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Houston Cranio Facial

Cleft Lip & Cleft Palate

What is a cleft lip?

The fourth most common birth defect, a cleft lip with or without a cleft palate is a type of facial cleft in which the facial and/or oral tissue does not properly join together during fetal development. As a result, a split or separation is left in the affected area. Dr. Eric Payne, our extensively trained craniofacial surgeon and board certified plastic surgeon, along with our skilled multispecialty team can help correct this condition using state-of-the-art techniques. His goal is to provide optimal cosmetic and functional improvement, and to help each child achieve as normal an appearance as possible. Today’s advanced techniques make cleft lip and palate treatment more effective than ever before.

What causes a cleft lip and palate?

Approximately one out of every 700 children are born with a cleft lip with or without a cleft palate. The individual cause of a cleft lip and/or palate is often unknown, but usually is not a result of anything the mother did or did not do before or during pregnancy. However, certain medications are known to increase the risk of a cleft lip and/or palate. Genetic factors also can play a role, particularly if the cleft is a sign associated with another syndrome; in this case, the heritability will depend on the condition. For more information, please contact our practice to ask additional questions or to schedule a consultation.

Dr. Payne and his staff are absolutely amazing! My daughter was born with a bilateral cleft lip/palate and Dr. Payne was assigned to her as her surgeon. I had been doing alot of research while pregnant on craniofacial surgeons and I only wanted the best. I had not yet picked one since she was born a month premature. After meeting him and looking into everything he has done including mission trips to help children in countries where this type of procedure isn’t provided, I knew we had been assigned just the right doctor for our daughter. He was so kind and gentle with her and you can really tell that he has a passion for what he does. Her first surgery to repair her lip looks absolutely amazing! I can’t say enough about how happy I am with him and his staff.

colleen jones

November 25, 2017

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What are the different types of cleft lip and palate?

Every iteration of a cleft palate or cleft lip is unique. Still, they generally can be categorized into a handful of subsets. The types of cleft lip are:

Forme fruste or microform unilateral cleft lip: a minor cleft on one side of the upper lip
Incomplete unilateral cleft lip: a cleft on one side of the upper lip that does not extend to the nose
Complete unilateral cleft lip: a cleft on one side of the upper lip that does extend to the nose
Incomplete bilateral cleft lip: clefts on both sides of the lip that do not extend to the nose
Complete bilateral cleft lip: clefts on both sides of the lip that do extend to the nose

Additionally, there are three main types of cleft palate, which are:

Incomplete cleft palate: a cleft in the back of the mouth in the soft palate
Complete cleft palate: a cleft that affects the hard and soft parts of the palate, leaving the nose and mouth cavities exposed to each other
Submucous cleft palate: a cleft involving either the hard or the soft palate (or sometimes both), which is covered by the mucous membrane that lines the roof of the mouth

Cleft lip and palate can occur separately or together, and your child’s treatment plan will be customized to address their unique needs.

DiGeorge Syndrome/Chromosome 22q11.2 Deletion Syndrome

DiGeorge syndrome is known by a number of names, including velocardiofacial syndrome, although the most accurate title today would be chromosome 22q11.2 deletion syndrome. This condition can present in a variety of ways, depending on the severity and the individual’s unique expression of the disorder. While some signs and symptoms may be apparent from birth, others may develop over several years. Examples of signs include:

  • Bluish skin color due to heart defects limiting oxygen supply in the blood
  • Breathing problems due to airway abnormalities
  • Muscle twitches or spasms around the mouth, hands, arms, or throat due to low calcium levels
  • Certain facial features, such as wide-set eyes, low-set ears, underdeveloped chin, or a narrow groove in the upper lip
  • Cleft palate
  • Difficulty feeding and gastrointestinal problems
  • Frequent infections due to weak immune system from low or missing T-cells
  • Inability to gain weight
  • Delayed growth and development (including delays in certain infant milestones and speech development)
  • Learning and behavioral issues

Each person receives two copies of chromosome 22, one from their mother and one from their father. DiGeorge syndrome occurs when part of one copy of chromosome 22 is missing a segment (known as 22q11.2). This defect rarely results from an inherited disorder, more often happening due to a random event. Genetic factors can play a role, regardless of whether or not the parent shows signs of the condition; however, this event is less common. Not all the genes involved in DiGeorge syndrome are well understood, therefore, there is some uncertainty about the causes of this defect. If you have any questions about your child’s condition, Dr. Payne will provide additional information and sources to help you become as well-informed as possible.