Cleft & Craniofacial Center

Cleft Lip & Cleft Palate Care

The University Health Cleft and Craniofacial Center in San Antonio is dedicated to meeting your child’s unique needs. We bring together a diversified team of pediatric specialists to provide the highest level care for your child. From diagnosis to treatment and beyond, we are here for your family.

What Is Cleft Lip and Cleft Palate

Cleft lip and cleft palate are birth defects that appear as splits or notches in the upper lip or roof of the mouth in a baby. Babies can be born with a cleft lip, cleft palate or both. 

A cleft lip is more noticeable than a cleft palate since cleft palate occurs inside the mouth.  Both arise when soft tissues and bone do not close during fetal development.

Types of Cleft Lip and Cleft Palate

  • Unilateral only affects one side of the mouth and is the most common type
  • Bilateral affects both sides of the mouth

Cleft lip and palate should be surgically treated because they can cause:

  • Problems with feeding
  • Hearing loss 
  • Speech and language delays
  • Dental problems
  • Psychological and social difficulties

Cleft Lip and Cleft Palate Care Team

  • Facial plastic and reconstructive surgeon
    • Performs cleft lip and palate surgery, cleft nasal surgery and pediatric rhinoplasty, speech surgery, microtia
  • Audiologist
  • Speech language pathologists
  • Social worker
  • Pediatric ENT (ear, nose, and throat doctor)
  • Dentist and orthodontist
  • Nurse coordinator 

Speech and Language Delay

Because the muscles in the back of the mouth are not properly developed and aligned, your child may have some speech and language difficulties. We will refer you to a speech therapist to help your child with these challenges.

Cleft Lip and Cleft Palate Diagnosis

At University Health, your health care provider can diagnose cleft lip or palate during a prenatal evaluation or shortly after birth. An early diagnosis allows our team to plan the most effective treatment for an optimal outcome.

Prenatal Evaluation

A prenatal evaluation for cleft lip or palate includes an ultrasound to look at the baby and determine if he or she is showing signs of craniofacial abnormalities or conditions associated with cleft lip and palate, including:

  • Van der Woude syndrome
  • Stickler syndrome
  • Pierre Robin sequence
  • Hemifacial microsomia
  • Goldenhar syndrome
  • Downs syndrome
  • CHARGE syndrome
  • 22q microdeletion and velocardiofacial syndrome
  • DiGeorge syndrome
  • Oro-mandibular limb hypoplasia syndrome
  • Opitz syndrome

Craniofacial Conditions We Treat

We specialize in treating cleft lip and cleft palate. Other craniofacial conditions we treat include:

Surgical Treatment of Cleft Lip and Cleft Palate

Surgery is necessary to treat cleft lip and palate. The timing of surgery for your child will vary depending on the severity of their condition and each child’s individual needs. 

Typically, the initial surgery for cleft lip should be performed before a baby turns 1 year old, and for cleft palate within 18 months after birth.

Your child then may or may not require additional surgeries throughout childhood and adolescence as they grow and develop.

Timeline of Repair

  1. Nasoalveolar molding (1 week to 3 months of age, if needed)
  2. Cleft lip repair (3 to 6 months)
  3. Cleft palate repair (9 to 18 months)
  4. Palatal expansion (5 to 7 years, if needed)
  5. Alveolar bone graft and fistula repair (6 to 9 years)
  6. Tip rhinoplasty (minor revisions) (6 to 9 years)
  7. Phase I orthodontics (6 to 9 years)
  8. Phase II orthodontics (14 to 18 years)
  9. Jaw surgery (14 to 18 years)
  10. Definitive cleft rhinoplasty (15-18 years)
  11. Final touchup surgery (adolescence or adulthood)

Follow-up Care

After our team repairs your child’s cleft lip and/or palate, your child will return to our clinic for yearly checkups. This is to ensure that they are having a healthy, optimal recovery and to provide extra support when they need it.

As your child grows and develops, they will need additional procedures to account for changes in their bone and tissue structure.

Your child may need additional services, including:

Whenever issues arise, are team will coordinate care for your child and connect you with the appropriate providers.

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