Orofacial Clefts and Oral Surgery

Every year more than two thousands babies are born with a cleft palate, and more than four thousand are born with a cleft lip. Orofacial clefts are one of the most common types of congenital defects in the world. Luckily, because this is such a common occurrence, dedicated oral surgeons like Dr. Sedaros are well equipped and able to operate on these strong children and reconstruct their cleft palates and lips, enabling them eat, speak, and develop with ease.

What are Cleft Lips and Cleft Palates?

Orofacial clefts such as cleft lips and cleft palates are birth defects that occur between the fourth and ninth week of pregnancy. As the skull of the fetus forms each side grows towards center. In most cases each sides meets and fuse together creating the sinus cavity, palate and lips; however, in some cases these bones and tissues do not fuse and a cleft is formed.

Cleft Lip

A cleft lip occurs when the tissues that create the nose and lips do not come together within the fourth and seventh month of pregnancy.  A cleft lip can be expressed as a wide gap that spans the opening of the mouth all the way up to the nose, to a small split in the lip. And, children who have a cleft lip can also, but not always necessarily, have a cleft palate.

Cleft Palate

Cleft palates occur between the sixth and ninth month of pregnancy when tissues do not come together in utero. They are characterized by an opening in the palate, or roof of the mouth. These defects can be very problematic for children who have them because they can be as large as much of the soft and hard palate. This can make it difficult for the child to speak and eat, and even more detrimental to their health, removes the barrier between the mouth and sinus cavity.

Treatment of Orofacial Clefts

Children with orofacial clefts can be treated as soon as seven months old. A skilled oral surgeon is often consulted as soon as possible to asses the degree of defect, and will discuss a treatment plan. A cleft palate can severely impact a child’s life by making it extremely difficult to eat and receive the nourishment they need to survive. A cleft lip can also cause an infant difficulty eating and learning how to speak as they grow.

The main goals of this oral surgery is to close the gap. For a cleft palate this means closing the space between the roof of the mouth, the sinuses and the nose, depending on the severity of the condition. It also involves reconnecting the muscles that make the palate work, and ensuring that the palate is long enough to allow the child normal oral function. There are many variations of this surgery and the prescription of one will depend on the child’s state. After an evaluation Dr. Sedaros will be able to discuss the pros and cons of each treatment options with the child’s parent. These oral surgeries are extremely complex because the surgeon must take into account the growth of the infant. Any surgery must allow for normal growth and subsequent change in oral function. The oral surgeon must close the defect, create an apparatus that will allow for normal eating and speech development, and also take into account that the maxilla will grow and develop over the years. However, it will likely be necessary for the child to undergo multiple surgeries, and speech and orthodontic therapies during their adolescents to completely correct a cleft palate.

The correction of a cleft lip is just as complicated as palate reconstruction, muscles must be reconnected as well as the soft tissues of the lips in order to restore the lip. Oral surgeons who perform cleft lip reconstructions become artists as well. They must reconstruct the lip in a way that makes the previous presence of the defect undetectable. Further, they must reconnect the muscles of the lip just right so that the child will be able to use their mouth to speak clearly and eat without burden.

Orofacial clefts are congenital birth defects that affect every function of the face except for sight. Thankfully skilled surgeons like Dr. Sedaros are able to reconstruct this vital part of the mouth and enable a child to grow and develop as any other child.