Most cases of cleft lip and cleft palate are noticed right away at birth and don’t require special tests for diagnosis. Increasingly, cleft lip and cleft palate are seen on ultrasound before the baby is born.
The goals of treatment for cleft lip and cleft palate are to improve the child’s ability to eat, speak and hear normally and to achieve a normal facial appearance.
Surgery to correct cleft lip and palate is based on your child’s particular situation. Following the initial cleft repair, your doctor may recommend follow-up surgeries to improve speech or improve the appearance of the lip and nose.
Surgeries typically are performed in this order:
- Cleft lip repair — within the first 3 to 6 months of age
- Cleft palate repair — by the age of 12 months, or earlier if possible
- Follow-up surgeries — between age 2 and late teen years
In general, procedures may include:
- Cleft lip repair. To close the separation in the lip, the surgeon makes incisions on both sides of the cleft and creates flaps of tissue. The flaps are then stitched together, including the lip muscles. The repair should create a more normal lip appearance, structure and function. Initial nasal repair, if needed, is usually done at the same time.
- Cleft palate repair. Various procedures may be used to close the separation and rebuild the roof of the mouth (hard and soft palate), depending on your child’s situation. The surgeon makes incisions on both sides of the cleft and repositions the tissue and muscles. The repair is then stitched closed.
- Ear tube surgery. For children with cleft palate, ear tubes may be placed to reduce the risk of chronic ear fluid, which can lead to hearing loss. Ear tube surgery involves placing tiny bobbin-shaped tubes in the eardrum to create an opening to prevent fluid buildup.
- Surgery to reconstruct appearance. Additional surgeries may be needed to improve the appearance of the mouth, lip and nose.
Surgery can significantly improve your child’s appearance, quality of life, and ability to eat, breathe and talk.