What do we know about the cleft palate?
The cleft lip is the common name for the labio-palatal malformation. It is fortunately rare, but quite impressive and disabling.
Thanks to advances in surgical medicine and orthodontics, it can be corrected if caught early. The results are spectacular, even if the patient retains some after-effects. Nutrident comes back in detail on this affection.
Contenus
Where does the harelip come from?
In the age of political correctness, the term cleft lip has been replaced by the medical term cleft palate. Both names are quite telling: the malformation affects the upper lip and palate and gives the appearance of a hare's mouth.
It is a congenital condition that originates in the development of the so-called fetal buds that later form the face. Rather than forming the distinct nose and jaw, the medial nasal bud and the maxillary mass merge to varying degrees.
The frequency of cleft lip depends on the child's origin. It affects about 1 in 1000 children in Caucasians, is more common in Japanese (1/584) and rarer in black Americans (1/2273). Girls are twice as affected as boys. Certain chromosomal abnormalities multiply the risk factors.
What causes harelip?
There are several factors that “promote” the formation of a cleft lip. Considerations include heredity, chromosomal problems and maternal behaviors.
The appearance of harelip is undeniably hereditary. Although it is not systematic, parents who have suffered from it are more likely to transmit the malformation to their offspring.
On the genetic side, cleft lip is associated with many syndromes. Of the 250 identified, the most common are trisomy 13 or trisomy 18, Goldenhar syndrome, Treacher Collins syndrome, Van der Woude syndrome, Shprintzen syndrome and Stickler syndrome.
Older mothers are the most likely to conceive children born with cleft lip. The use of certain medications, tobacco and alcohol are aggravating factors.
The different forms of harelip
The harelip is located in different places. It can be more or less pronounced, partial or total, unilateral or bilateral. It affects the palate and/or the upper lip.
The malformation of the palate
The palate can be more or less affected. In extreme cases, it is even totally absent, which opens the total communication between the mouth and the nose.
The lip deformity
The upper lip may be more or less split. In the most pronounced cases, the separation goes up to the base of the nose and can even reach the gums. In this case, we no longer speak of a cleft lip, but of a cleft lip and jaw.
What are the consequences of a harelip?
Harelip is a disabling deformity on many levels. It can cause difficulties in breathing and eating, but also problems related to the auditory system, with failures in the quality of hearing, as well as recurrent ailments, especially ear infections.
Harelip affects the growth of the jaws and many oral problems result from it. Teeth grow uncontrollably and frequent bite problems occur.
Harelip leaves physical after-effects, more or less unsightly.
Can harelip damage be repaired?
Harelip can be detected in ultrasounds during the first trimester of pregnancy, as it appears as early as the fifth week. It is easier to identify when it touches the lip, rather than the palate. There is no intervention possible at this stage.
The extent of the malformation is measured at birth and surgery must be performed within the first few weeks of life to limit the problem. If the cleft lip touches the lip, it must be closed, which is possible from the second week. It is usually not necessary to wait beyond the third month.
If it is the veil that needs to be closed, the surgery should not take place until after the third month, but preferably before the eighth month.
When the cleft lip reaches the palate, it is the most delicate configuration. The operation will take place between the 6 and 12 months of the child.
On the other hand, depending on the severity of the malformation, several operations may follow. However, it is essential to correct the problems before the child reaches the age of one, so that he/she has as few after-effects as possible.
Often, the child will need orthodontic and speech therapy to compensate for the damage caused by the cleft lip.
Hare's beak : FAQ
How to avoid harelip?
It is not always possible to avoid the appearance of this malformation, but women are advised to avoid smoking, alcohol or drugs, as well as taking certain medications such as anti-epileptics, retinoids, corticoids, folic acid antagonists.
When can harelip be detected on ultrasound?
The first ultrasound at 13 weeks can theoretically detect this anomaly.
When to operate a harelip?
If it is a simple cleft lip, surgery to close the cleft can be scheduled as early as 3 months of age. But when the case is more complex, surgeons often recommend waiting a little longer and intervening before the age of one year (between 6 and 12 months).
University Hospital of Lyon. Cleft lip and palate and rare facial cleft.
University Hospital of Poitiers. Cleft lip, palate and lip-palate.
Saint-Justine UHC. Cleft lip and palate.