Causes of cleft palate. Cleft lip (cleft palate). About the disease, causes, surgery, before and after photos. Surgery to repair cleft lip or palate with before and after photos

At the end of the first month of pregnancy, the baby's mouth forms from two separate halves that grow next to each other. Around the sixth to eighth week, they fuse together to form the upper jaw. Next, the seam goes back and forth to seal the lips with the tongue. By the tenth week of pregnancy, the mouth is fully formed and the nose has acquired its familiar structure and location.

It is a congenital defect in which the child’s upper lip is completely formed and has a hole. - a similar congenital anomaly in which the palate of the unborn child is not fully formed, but has a hole. Some children with a cleft lip have only a small indentation in their upper lip. Others have a full open opening that extends through the upper jaw to the bottom of the nose. The abnormality may appear on one or both sides of the child's mouth. This birth defect is called an oral cleft, or cleft lip. In children, the causes of its occurrence are still unknown.

Defects and the conditions for their development vary in severity and degree with variations:

Cleft lip (lip defect).
Cleft palate (defect of the roof of the mouth).
Cleft lip and palate (both defects).
Microform of a cleft (crack or scar).
Unilateral cleft (one side of the lip and palate).
Bilateral cleft (both sides of the lip and palate).

Cleft lip and cleft palate: causes

The causes of cleft lip, cleft palate and other facial abnormalities are not well understood, but they are directly related to changes in the child's genes. It is believed that 25% of cases are due to heredity, up to 15% - chromosomal abnormalities and 60% - external reasons birth of children with cleft lip. The tendency to become deformed may be inherited from one or both parents. The potential for developing the disease increases when it occurs among close members of the same family.

Other factors that can affect the genes that cause the split include viruses, certain medications, diet, and environmental toxins. Recent studies have identified smoking and drug use as risk factors for the development of cleft lip and palate, as well as other birth defects. In addition, having diabetes significantly increases the risk of having a baby with a cleft lip or without a palate. Drug use and intoxication of the body can also cause these birth defects. Cleft lip and palate can occur along with other congenital anomalies. This can lead to a number of difficulties in Everyday life. It is not uncommon for babies to be born with a cleft lip or palate if their relatives have had the condition or have a history of other birth defects.

Genetics and heredity

To this day real reasons The development of cleft palate and lip is unknown, but doctors believe the defects are due to genetic and environmental factors. Genetics may play a role in the development of a disease such as cleft lip. The causes may combine several factors. If one or both parents had this deviation, this significantly increases the manifestation of the anomaly in the child. Your lifestyle during pregnancy can also make your baby more likely to develop an abnormality.

So, why does a disease such as cleft lip develop? Photos, causes and methods of treatment will help to learn more about this pathology.

Exposure to phenytoin or drug use during pregnancy increases the risk of developing an anomaly by 10 times or more.
Smoking during pregnancy increases the chance of developing a defect by 2 times.
Use of alcohol, anticonvulsant drugs, or retinoic acid has been linked to birth defects, which include cleft lip and palate
During pregnancy, vitamin deficiency, and especially folic acid, can also cause the development of craniofacial anomalies.

There are many factors that cause cleft lip in children. The reasons and photos of this disease make it clear the seriousness of the situation. Cleft palate can develop as an isolated birth defect or as part of a larger genetic syndrome that can lead to more severe defects.

Environment

During pregnancy, what a mother takes, eats and drinks is critical to the development of her unborn child. Vitamins and useful material enter the growing body through the mother's blood. But between a woman and her unborn baby there is a strong protective shell called the placenta. It does not allow some toxic substances to pass through and reliably protects the child in the womb. While the placenta is really good at filtering out toxins, other dangerous chemicals can pass through this barrier and enter the fetal blood stream.

Cleft lip disease has a genetic cause, so during pregnancy, you need to carefully monitor your health.

Toxic substances

Harmful substances such as pesticides and mercury can enter the baby's bloodstream, causing serious violations in its development. In 2004, a special environmental working group studied ten newborns. The researchers found, on average, about 200 types of industrial chemicals and pollutants. 180 of these compounds are known carcinogens.
There is a theory that the system human body formed long before the development of most harmful chemical substances. Our body is simply not able to recognize and neutralize such elements.

In any case, the health community is convinced that some of these chemicals contribute to the development of birth defects. Foreign scientists have discovered that certain gene regions on chromosomes 1, 2, 3, 8, 13 and 15 are associated with the formation of cleft palate and lip. This study takes an important step to better understand the genetic and environmental causes of disease.

What to do to prevent an anomaly?

Some researchers suggest that taking folic acid during pregnancy may reduce the baby's chances of developing these abnormalities. This substance is found in most multivitamins. Folic acid is known to actually reduce the risk of other unrelated birth defects.

What chemicals can affect the development of the defect?

Finding out which substances lead to the diagnosis is a rather difficult task.
The occurrence of a defect such as a cleft lip has different causes, but mainly it is a combination of genetic factors and environmental toxins. Genes can start to develop incorrectly, but they need a little push from the outside world.

Medicines that, according to experts, can cause clefts:

that increase or decrease blood pressure ("Pseudoephedrine" and "Aspirin").
Antiepileptic drugs such as Carbamazepine and Phenytoin. Some researchers believe that the cause is actually epilepsy itself, not the drugs used to treat it.
"Isotretinoin", or "Accutane" - a medical drug taken to treat severe manifestations of acne (acne). Do not take Accutane during pregnancy. You should not plan pregnancy during the entire course of using the drug and within a month after.
Corticosteroids such as Hydrocortisone and Cortisone. The use of these drugs during pregnancy can lead to a diagnosis of cleft lip. The causes may also serve as risk factors during pregnancy.

There are several complications that can affect infants and children with cleft lip or palate.

Feeding problems

Due to the anatomical defect, the process of breastfeeding can be quite difficult for newborns. Abnormal separation upper lip makes feeding uncomfortable. With such an anomaly, it is impossible to obtain a good compaction, which is necessary for the successful flow of the process. Regular bottle feeding nipples present the same problem. However, there are specialized utensils that contribute to efficient nutrition.

Children with cleft palate, as a rule, are equipped with a removable artificial palate from the very beginning of life. This device limits the ability of liquids to enter the nostrils and also facilitates the ability to suck from specialized nipples.

Ear infections or partial hearing loss

Children with cleft palate most often have ear infections and associated fluid buildup in the inside of the eardrum. To limit these problems, most children with cleft palate have AEDs (tubes) passed through the eardrum during the first months of life.

Speech problems

As you might expect, developmental abnormalities associated with the palate and lip can affect articulation. The most common problem is usually voice quality. Corrective surgeries can help reduce these speech problems, but most children with a cleft lip or palate benefit from speech therapy with a speech therapist.

Dental problems

Children with cleft lip or palate often have problems with missing or distorted teeth and usually require orthodontic treatment. If the upper jaw has dysfunction, such as improper placement and positioning of the permanent teeth, then the situation calls for maxillofacial surgery.

Treatment of cleft lip and cleft palate

Doctors can now diagnose an abnormality based on ultrasound readings already at 18 weeks of pregnancy. Diagnosing a cleft palate is more difficult because it is hidden inside the mouth. Once a diagnosis is made, doctors may perform a procedure in which amniotic fluid is removed to test for the presence of the genetic syndrome. To determine the cleft early stage and formulate correct therapy Typically, a large team of specialists is required.

Surgery

Correction of the cleft by surgery usually occurs after the 7th week of a newborn's life. This type of operation refers to plastic surgery. If the child's nose is affected by changes due to this defect, then rhinoplasty may be necessary. Children born with a cleft lip typically require ongoing therapy with a variety of specialized procedures to achieve full recovery.

In the vast majority of cases, the reason for the birth of a child with a cleft palate lies within the framework hereditary predisposition. A significant factor that can trigger the occurrence of this birth defect is the presence bad habits during pregnancy (alcohol, smoking), sometimes this pathology can lead to late pregnancy. The defect occurs in the first two months of bearing a baby, this is the period of development of the maxillofacial organs.

So that's it causal factors, which contribute to the appearance of such an anatomical anomaly, can be classified as follows.

Genetics. Currently, there is no exact solution to the issue of the nuances of the formation of the anatomy of the jaw and face. But according to statistics, we can conclude that on average, a person born with this diagnosis has a chance of passing this congenital structural defect to his child about 7 percent.
The defect is accompanied by the presence of a more serious pathology. Some complex ailments often have nuances of the standard clinical picture variants of cleft lip and/or palate, for example: Stickler syndrome, Van der Woude syndrome.
Environmental influence in the prenatal period: development of a state of oxygen deficiency in the 1st trimester of pregnancy (including maternal smoking, consumption of alcoholic beverages, as well as the use of certain medications for arterial hypertension). Also, the danger of this pathology can provoke the exposure of the mother’s body to the influence of unhealthy diet, anticonvulsants medicines, sodium compounds, influence of lead.

The main reasons for the birth of babies with cleft palate are external factors, which affect the pregnant woman’s body at the very beginning of this condition. These include:

chemical exposure (22.8 percent),
mental and mechanical influence (9 percent),
getting injured (6 percent),
biological (5 percent) and physical (2 percent) effects.

Symptoms

The symptoms of this disease are closely related to its form. In most cases, the signs are quite serious and pose a real problem for babies and their parents. A cleft palate can manifest itself as follows:

The soft palate does not overgrow.
The soft and partially hard palate does not overgrow.
The soft and hard palates are not completely overgrown on one side.
The soft and hard palates on both sides do not completely overgrow.

Common symptoms of this defect are

the child cannot make sucking movements due to a closed palate;
the baby refuses to eat because the milk penetrates into the nasal cavity, which causes an unpleasant feeling;
baby is lagging behind physical development due to malnutrition.

Diagnosis of cleft palate in newborns

Diagnosing this defect in a child is quite simple and is done immediately after birth.

Doctor examines oral cavity newborn, where the palate is noticeably cleft.
A medical history is taken of the mother of such a child, and the doctor studies the history of her pregnancy.
The hereditary factor and the presence of a similar defect in one of the baby’s relatives are taken into account.
The fact of cleft palate in a baby who has not yet been born can be detected through an ultrasound, but only in late gestation at 6-7 months of pregnancy.
May need professional help pediatric surgeon, Laura.

Complications

The main problem in children with cleft palate concerns the way they are fed and difficulties with nasal breathing.

Over time, if this problem is not solved surgically, the child will develop:

speech disorders,
inflammatory processes of the paranasal sinuses,
inflammation of the eustachian tube,
problems with adaptation in a team.

Treatment

What can you do

If you had a baby with this defect, first of all, do not despair. Today, the so-called cleft lip or cleft palate can be successfully treated surgically, and over time, in most cases, no one will even guess from the child that he was born with such a defect. There is no other treatment.

It is necessary to listen to the doctor’s recommendations regarding the baby’s nutritional habits, as well as wait and prepare for surgery. Usually several operations are required, but they will allow the baby to live a full life, indistinguishable from the life of his peers.

The main difficulty for a mother in the preoperative period is to establish the best way When feeding a child with this diagnosis, there are a number of practices and recommendations that will definitely help you adapt to the situation.

What does a doctor do

Surgical treatment is the only way to eliminate this defect in an infant.

Surgical therapy is carried out in several stages according to a specific scheme developed by the doctor. It is advisable to eliminate this problem before the child reaches three years of age so that this defect does not affect the child’s speech and self-esteem.

After surgical intervention You may need sessions with a speech therapist.

Prevention

Since this birth defect is caused by hereditary factor, then special preventive measures not provided. We can only advise you to take multivitamins, healthy image life, avoid infectious diseases during the period of bearing a baby.

The cleft palate is congenital pathology, manifested as a cleft that is located in the middle of the sky. This disease is accompanied by disorders respiratory functions, and at the same time difficulties in eating. This pathology can be fraught with the development of many complications and therefore requires mandatory and urgent treatment. A photo of a human cleft palate is given in the article.

What it is?

A cleft palate is a congenital malformation in which a person is born with damage in the facial area. At the same time, there is a direct connection between his nose and mouth due to the cleft in the sky.

What are the causes of cleft palate in children?

This may happen:

Due to improper growth of the palatine shelves.
The shelves do not grow horizontally, so they do not meet.
There is no contact between the shelves.
After the shelves merged, a gap occurred.

In general, any factor that prevents the union of the palatal shelves due to the fact that the migration of embryonic cells has slowed down or tissue growth has stopped, or that kills some cells, will provoke the development of a cleft palate.

Very often this defect can be combined with a cleft lip, since these deviations general mechanism development. In the event that the lip is not damaged, but only some part of the palate is damaged, then the pathology remains unnoticed for some time until the parents pay attention to it. strange behavior baby while feeding.

Cleft palate with cleft palate without labial cleft is observed in approximately two cases per thousand newborns, most often girls suffer from this. An isolated cleft lip is found mainly in boys. This disease leads to various complications from the otolaryngological organs and other body systems, and therefore it is mandatory needs to be treated. Only surgery can help eliminate this defect, the first stage of which can be performed before the age of one year. After the operation, long-term recovery is required complex treatment.

How is cleft palate diagnosed?

Diagnostics of pathology

A cleft palate defect is detected using routine ultrasound screening of the fetus as early as approximately the fifteenth week of pregnancy. But the volume and shape of the lesion can only be examined after the baby is born. If, against the background of an ultrasound examination, this pathology is discovered in the unborn child, then it is necessary to additional techniques research.

Such a deviation is fraught various pathologies in development cranium. Hearing impairment, deterioration of breathing and sense of smell are possible. The diagnosis of cleft palate is established immediately after the birth of the baby. In this case, the level of the defect, along with its type, is determined by examining the child’s pharynx.

Uranoplasty as the main method of treatment

Treatment of a pathology such as cleft palate is carried out exclusively through surgical method. In this case, several cosmetic surgeries are performed. As a rule, doctors give preference to uranoplasty, which is surgical technique, during which the soft palate is lengthened, connecting its muscles in the right direction, among other things, a narrowing of the middle part of the pharynx is achieved.

The sucking process immediately after such an operation is almost impossible, since this may cause severe pain. In addition, there is a risk of rough scars, and at the same time the healing of the wound itself slows down. In this regard, it is necessary to first accustom the child to eating using a special spoon.

You can see in the photo how cleft palate is treated in children.

Treatment

Depending on the degree of cleft palate, the surgeon chooses the tactics of the therapeutic process. Patients who have correct form teeth in the upper jaw, uranoplasty is recommended from the age of two years. In this case, the cleft should be incomplete. In cases of violation of the narrowing of the upper jaw and the integrity of the alveoli, immediately before surgery, doctors recommend preliminary treatment by an orthodontist. Such deviations are usually caused by cleft palates. Uranoplasty in in this case carried out no earlier than four to six years.

There are rare cases of treatment in which the cleft palate has bilateral clefts, accompanied by tissue defects. In such a situation, treatment is carried out in two stages. First of all, plastic surgery of the hard and soft palate is required - this will help narrow the middle region of the pharynx. The second stage of treatment is carried out six months later. It consists of closing the cleft anterior section hard palate and alveolar process. In parallel with this, bone tissue grafting is performed.

Application of the uranoplasty technique

So, how do doctors perform this operation in children with cleft palate (the photo gives an idea of the appearance of the deformity)? It is corrected through restoration natural structure palate and various parts of the pharynx. Classic option uranoplasty is an operation using the Limberg technique. Currently it is main way, aimed at eliminating congenital palatal defects. In addition, cheiloplasty is performed if cleft lip and cleft palate are combined. We discussed the reasons above. During this operation, the upper lip is corrected.

Careful planning of the surgical intervention is carried out immediately before performing uranoplasty. Such planning is always carried out strictly individually, depending on the specific case. In this case, an individual selection of plastic materials can be carried out to eliminate the splitting of the palatal tissues. Modern methods uranoplasty, along with highly qualified surgeons, can ensure the restoration of the natural, and at the same time, complete structure of the larynx and upper jaw in approximately ninety-five percent of patients.

Radical technique of uranoplasty for cleft palate

Sometimes cleft palate disease requires surgeons to radically correct the soft and hard palate. At the same time, doctors have to solve a complex set of various problems. It's about and about restoring the natural continuity of the palatal tissues and their size and about eliminating the improper attachment of the muscles, as well as about connecting them to their normal position. Among other things, the complex of tasks in the process of uranoplasty includes the prevention of possible damage to the nerves that provide muscle contraction. In addition, it is necessary to stabilize the structure, functions and shape of the organs that undergo surgical intervention.

Such a radical method of therapy, as a rule, is recommended for patients who are between the ages of three and five years if they have non-through clefts in the palate. At the age of six, the operation is performed in the presence of through clefts. This surgery may cause a delay in further development jaws if done earlier. As for gentle methods of uranoplasty, they can be used to eliminate the defect as early as the age of two years.

You already know what a cleft palate looks like before surgery.

Preoperative period

In the period preceding uranoplasty, doctors recommend that children wear a floating obturator, which promotes normal respiratory process. In addition, such a measure helps normal nutrition and promotes speech development. This special prosthesis can be removed twelve days before surgery.

The period after surgery

IN postoperative period, after the cleft palate is corrected, the patient needs bed rest for three days along with eating exclusively pureed food and drinking plenty of fluids. In addition to everything, it is necessary to care for the oral cavity as carefully as possible, and in addition, immediately before and after eating food, it is required to irrigate it with a weak solution of potassium permanganate. In addition, several times a day it is necessary to inflate Balloons. Two weeks after surgery, it is necessary to regularly perform a special set of various exercises along with massage of the soft palate using the fingers.

To prevent infection, seven days after uranoplasty, antibiotic therapy is used comprehensively. In order to buy pain syndrome, use painkillers. It should be noted that after surgery, a scar usually remains on the face. The patient is discharged from the hospital three to four weeks after uranoplasty.

Features of surgical intervention

Cleft palate in humans, as a rule, causes repeated operations after uranoplasty. Such intervention should be carried out no earlier than a year later. Such treatment methods are aimed at eliminating postoperative defects. Approximately twelve months is usually sufficient for mild and bone tissue restored blood flow.

In cases enough big size cleft palate, due to which doctors are unable to close the cleft using local tissues, use muscle-mucosal flaps, they are taken from the tongue and cheeks. But it must be emphasized that the treatment of this pathology does not end at the stage of surgery. Additionally, it is necessary to conduct classes with a speech therapist, and in addition, with a defectologist. Treatment is also required by an orthodontist, who controls the development of the jaw and, if necessary, ensures the relationship of the dental arches. Photos of a cleft palate in humans are shocking to many, but after full treatment, patients acquire normal appearance.

Contacting a speech therapist and otolaryngologist

A speech therapist helps a child with a diagnosis of cleft palate develop correct and normal speech. This specialist usually provides therapeutic consultations with children who have already reached the age of two. It regulates in various ways external breathing. An otolaryngologist is required to conduct systematic monitoring of patients who have a cleft palate.

In the presence of this pathology, it is possible to develop chronic diseases otolaryngological organs. Those in the presence of this defect occur ten times more often compared to healthy children. This happens due to the connection between the oral cavity and the nasal region and due to disturbances in the structure of the pharynx and palate. To prevent the development of complications, it is necessary to carry out timely treatment along with the prevention of tonsillitis, pharyngitis, rhinitis, otitis media and the like.

In what cases can uranoplasty be contraindicated?

Surgical intervention in the presence of a cleft palate, like other operations, has a number of limitations and contraindications. Thus, experts do not recommend surgical intervention in a number of cases. following cases:

The patient has pneumonia or anemia.
The appearance of spinal hernia formations.
Emergence respiratory diseases.
Certain pathologies that occur in the patient in acute form.
The emergence of acute infectious diseases.
The occurrence of pulmonary pathologies.
Development of pulmonary hypoplasia.
The occurrence of diseases of the cardiovascular system, which occur in a complicated form.
Presence respiratory disorders.
The occurrence of asthma attacks.
The patient has severe developmental defects.

It is necessary to pay attention to the fact that immediately before surgery, it is imperative to consult with doctors such as a pediatrician, speech therapist, otolaryngologist, neurologist and maxillofacial surgeon.

Correction of cleft palate in humans: main principles of treatment

Experts recommend uranoplasty surgery, aimed at correcting the hard palate, when the child grows up a little. Effective and at the same time safe surgical therapy cleft palate, as a rule, requires mandatory adherence to certain principles:

Surgical intervention requires a step-by-step procedure.
It is very important to complete therapy before the child is seven years old.
Requires individual determination of optimal age category to carry out the operation.

Photos of the cleft palate before and after surgery are presented below.

It should be emphasized that, according to doctors, it is best to perform uranoplasty between three and six years of age. In the preschool period, children tolerate any cosmetic surgery quite well, and in addition, their body has time to fully recover immediately before entering school. Immediately after the successful operation and the child completes the necessary rehabilitation course, his disability is removed. Thus, he gets the opportunity to continue to live an absolutely fulfilling life, and at the same time develop and learn normally, regardless of the causes of the cleft palate.

How can this pathology be prevented?

Prevention in this case plays a significant role in preventing the birth of a child with such a disease. While expecting a baby expectant mother should try to take special care of your health, following the following medical recommendations:

Every woman should abstain from smoking. It's also about passive smoking including. The consumption of alcoholic beverages and, in addition, narcotic substances is prohibited.
You should eat well and properly. At the same time, we must not forget about taking vitamins and mineral complexes, intended for pregnant women. Calcium supplements are also needed along with folic acid.
It is very important to try to avoid heavy physical activity.
Needed good rest and dream.
Avoidance stressful situations, and in addition, all kinds of psycho-emotional shocks.
It is important to monitor your weight and avoid gaining extra pounds during pregnancy.
Must be avoided traumatic injury abdomen and organs.
Regular ultrasound examinations and visits to specialists in case of health problems.

Thus, timely performance of uranoplasty can save a person from a cleft palate. General forecast in the presence of of this disease quite favorable.

Cheiloschisis and palatoschisis or cleft lip and cleft palate are birth defects development of the child’s maxillofacial apparatus. Such congenital clefts of the upper lip and palate arise from various reasons. Treatment of such defects, regardless of their size and severity, is only surgical.

Cheiloschisis or cleft lip is a congenital anomaly of the facial region. This is a cleft lip. Characterized by the division of the lip into two parts. Moreover, this condition is often combined with other defects. With this anomaly, tissues do not grow together when intrauterine development child.

The main manifestations are an external unaesthetic appearance, problems in feeding and in the development of the speech apparatus. Although this condition looks ugly, it general development the baby is not impaired.

Even during a woman undergoing an ultrasound examination in the last trimester of gestation, this defect is visible. Treatment is carried out only surgically - cheiloplasty is performed, and if the defects are combined, rhinocheiloplasty is performed.

In parallel, very often, along with a cleft lip, newborns with maxillofacial defects have a congenital cleft palate - cleft palate. The cleft palate is a congenital deformity that visually looks like a splitting of the tissues of the hard and soft palate. In this case, the oral and nasal cavities communicate with each other. A cleft palate affects the physical development of a child. Children with this developmental defect have difficulty eating and breathing from birth. They lag behind in physical development and weight, often get sick, and as the speech apparatus develops, various speech disorders appear. Treatment is performed only surgically, uranoplasty or velopharyngoplasty. After surgical treatment, you will additionally need recovery and assistance from an orthopedist, speech therapist, or physiotherapist.

Problem statistics

Congenital clefts of the upper lip and palate are developmental defects maxillofacial area. This is a cleft of the upper lip and palate. Cheiloschisis occurs in every 4000 babies. Most often these are boys. Palatoschisis is detected in one out of 750-800 babies. During the formation of the maxillofacial system during pregnancy, fusion does not occur.

Similar deformations in rare cases are isolated pathologies. More often this is only a symptom of one of the congenital serious illnesses or genetic syndromes. Such developmental disorders are treated maxillofacial surgeons, dentists, speech therapists and pediatricians.

Causes of pathology

Cleft lip or cleft palate are formed at the genetic level. There is a mutation in the TBX22 gene, which is associated with facial anomalies. Such a mutation can be provoked by: prolonged and severe toxicosis, stress, prolonged and uncontrolled use of antibacterial drugs, exposure to radioactive or chemical substances, taking drugs and alcoholic beverages, as well as smoking during pregnancy, when all organs and systems are formed.

The listed factors have a particularly negative effect in the first trimester of gestation. Another risk factor is late pregnancy – after 40 years. Heredity plays an important role. Such a defect can be detected using ultrasound examination in the last trimester of gestation. If the family already has children with such a malformation of the jaw, parents should undergo genetic testing from specialists in the future when planning other children.

Cheiloschisis and palatoschisis are congenital anomalies development. In many cases, doctors are unable to determine the exact cause of their development. Also, according to experts, such a pathology can be formed either under the influence of one of the provoking factors or several.

Common causes of anomaly development

The main reasons for the formation of clefts include:

influence of endogenous factors;
exposure to adverse environmental conditions;
radioactive influence;
ingestion of toxic or chemical substances into the body of a pregnant woman;
acute deficiency of vitamin substances during the formation and formation of organs and systems;
conducting wrong image life during pregnancy;
use of certain medications;
severe infectious diseases;
external conditions;
hereditary factor;
Also, such a defect can be formed under the influence of smoking, drinking alcoholic beverages, and narcotic substances.

Influence of endogenous factors

Endogenous factors influence the development of pathology from the inside. Endogenous provoking factors include: genetic predisposition, age of mother and father, biological inferiority of germ cells.

Inferiority of germ cells is their inability to create cellular structures that have a complete set of chromosomes. Abnormalities can be caused by defective reproductive cells of the father and mother equally. The main reasons for such inferiority include: overripeness of the egg. This is more common among smoking parents. Abuse of alcoholic beverages and the presence of unfavorable environmental conditions also affect this.

Negative effects of environmental conditions

Influenced exogenous factors Embryonic development is also disrupted. Negative conditions include: living in unfavorable ecological environment, electromagnetic and radiation radiation. Women who live or work in areas of environmental pollution are included in the risk category for having children with developmental anomalies. Be exposed to electromagnetic radiation possible at work and at home, constantly in contact with technology and household appliances.

One of the key negative factors is ionizing radiation. Penetrating into a woman’s body, such substances are able to accumulate in it and remain a long period time.

Chemical poisoning

Some inorganic chemical compounds, penetrating into the body, can cause defects in the development of children. Such compounds are called teratogenic poisons. They are contained in some cosmetics, household chemicals and means that are used in agriculture. Among all substances, one of the most common and dangerous is lead. It is able to enter the body along with food. Mercury, cadmium and arsenic can also cause an anomaly.

Other teratogenic poisons include:

poisons used in the agricultural industry (pesticides, fungicides, herbicides);
mineral fertilizers (nitrates);
food additives (dyes and preservatives);
substances in cosmetics(retinoids, sodium lauryl sulfate);
household chemicals (chlorine, ammonia, phosphates).

Acute deficiency of vitamins

If there is a lack of vitamin substances in the body, the risk of having a child with developmental abnormalities increases. Particularly important is the full amount of vitamins in the first months of pregnancy, when the baby begins to form. A great danger is the lack of folic acid, vitamins A, E, C, B12.

Poor lifestyle and infections

Many experts associate such pathologies with the fact that a woman abuses alcohol during gestation and continues to smoke and use drugs.

If a woman suffers any infections during pregnancy, the risk of defects in the child increases. At the same time, both viral and bacterial infections. To the very dangerous diseases that cause similar consequences include: measles, rubella, cytomegalovirus infection, Coxsackie virus, herpes, smallpox.

Taking medications

After using some medicines the body also receives a teratogenic effect. Quantity negative impact directly determined by the degree of penetration active substances drugs through the placenta. High-risk drugs:

psychotropic;
medications against epilepsy;
cytostatics;
antibacterial drugs;
remedies designed to combat depression.

Exogenous conditions

The following factors can provoke the development of pathologies in the facial region: neoplasms in the uterus, attempts by the mother to terminate the pregnancy, abortions, blows to the stomach, careless falls from a height, thermal effect, constant overheating in the sun, frequent visits steam rooms

Another reason may be fetal hypoxia, diseases of the cardiovascular system, diseases of the hematopoietic system, and intense toxicosis. All these factors negatively affect the child's health.

Types of defect

There are several types of cleft lip:

Hidden cleft lip.
Incomplete cleft lip.
One-sided cleft.
Double-sided.
Full.

The cleft palate also has a classification: complete, incomplete, bifurcation of the uvula, nasal septum.

Cleft lip and cleft palate in a child can only be treated surgically. Depending on the severity of the anomaly, the area of intervention is determined.

Problems associated with these developmental defects

Cleft lip causes the following disorders:

difficulties in sucking. If cleft lip and palate are severe, feed the baby in a natural way impossible, only with the use of a nasal probe;
abnormal development of the dentition, disturbances in normal speech;
psychological difficulties.

Congenital complete cleft of the hard and soft palate is also fraught with various developmental difficulties. Most of them are associated with hearing loss or impairment, because there is a lack of the required amount of tissue for the formation of a full-fledged hearing aid. There are cases when the cleft reaches the internal cavity of the nasopharynx, causing hearing impairment in the child.

Diagnosis of the problem

Such a diagnosis can be made in a fetus when ultrasound examination. Diagnostics makes it possible to identify this pathology in the third trimester of pregnancy.

Basic principles of treatment

Cleft lip and palate can only be eliminated through surgery. An operation called cheiloplasty is performed for cleft lip. For cleft palate, uranoplasty surgery is performed. Surgical dentistry treats children with such diagnoses. The doctor who performs the treatment is a plastic surgeon. After surgery, laser resurfacing of the scar will be required.

Cleft lip correction options

The only method to eliminate such a defect is to carry out plastic surgery. It is usually carried out within two weeks after the birth of the baby or three months after birth (in the absence of complications). Contraindications to treatment are: physiological jaundice, birth injuries, severe developmental anomalies, infectious processes in the child’s body.

A cleft lip requires treatment from specialists. Most often these are plastic surgeons. Traditionally surgical treatment It is carried out in children who have a significant depth of cleft, as well as a length that becomes an obstacle to adequate feeding of the child. The advantages of early correction include: improving the conditions for the development of lips and nose, reducing psychological discomfort and stress among parents. This type treatment for early stages It also has disadvantages that need to be taken into account:

excessively small size lips, this makes work difficult plastic surgeon, the result will not be ideal in appearance, additional aesthetic correction will be required in the future;
the danger of blood loss and complications, since many systems function poorly in the first days of the baby’s life.

Most specialists prefer to deal with the problem at a later date - when the child is 3-6 months old. If such a defect is combined with a cleft palate, more than one surgical intervention will be required, since for the first time it will be necessary to close the cleft palate in order to ensure normal nutrition. Next, a series of operations are carried out, the last of which are carried out at the age of 14.

The main types of cleft lip correction are:

Cheiloplasty. Indicated in the presence of a cleft in the upper lip.
Rhinocheiloplasty. It is indicated, if necessary, to correct not only the lips, but also to correct the muscles of the oral cavity and nasal cartilage.
Rhinocheilognatoplasty. Indicated in the presence of severe pathologies of the facial skeleton, in which the structure of the dentition and jaw apparatus is disturbed.

Correction of the cleft palate using uranoplasty

Currently, anomalies in the structure of the palate are successfully corrected through surgery. Traditionally, such treatment is carried out in stages, the number of operations ranges from two to seven. Treatment is carried out no earlier than 3 months of the child’s life (except for severe cases). One type of surgical correction of a defect is uranoplasty. During its implementation, the specialist restores the correct anatomical structure of the soft and hard palate and the middle sections of the oropharynx.

The traditional version of uranoplasty, which solves problems associated with feeding and breathing, is the Limberg operation. Before treatment, the doctor selects a plastic material to eliminate the defect. Thanks to modern surgical techniques and qualified specialists, it is possible to completely restore the structure of the palate in more than 95% of patients.

Plastic results

A cleft lip leaves behind a somewhat noticeable scar. In the future, the goal of treatment is to combat it with laser resurfacing. Postoperative recovery usually occurs quickly, blood circulation is quickly restored, and there are no serious defects. If the cleft of the upper lip is massive and swallowing and sucking are impaired, feeding through a tube is used at first. Today, surgeons cope with these problems very effectively. Children live full lives.

Comprehensive rehabilitation of patients

Children with cleft lip and cleft palate need bed rest after surgery. Feeding is carried out through a tube. Next, feeding pureed food or formula is shown. Drinking plenty of alkaline fluids is necessary. Irrigation of the mouth with antiseptics prescribed by a doctor is mandatory. To prevent the development infectious process, the doctor prescribes antibacterial drugs, and painkillers are indicated to combat pain.

It is very important to carefully follow all medical recommendations in postoperative period. The length of the recovery period for children with cleft lip and palate is directly determined by such factors.

Newborn babies are not always born without defects. U certain group In children, types of deformities of the face and mouth area such as cleft lip and cleft palate may be detected. Their peculiarity is that the process of their formation occurs in the first months of pregnancy, when the child is still in the mother’s womb.

The formation of such deformations is facilitated by improper connection of certain parts of the body, caused by an insufficient amount of tissue in a particular area.

A cleft lip looks like a cleft, formed on both sides of the upper lip, resulting physiological abnormality. In appearance, it resembles a narrow hole or gap in the skin of the upper lip. There are cases when the cleft reaches the nasal area and also affects the upper jaw bone and upper gum.

The cleft palate is also a kind of expansion that affects the palate area. In some newborns, the cleft palate may involve the hard or soft palate.

General a sign characteristic of each of the considered defects, is that they can affect one or both sides of the mouth at once.

Because the lips and palate develop separately, a child may have one or both of these deformities.

Who gets cleft palate and cleft lip?

Looking at a cleft lip that may appear alone or in combination with cleft palate, it should be noted that such a deformity is diagnosed in every seven hundred child every year. In the USA, this deformation is one of the most common; it is ranked 4th in the list of such defects. Children of Asian, Hispanic, or Native American descent are most susceptible to them.

More often than others these deformities affect boys, in whom they are diagnosed 2 times more often than in girls. In this case, this refers to a cleft lip. At the same time, girls are much more likely to have a cleft palate or cleft palate, and there are 50% more such cases than in boys.

What are the causes of cleft lip and cleft palate?

To date scientists cannot say what reasons cause the appearance of such deformations. Therefore, they cannot provide advice on how to avoid these defects. According to some experts, such defects are primarily associated with the combined influence of genetic and environmental factors. Therefore, if the parents of a newborn, his relatives or brothers already have such a deformity, then there is a high probability that it will be passed on to the child.

Also similar defects may arise as a result mother's use medical supplies during pregnancy. Among the medications there are those that can cause the appearance of a cleft palate or lip.

The list of the most common should include:

Also create favorable conditions for the development of cleft lip or cleft palate may expose the fetus to viruses or chemicals. In all other cases, such deformations are usually associated with the development of diseases that have a different etiology.

How is cleft palate and cleft lip diagnosed?

The very fact that with the development of a cleft palate or lip physiological defects are noted, this significantly simplifies the process of diagnosing them. In some cases, the fact of their presence can be determined using a prenatal ultrasound examination. If prenatal ultrasound examination does not give positive results, then after the birth of a newborn, a physical examination of the oral cavity, nose and palate is required to obtain confirmation that there are no conditions for the development of such defects. In some cases similar diagnosis may be diagnosed during an examination conducted to identify other developmental disorders.

What problems are associated with the appearance of cleft palate and cleft lip?

If a child has such deformities, this seriously limits him in performing the usual actions necessary to maintain life.

Difficulty eating

If a child has one of these deformities, then During a meal, food and liquid may begin to move into the nasal cavity, and from there get into the mouth. Today, this problem is being actively solved and special bottles and nipples for infant feeding are offered for such newborns, thanks to which it is possible to feed them in such a way that food moves down to the esophagus.

To it was easier to feed children with cleft palates, they will need to install an artificial palate, with which they can facilitate the process of food entering the esophagus. They will have to be fed in this way until the attending physician decides to perform the necessary surgical operation.

Ear infections and hearing loss

If a child has a cleft palate, there is a high chance that he will be diagnosed ear infection . This risk is high due to the fact that such children have a tendency to form and accumulate fluid in the middle ear. Similar state requires appropriate treatment, in otherwise creates a risk of hearing loss in the child.

To avoid this for such children it is recommended to use special tubes, which are installed on eardrum, thereby creating conditions for the removal of liquid. In addition to this, children with similar risks Must be examined annually by a physician to ensure good hearing.

Speech problems

The presence of deformities such as cleft lip and cleft palate in a child increases the likelihood that it will be difficult for him to master speech. Due to the characteristics of the body, such children can make nasal sounds, and this can often prevent others from understanding their speech. Fortunately, this does not happen to all children. There are cases where, through surgery, it was possible to restore the ability to normal speech to a child with similar defects.

If a child has clearly visible difficulties in mastering speech, then he will need to work with a speech therapist. This specialist will work separately with the child, creating exercises for him so that he can restore his speech to a normal level.

Dental problems

One of the problems that can affect children diagnosed with cleft palate and cleft lip is tooth decay. Sometimes they extra, crooked or displaced teeth may be found, which usually requires the help of a specialist dentist or orthodontist. In addition, there are cases where alveolar ridge defects were discovered in children with similar deformities. The alveoli are the bony part of the upper gums that act as the basis for the teeth.

If a child has an alveolar defect, this is fraught with the following troubles:

A defect associated with the location of permanent teeth, which can be expressed in their displacement, protrusion or rotation;
Interfering with normal development permanent teeth;
Creating difficulties for the normal formation of the alveolar ridge.

To combat such manifestations modern medicine offers methods of maxillofacial surgery that can effectively eliminate the above problems.

Who treats children with cleft palate and lip?

Considering that such deformation affects areas that are under control various specialists , most often it is necessary to involve a whole team of doctors to combat these defects. And, as a rule, such a team includes the following doctors:

Treatment of a child provides for the preparation of a special program, which involves the joint participation of each specialist and accounting individual needs patient. Most often, already in infancy, specialists prescribe and carry out the first measures to get rid of detected deformities. However, this process is quite lengthy and most often ends when the patient reaches early adulthood.

How is a cleft palate or lip treated?

To completely remove the deformity, specialists have to perform one or two surgical operations. The final decision is made after studying the condition of the defect. The first time surgery is performed when the child reaches three months of age.

Treatment of cleft palate is difficult because to eliminate such a defect have to carry out a large number of operations and therefore most often only after reaching 18 years of age can be returned to the patient normal look. The first time an intervention aimed at correcting the palate is performed when the patient is 6 months or 1 year old.

After the first operation, there is not only an improvement in the functioning of the palate, but also a decrease in the risk that fluid will enter the middle ear. From others positive effects it is necessary to highlight the creation of conditions for correct formation teeth and facial bones.

Conclusion

They are quite serious diseases that can complicate the life of any person even in early infancy. Therefore, from birth such children require the attention of doctors. Fortunately, today medicine offers many methods to return such children to a normal life.

Cleft palate and cleft lip

Unfortunately, this process is quite long and often requires multiple operations. However, by adhering to the recommendations of specialists and carrying out the entire range of procedures prescribed by a group of treating doctors, in most cases the prognosis for curing this disease is favorable.