Cleft Lip


What is Cleft Lip

Clefts of the lips are one of the most commonly seen conditions affecting the face in newborn babies. Clefts occur somewhere between 1 in 500 to 1 in 2000 births, depending on the race of the parents. Children can be born with just a cleft lip, a cleft lip and palate, or just a cleft palate. Most commonly, 50% of the time, the cleft patient has components of both cleft lip and palate. The cleft lip can be incomplete, complete or bilateral.

A cleft lip is a separation in the lip that results from a disturbance in lip growth during the first trimester of development. The parts of the lip that are separated vary from child to child. Some children can simply have a notching or cleft in the lip. This notching can vary in degree and is called an incomplete cleft. Other children have a complete separation of the lip that extends all the way up into the nose. This is called a complete cleft lip. This type of cleft often distorts the nose as well. Clefts of the lip can be on one side (unilateral) or on both sides (bilateral) of the lip.

Treating Cleft Lip

The cleft in the lip commonly affects the nose on that side causing it to be wide and flattened.  Modern cleft care today focuses on techniques to improve the nose contour prior to surgery in hopes of avoiding secondary nasal deformities.  Different devices (NAM, Lathem, and nasal retainers) can be used in the first few months of life to improve the gumline and shape the nose.  The timing for the lip repair is most often between 3-4 months of age. The traditional rule has been that the baby should be ten weeks old, and weigh at least ten pounds for safe administration of anesthesia.

The procedure itself can take anywhere from 2-4 hours depending on what structures are involved and what needs to be repaired.  At the end, your child is returned to you and you will stay in the hospital until you feel comfortable going home (usually between 4-24 hours).  There will be medical superglue covering the lip and a nasal stent in the nose.  The stent will come out in a few weeks and the glue should fall off within 7-10 days.  All the stitches are disolvable and there is no need to take them out.  Elbow restraints will be in place and are recommended for the next 7-10 days.  Your child can use bottles and pacifiers immediately.

 

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Our Expertise

Cleft Lip/Palate

 Cleft lips and palates are one of the most common birth anomalies that affect about 1/600 newborn babies in the United States and around 1/500 in the state of Utah.  Clefts can range from quite mild to fairly severe.  Most of the time they are an isolated anomaly, but are also associated with a number of gentic syndromes.  Depending on what structures are involved dictates the complexity of the treatment plan.   Our team works together with you to make a customized plan for  your baby.  Even the most severe of cases should be able to be treated with only a few surgical interventions by a well coordinated and efficient team.

 

 

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Craniosynostosis

The skull is made up of several different bones that are joined together by growth plates called "sutures."  Craniosynostosis is a condition where one or more of these sutures fuse prematurely causing an abnormal head shape, decreased cranial volume, and the possiblilty of raised intracranial pressure.  The treatment of craniosynostosis is surgical and the goals of surgery are to increase the volume of the skul and to correct the abnormal appearance of the head shape.  There are two methods of surgical correction: open vault reconstruction and strip craniectomy.  Dr. Griner's extensive training allows him to perform these complex procedures without the need for blood transfusions and spending only 1-2 nights in the hospital. 

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Syndromes

There are many syndromes that can affect the shape of the head and face and include Aperts, Crouzon, Pfieffer, Treacher Collins, and many others.  Most of these syndromes include many other complex anomalies and need to be treated in a coordinated approach in order to reduce the number of operations the child will need.  These syndromes are rare and require specialists that are very familiar with the intricacies of each syndrome.  Dr. Griner's unique training provided him with extensive experience with craniofacial syndromes and makes him the premier choice to guide the management of your child's needs in Utah.

 

 

 

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Ear Deformities

Ear deformities range from mild changes in shape to the complete abscence of an ear and deafness.  Mild deformities can be treated in the first few weeks of life while others will require reconstructive surgery and hearing aids.  No matter the severity, our specialists work together to provide normal appearance and improved hearing.

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From the Blog

Parenting a Cleft Child: Selecting a Surgeon

You stare at that ultrasound, taking in the news that your baby has a cleft lip and/or palate. You’re referred to a specialist to confirm that diagnosis. You see the specialist, baby’s cleft is confirmed. You don’t know how to feel or what questions to ask. It all...

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Staged palate repairs

Staged palate repairs were implemented to try and reduce the chance of stunting the upper jaw growth and needing to have it surgically advanced later in life, while at the same time allowing normal speech to develop.  We know from several studies that the growth of...

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