In different forms and degrees of expression – statistically seen in about every 500th newborn; With a share of 15 percent, they are among the most common malformations. The causes of this have not been elucidated to this day, but many factors seem to play a role. What is certain is that about every fifth child affected has a family burden that may have been several generations ago.
For parents who were themselves affected, the statistical risk for the birth of a child with a gap formation is 4-5 percent; about the same applies to healthy parents who have already given birth to a split child. If the first child is already a split child, the statistical risk for further children with this malformation increases to 13-14 percent. Some mothers wonder if they may have behaved incorrectly during pregnancy, but these guilt feelings are completely unfounded! To what extent there is a hereditary predisposition and how high the likelihood is that further children could also show a gap can be clarified at a genetic counseling center; rare combinations with other malformations are also analyzed here. During the child’s growth in the uterus, between the 5th and 9th week there is either a lack of union or tearing of tissue from which the nose, lip and upper jaw later develop. Depending on the point in time at which the developmental disorder occurs and how serious it is, different types of cleft (one-sided or bilateral lip cleft, cleft lip-cleft lip, cleft lip-cleft palate or complete cleft palate and isolated cleft of the soft palate) with different degrees of expression.
Although the basis for the success of the treatment is laid by the plastic surgery, representatives of other medical specialties are also significantly involved in the care of your child, namely the orthodontist, the pediatrician and ENT specialist, the speech therapist and the dentist. Since many treatment steps interlock and your child’s appearance changes constantly due to growth, the final result can only be assessed after puberty.
For many parents it is difficult to understand why certain operations take place later and others relatively early or why not all sections of a cleft lip and palate can be closed in a single, as early as possible operation. The reason for this is that operations performed too early on certain sections of the cleft, especially on the hard palate, can lead to growth disorders, while operations performed too late, e.g. on the soft palate, are associated with a delayed or faulty language development. From decades of experience in split surgery, the best times for surgery for each section of the column are known today, although there may still be differences from clinic to clinic.
The first treatment step usually consists in the preparation of the aforementioned palate plate, which is used for the child in the first days of life. Not only does it make it easier for your baby to drink, it can also be used to shape the dental arch or narrow the gaps by grinding it out on the lower surface of the plate. If your child’s hard palate has no gaps, i.e. there is only a cleft lip or an isolated cleft of the soft palate, this type of plate treatment is not necessary.