Cleft Lip & Palate

Cleft of the lip arises by non-fusion of various processes that form the face. Cleft lip (hare lip) may also include the alveolar processes and the palate. Clefts may be unilateral, predominantly on the left, or bilateral. Most infants with cleft lip have no associated malformations.

There is a genetic background for cleft lip and a recurrence risk exists for the siblings. Factors such as certain drugs and maternal smoking play a role.

Clefts may be surgically repaired with some functional and cosmetic restoration but often a series of treatments is needed till the child is of school age or more.

Facial clefts may be detected prenatally by ultrasound but usually not until late pregnancy.

Cleft Palate (without cleft lip)

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A congenital malformation characterized by a closure defect of the hard and/or soft palate behind the foramen incisivum without cleft lip. Includes sub mucous cleft palate.

Cleft palate is characterized by a cleft throughout the soft and hard palate, usually in the midline but without clefting lips or alveolar process. Cleft palate is often associated with other malformations in various syndromes.

Genetic factors play a role in non-syndromic isolated cleft palate and a recurrence risk exists in siblings. Environmental factors like certain drugs and maternal smoking may increase risk.

Palatal clefts impairs swallowing and later speech. Treatment usually starts with a prosthesis to cover the cleft, followed by surgical repair. If no chromosomal abnormalities or serious malformations are associated, prognosis is excellent.

Reference and Links:

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1 Global registry and database on craniofacial anomalies. Report of a WHO Registry meeting on Craniofacial anomalies. WHO, Geneva, 2003.

2. Explanation of Cleft Lips and Palates
(http://encyclopedia.thefreedictionary.com/Hare+lip), accessed Nov 2008.

3. Global database on Cleft Lips and Palates
(http://www.who.int/genomics/anomalies/en/ZZ-Annex.pdf), accessed Nov 2008.