Cleft Lip: Causes And Treatment
Cleft lip is a congenital defect that refers to a cleft lip. It is one of the most frequent malformations in newborns (affects 1 in 500), and has a higher prevalence in men.
We can distinguish two types of this disease, depending on whether the cleft palate is present together or not. In any case, this alteration is always related to poor development of the palate and upper lip during the first months of the fetus’ formation.
During fetal development there are parts that close in their formative period until they are fully developed. When these parts do not follow this procedure, various diseases arise. For example, we can mention spina bifida, caused by a closure defect in the neural tube.
In the case of cleft lip, there have been certain alterations in the fusion of the parts of the lower face. Therefore, the patient has a fissure between the nostrils and the upper lip.
Likewise, the size of the fissure varies depending on the subjects, and can even include the gum and palate. Another name that we found for this clinical case would be cleft lip-alveolus-palatal (FLAP).
Cleft lip signs and symptoms
Among the most common we find:
- Change in the shape of the mouth and nose (varies depending on the severity of the cleft). It therefore affects the appearance of the baby’s face.
- Displaced or misaligned teeth.
- Feeding problems The fissure sometimes disrupts the breastfeeding process, since the baby cannot suckle properly and sometimes the milk is diverted to the nose. Because of this, the baby gains weight very slowly.
- Recurrent ear infections.
- Growth retardation.
- Difficulties in developing speech.
The MSD Manual states that “isolated cleft lip and palate are collectively referred to as oral clefts .”
Diagnostic methods
Within the diagnosis, we find two variants.
Prenatal diagnosis
It is done through routine ultrasounds, especially during the second trimester of pregnancy. Both two-dimensional (2D) and three-dimensional (3D) ultrasounds are used in the event that greater precision is needed, so that the medical team can identify this disorder.
In three-dimensional ultrasound, it is much easier to diagnose cleft lip since it offers a more complete image of the fetus, but it is reserved for a more advanced gestational state since at an early age it can damage the fetus and alter its development.
Postnatal diagnosis
A physical examination is performed, which may include other techniques, in order to detect changes associated with the cleft lip.
Treatment
Treatment is based on performing surgery to reconstruct the areas affected by the fissure. It is done during the baby’s first year of life.
First, the cleft lip is operated and then the cleft palate, if present. The specialists will look in both operations for the baby to have the smallest and most discreet scar possible.
In the case of cleft lip, general anesthesia is applied to the baby and the surgeon will repair the tissues and sew the lip together.
For cleft palate, general anesthesia is also used and healthy palate tissue may be transferred to the malformation. Sometimes, it may be necessary to repair certain areas of the baby’s nose, then we talk about rhinoplasty operations.
Likewise, treatment may include psychological therapy, as the disfigurement of the fetus may lead the mother to choose an abortion. However, surgeries have a high success rate and babies lead a very normal life.
Factors related to cleft lip
The causes of cleft lip include both a genetic predisposition and certain environmental factors. The results of various studies have shown that tobacco and folic acid can alter the genes that give rise to this disease.
Specifically, folic acid deficiency is related to the development of other congenital diseases, such as neural tube defects. In this sense, it must be remembered that folic acid is a vitamin that the body uses to produce new cells on a daily basis.
In this case, the only possible prevention would be to take supplements of this vitamin before and during pregnancy. This precaution could significantly reduce the risk of cleft lip, even in families where the parents have had it.
