Cleft lip/palate cause much more than cosmetic problems

May 22, 2012

Children born with cleft lip, cleft palate and other craniofacial disorders face numerous medical challenges beyond appearance.

Patients can face serious airway, feeding, speech and hearing problems, as well as social and psychological challenges, Laura Swibel Rosenthal, MD, of Loyola University Medical Center and colleagues write in the June 2012 issue of Otolaryngologic Clinics of North America.

"The management of with craniofacial syndromes is complex," Rosenthal and colleagues write. "Otolaryngologic [ear-nose-throat] evaluation is of paramount importance in providing adequate care for this patient population."

About 1 in 600 babies in the United States is born with a cleft lip and/or , according to the Cleft Palate Foundation. The defect can range from a small notch in the lip to a grove that runs into the roof of the mouth. It can occur in isolation or in combination with other craniofacial birth defects. (A craniofacial disorder refers to an abnormality of the face and/or head.)

The first step in managing craniofacial patients is ensuring a safe airway. There's also a great potential for and . And patients are at increased risk of developing upper airway problems such as sinusitis, laryngitis and rhinitis.

Hearing loss is common and often progressive. Thus, in addition to receiving standard newborn hearing screening, craniofacial patients should continue to receive periodic hearing tests, Rosenthal and colleagues write.

Craniofacial patients typically require several corrective surgeries, performed in staged fashion. Surgeons and anesthesiologists should be aware of the potential challenges these patients may have with .

The authors recommend a multidisciplinary approach, beginning with to determine the cause of the malformation, to inform parents about what to expect and to learn about the implications for other family members.

In addition to otolaryngologists, other specialists who typically care for craniofacial patients include pulmonologists, gastroenterologists, dentists and orthodontists. Depending on the congenital condition, a patient also may see pediatric specialists, such as cardiologists, ophthalmologists, neurosurgeons, endocrinologists, urologists, nephrologists and orthopaedic surgeons.

Most patients also need additional support services, including case management (social work), psychology or psychiatry, speech pathology, physical therapy, occupational therapy and other educational services.

Explore further: Wider cleft width appears associated with hypernasal speech, nasal air escape

Related Stories

Recommended for you

Zika virus infection alters human and viral RNA

October 20, 2016

Researchers at University of California San Diego School of Medicine have discovered that Zika virus infection leads to modifications of both viral and human genetic material. These modifications—chemical tags known as ...

Food-poisoning bacteria may be behind Crohn's disease

October 19, 2016

People who retain a particular bacterium in their gut after a bout of food poisoning may be at an increased risk of developing Crohn's disease later in life, according to a new study led by researchers at McMaster University.

Neurodevelopmental model of Zika may provide rapid answers

October 19, 2016

A newly published study from researchers working in collaboration with the Regenerative Bioscience Center at the University of Georgia demonstrates fetal death and brain damage in early chick embryos similar to microcephaly—a ...

Scientists uncover new facets of Zika-related birth defects

October 17, 2016

In a study that could one day help eliminate the tragic birth defects caused by Zika virus, scientists from the Florida campus of The Scripps Research Institute (TSRI) have elucidated how the virus attacks the brains of newborns, ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.