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Cleft Lip & Cleft Palate

Cleft lip and cleft palate are birth defects that fall into the category of cranio-facial defects. They are collectively referred to as oral clefts.

What it is

Cleft lip and cleft palate are birth defects that cause abnormalities in the upper lip and in the roof of the mouth. In both conditions, the cleft is a gap that is formed when the tissue of the lip and/or the palate fails to join before birth. While cleft lip may occur independently, cleft palate usually occurs along with cleft lip. The appearance of other parts of the face may be affected by the deformity, as well.

If left untreated, oral clefts can cause problems with a child’s ability to eat. Either defect can also lead to speech problems and ear infections. Children who do not receive surgical treatment are prone to social isolation and poor self-image, due to the magnitude of the defect’s distortion of the face. Cleft lip and palate may occur independently, or along with other birth defects. About 1 in 2,500 babies are born with a cleft lip and/or palate.

Symptoms

  • Cleft lip manifests in an abnormal formation of the lip ranging in severity from a small dent in the lip to a full split that stretches from the lip to the base of the nose
  • Cleft palate appears as a split on one or both sides of the roof of the mouth
  • Change in the shape of the nose
  • Poorly aligned teeth
  • Feeding problems that may lead to an inability to gain weight
  • Flow of milk through nostrils during attempted feeding
  • Deficient growth due to problems with feeding
  • Recurrent ear infections
  • Speech impairment

Cause

Topamax: A recent statement issued by the FDA warned that Topamax (topiramate), a drug used to prevent seizures and migraines, has been linked with an increased risk for certain birth defects. According to the statement, women who take Topamax during their first trimester of pregnancy are between 16x and 21x more likely than unexposed pregnant women to deliver a baby with oral cleft defects.

Depakote: According to a recent study published in a leading medical journal, babies who experience exposure to the anti-seizure drug Depakote (valproic acid) before birth are 5x more likely than unexposed babies to be born with oral cleft defects.

Treatment

Surgery to correct the cleft lip or cleft palate is usually preformed before the child is one year old. Cleft lip surgery is typically performed between 6 weeks and 9 months and involves stitching the lip together. Cleft palate surgery is done when the child is a little bit older, usually between nine months and one year. During this surgery, tissue is moved from one area of the mouth and repositioned to cover the soft palate. In both surgeries, the physician may need to preform rhinoplasty (surgery to the nose) to repair the tip of the child’s nose.

 

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