Our work is all about helping people who don't have access to the surgery that we are lucky enough to take for granted. We perform as many operations as our funds and time will allow, completely transforming peoples quality of life.
During the early stages of pregnancy, the upper lip and palate develop from tissues lying on either side of the tongue. Click to expand / collapse
Normally, as the face and skull are formed, these tissues grow towards each other and join up in the middle.
When the tissues that form the upper lip fail to join up in the middle of the face, a gap occurs in the lip. Usually, a single gap occurs below one or other nostril (unilateral cleft lip). Sometimes there are two gaps in the upper lip, each below a nostril (bilateral cleft lip). When the palate fails to join up, a gap is left in the roof of the mouth up into the nose.
We don't know why the 'joining up' process fails in this way. Some evidence suggests there may be a genetic factor, as cleft lip and palate can run in families.
It is thought, however, that certain types of drugs may increase the risk.
Feeding: The most immediate problem caused by a cleft lip or palate is likely to be difficulty with feeding. Click to expand / collapse
Many babies with a cleft lip can breastfeed. However, some have difficulty in forming a vacuum in order to suck properly. Babies with these problems may need a special teat and bottle that allow milk to be delivered to the back of the throat where it can be swallowed. Sometimes, special dental plates can be used to seal the roof of the mouth to help the baby suckle milk better.
Babies who find it difficult to feed may gain weight slowly at first, but have usually caught up by the time they are six months old.
Speech and hearing
Cleft palate can cause problems with speech. The size of the cleft is not an indicator of how serious such problems are likely to be - even a small cleft can affect speech quite seriously. Most children go on to speak normally after the palate is repaired, although some may develop problems such as nasal speech.
Hearing may be affected because the muscles of the palate affect the ear, making the child more likely to develop "glue ear". This is a condition where thick sticky fluid accumulates behind the eardrum as a result of an infection of the middle ear. Doctors call it otitis media with effusion. It can cause temporary hearing loss but can be treated with antibiotics or, if it is an ongoing problem, with a minor operation to insert a tiny plastic tube (a grommet) into the eardrum through which the fluid can drain.
Occasionally, cleft palate may also affect the growth of the jaw and the development of the teeth.
Surgery is the most common treatment for cleft lip and palate. Click to expand / collapse
The type of operation required depends on the severity of the cleft. Often a number of operations are performed as the child grows.
Surgery to close the gap in the lip is usually first performed three months after the baby is born. Surgery to close the gap in the palate is usually done at about six months old. Both operations are done with the baby asleep under general anaesthetic and involve a hospital stay of three to five days.
As the child grows older further surgery may be needed to improve the appearance of the lip and nose and the function of the palate. If there is a gap in the gum, a bone graft may be used to fill it.