cleft lip

What is Cleft Lip?

Cleft lip, also known as cleft palate when it occurs in conjunction with a cleft in the roof of the mouth (palate), is a congenital condition where there is a separation or gap in the upper lip and/or palate. This can occur on one side or both sides of the lip.

Types of Cleft Lip

The opening in a cleft lip can vary in size, ranging from a small slit to a large split that extends into the nose. The cleft can be isolated to the lip or accompanied by a cleft in the palate.

Causes and Prevalence

Cleft lip is one of the most common congenital facial abnormalities in children, occurring in approximately 1 in every 700 births [7]. While the exact cause is unknown, it is believed to involve genetic and environmental factors during fetal development.

Common Signs and Symptoms of Cleft Lip

Cleft lip, also known as cleft palate or lip, is a congenital condition where there is an opening in the upper lip, which can extend into the roof of the mouth. The signs and symptoms of cleft lip can vary depending on the severity and location of the defect.

Common Symptoms:

• Difficulty with feeding: Infants with cleft lip may have trouble latching onto the breast or bottle nipple, leading to difficulty feeding.
• Nasal speaking voice: Children with cleft lip may have a nasal tone to their voice due to the abnormal formation of the palate and lip.
• Chronic ear infections: Cleft lip can increase the risk of ear infections, which can lead to hearing loss if left untreated.
• Rarely, difficulty swallowing: In some cases, children with cleft lip may experience difficulty swallowing liquids or foods.

Other Signs:

• Snorting or mouth breathing
• Decreased appetite
• Delayed speech development

It's essential for parents and caregivers to be aware of these signs and symptoms, as early detection and treatment can significantly improve the quality of life for children with cleft lip. [1][2][3][4][5][6]

References: [1] Symptoms · Having a hard time feeding. · Nasal speaking voice. · Constant ear infections. · Rarely, having a hard time swallowing. Liquids or foods ... (Search Result 1) [2] Signs of this include snorting, mouth breathing and decreased appetite. Eating and Drinking. Patients do not eat or drink as usual for two to three days after ... (Search Result 2) [3] Cleft Lip and Cleft Palate Symptoms · Difficulty with feeding · Difficulty swallowing · Speech issues · Dental problems · Chronic ear infections ... (Search Result 3) [4] Delayed speech or trouble speaking · Hearing loss · Missing, crooked, or small teeth · Teeth and jaws that don ... (Search Result 4) [5] Children with cleft lip or palate are also more likely to have ear infections, hearing loss, and problems with their teeth. Back to top. Causes. The most recent ... (Search Result 5) [6] A split in the lip on one or both sides of the face might look like a small gap in the lip or might be a ... (Search Result 6)

Diagnostic Tests for Cleft Lip

Cleft lip can be diagnosed through various diagnostic tests, which are essential for planning appropriate care and treatment.

• Ultrasound: A prenatal ultrasound can sometimes detect a cleft lip or cleft palate in the fetus. After birth, an ultrasound may also be used to confirm the diagnosis.
• Physical Exam: A physical examination of the baby's nose, lip, and mouth upon birth can help diagnose a cleft lip or cleft palate.
• Blood Tests: Blood tests, such as a Complete Blood Count (CBC), may be ordered to rule out other conditions that could cause similar symptoms. Chromosomal studies, like chromosome band 22q11.2 deletion, may also be performed if indicated.

According to [1], two-dimensional ultrasound is often superior to MRI in evaluating small or less severe clefts. Additionally, blood tests can help identify any underlying genetic conditions that may have contributed to the development of a cleft lip or cleft palate [4].

It's essential to note that most cases of cleft lip and cleft palate are diagnosed through a combination of these diagnostic tests, and there is no known cause for the condition in most cases [7].

Treatment Options for Cleft Lip

Cleft lip surgery is usually done to repair the physical deformity, but it may not address any underlying conditions that contributed to the cleft lip. In some cases, medications may be used in conjunction with surgery to treat related conditions.

• Surgery: The primary treatment for cleft lip is surgical repair, which can be performed as early as 1 week of age for severe cases [6]. Surgery involves closing the lip and palate using various techniques, such as Nasoalveolar Molding (NAM) for very severe clefts [6].
• Speech Therapy: Children with cleft lip may experience speech difficulties due to the physical deformity. Speech therapy can help improve articulation and communication skills.
• Dental Care: Regular dental check-ups are essential to prevent oral health issues, such as tooth decay or gum disease, which can be more common in individuals with cleft lip.

Medications Used in Cleft Lip Treatment

While medications may not directly treat the physical deformity of a cleft lip, they can be used to address related conditions. For example:

• Pain Management: Medications like acetaminophen or bupivacaine may be used to manage pain and discomfort associated with surgery or other treatments.
• Infection Prevention: Antibiotics may be prescribed to prevent infection after surgery.

Important Considerations

It's essential to note that medications should only be used under the guidance of a healthcare professional. Additionally, while medications can help address related conditions, they do not replace surgical repair as the primary treatment for cleft lip.

References:

[6] Treatment can begin as early as 1 week of age for severe cleft lip patients. [11] Cleft lip surgery is usually recommended at three to four months of life.

Understanding Differential Diagnosis of Cleft Lip

Cleft lip, also known as cleft palate or lip, is a congenital deformity that affects the upper lip and/or palate. In some cases, it can be challenging to diagnose cleft lip accurately, especially when other conditions are present. Here's what you need to know about differential diagnosis of cleft lip:

• Microform or occult cleft: This type of cleft occurs when there is incomplete separation of the lip with distortion but not separation of the white roll/vermillion border [3].
• Syndromes associated with cleft lip: Cleft lip can occur on its own or together with other syndromes, such as Pierre Robin syndrome, Stickler syndrome, and others. In these cases, a comprehensive evaluation is necessary to rule out underlying conditions [4].
• Differential diagnosis: When diagnosing cleft lip, it's essential to consider other possible causes of the deformity, such as:
  • Cleft palate
  • Microform or occult cleft
  • Syndromes associated with cleft lip
  • Other congenital anomalies [1]
• Diagnostic methods: A physical exam of the mouth, nose, and palate can diagnose cleft lip or cleft palate after birth. In some cases, an ultrasound may be performed during pregnancy to detect cleft lip or cleft palate [2].

Key Takeaways

• Cleft lip can occur on its own or together with other syndromes.
• Microform or occult cleft is a type of cleft lip that occurs when there is incomplete separation of the lip.
• Differential diagnosis is essential to rule out underlying conditions and ensure accurate diagnosis.

References:

[1] by N Phalke · 2023 · Cited by 21 — Differential Diagnosis. Cleft palate is a straight forward diagnosis. However, it is critical to identify and rule out larger syndromes of ...

[2] If an ultrasound doesn't detect a cleft before birth, a physical exam of the mouth, nose and palate can diagnose cleft lip or cleft palate after birth.

[3] by NJ Walker · 2023 · Cited by 19 — A microform or occult cleft occurs when the patient has incomplete separation of the lip with distortion but not separation of the white roll/vermillion border.

[4] Nov 23, 2024 — Cleft lip and cleft palate are among the most common birth defects. These birth defects can occur on their own or together. Sometimes a syndrome ...