in children with clefts by age 2 years. The authors believe that for optimal care, children with clefts need to be followed by a multidisciplinary team that includes a pediatrician, plastic surgeon, orthodontist, pediatric otolaryngologist, and a speech and hearing expert.

More information can be obtained from the American Cleft Palate/Craniofacial Society; the Web site address is www.cleftline.org. The telephone number is (800) 24-CLEFT.

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