Cleft lip and palate (CLP)

What is a cleft lip and palate?

The cleft lip can pass through the upper lip to the nose, possibly even the upper jaw or to a part of the upper lip even as a relatively short notch. The cleft lip is usually simple, sometimes even double created.

In the cleft palate, both the anterior hard palate and the posterior soft palate may be affected. Here, a cleft jaw or a cleft palate never occur alone, but always together with a cleft lip on. Only the cleft lip itself and the cleft palate can occur in isolation.

The cleft lip and palate is never exactly centered, but always slightly to the right or left of the symmetrical central axis. The same is true with the double column formation.

An exception is the soft palate, in which the malformation runs exactly on the symmetrical central axis and in which there is no double splitting.

How does a cleft lip and palate develop?

In the early stages of embryonic development, different facial parts form separately, before later growing together. The so-called philtrum, the vertical furrow between the middle of the upper lip and the beginning of the nasal septum, is virtually the interface between two areas grown together.

The non-merging or not completely forms, as well, when freshly grown tissue ruptures again. The connection of the facial parts takes place a little later. If the connection process is disturbed, it will also split. So these are two separate developmental disorders. Often, however, both occur together.

A cleft lip and palate may have both an internal - ie hereditary or genetic - cause as well as caused by external influences that interfere with the development of the embryo.

Non-hereditary cleft lip and cleft palate

External influences have also been observed that seem to favor the appearance of cleft lip and palate. Again, many questions remain. Examples of suspected external factors include:

• Alcohol abuse of pregnant women
• Smoking during pregnancy
• Viral infections during pregnancy, such as rubella
• Physical or mental stress in pregnant women
• Taking certain medications
• X-rays

Treatment of cleft lip and palate

As varied as the cleft lip and palate occurs, individual based treatments are done. The main goal of the therapy is closing the gaps surgically. It is important on the one hand to eliminate the disorders and impairments associated with the cleft lip and palate and to counteract foreseeable stunted growth and, on the other hand, to achieve a good cosmetic result. Later, further corrective surgery may be required.

Medical treatment involves oral and maxillofacial surgeons and, if necessary, orthodontists, as well as ear, nose and throat doctors. Speech therapists undergo special speech exercises with the patients. Thanks to modern medicine, patients today are virtually symptom-free after a surgically corrected cleft lip and palate and the operation scar is not or hardly recognizable from the outside.