CRANIOFACIAL | CLEFT

An Introduction

Cleft lip and palate, or orofacial clefts, occur in about 1 in 700 children when the baby is developing in the womb, and can affect the lip, palate, jaw, gumline and teeth. During the first 6-8 weeks of pregnancy, the cells that form the baby’s nose, mouth, and upper jaw fuse to create the roof of the mouth, gumline, and the upper lip. A cleft occurs when parts of the lip and/or palate do not completely fuse together. It is important to identify this condition early in your child’s life as it can have a significant impact on eating, speech development, and hearing. Dr. Snider believes that having a cleft lip and/or cleft palate should not prevent your child in any way from living his/her best life. She treats all types of clefts and will create an individualized multidisciplinary plan of care to restore your child’s function and appearance, and facilitate growth and development with minimally invasive procedures that provide the greatest long-term result.

Cleft Lip

A cleft lip can be incomplete or complete, involve one or both sides, and may extend into the nose. It can often be identified on prenatal ultrasound before your child is born. Dr. Snider facilitates a multidisciplinary approach with feeding and speech specialists to provide the best care for your child with a cleft. She performs cleft repair as an outpatient and uses a meticulous anatomic repair method with a limited scar technique to achieve beautiful outcomes for both the lip and nose. Dr. Snider is focused on growth and development of your child and reduced treatment burden so that your child grows up feeling no differently than his/her peers.

Cleft Palate

Cleft palate can involve the soft palate, hard palate, or both. It can also involve the upper gumline and therefore affect the teeth. Speech development relies significantly on the ability of the functioning palate. Palate closure, palate length, and palatal muscle function are all important for adequate speech development. For best results, cleft palate repair is performed before speech development. Cleft palate can be associated with other syndromes including Pierre Robin Sequence, Velocardiofacial, Trisomy 13 and 18, and Van der Woude. Dr. Snider will work closely with you and your family to provide a multidisciplinary approach for best outcomes and will follow your child throughout their growth and development.

Submucous cleft palate

A submucous cleft is a cleft of the soft palate that is hidden under the mucosal layer and therefore more difficult to detect. It can be evident by a translucent bluish layer of mucosa in the middle of the soft palate, a bifid uvula, or a palpable notch in the back of the palate. It is not uncommon for the diagnosis of a submucous cleft to be missed. Usually there are signs such as difficulty feeding, nasal leakage of breastmilk or formula, chronic ear infections requiring ear tubes, or hypernasal speech. Submucous cleft palates typically require repair to realign the palatal muscles for improved speech and feeding. Dr. Snider will assess your child’s palate and speech to identify if surgical intervention is needed.

Bifid uvula

The tissue that hangs down in the back of the throat is called the uvula. If the uvula is bifid, or split, it could indicate a submucous cleft palate. A bifid uvula or submucous cleft palate may indicate that the palatal muscles that are necessary for speech are misaligned and may need to be repaired back into their proper position. Dr. Snider will examine your child to identify an underlying submucous cleft, and if intervention is required for full development.