Cleft Palate

What is Cleft Palate?

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  • Cleft palate is a physical abnormality that occurs in the secondary palate, a structure that separates the nasal and oral cavity (Kati, 2018). The defect is common among babies and may prevail during adulthood if not treated.
  • Cleft palates can either be complete, incomplete, bilateral, or unilateral (Kati, 2018). Complete unilateral clefts are characterized by an opening on the palate (roof of the mouth) that runs from the nasal to the back of the oral cavity. Incomplete unilateral clefts are less severe and may extend halfway through the lip palate.
  • Bilateral clefts are characterized by openings on both sides of the lip edges, which run from the nasal to the mouth cavity. On the other hand, children with unilateral clefts have a single split that extends from the back of the mouth to the nasal cavity.

Statistics

  • About 1 in 2000 incidences of cleft palate in the United States are reported each year (Noorollahian et al., 2015). The data account for approximately 2,650 babies born in the state (Jalilevand & Jalaie, 2015). The condition is prevalent across all ethnic groups in the country, including Native Americans, Asians, white-skinned, and the Black people.
  • Studies show less frequency of cleft palate among boys than girls (Noorollahian et al., 2015). This disparity can be explained by the variation in embryonic development between the two genders.

Risk Factors

The following risk factors are associated with the development of cleft palate among children:

  • Smoking and Alcohol

Pregnant women with drinking habits are at a high risk of delivering babies with cleft palate (Kati, 2018). Smoking can also affect embryonic growth.

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  • Nutritional Factors

Deficiency of vitamin B6 among pregnant women is also linked to the development of cleft palates in unborn babies (Kati, 2018). Additionally, a deficiency of folic acid can result in abnormal development of the palate.

  • Medical Conditions

Women diagnosed with hypoxia have a higher risk of delivering children with cleft palates (Kati, 2019). Hypoxia is a medical condition characterized by oxygen deprivation in the body tissues, which is common among people with lung diseases such as chronic obstructive pulmonary disease (COPD).

It is essential to recognize that the above-listed factors do not exclusively cause cleft palates. The condition can also be inherited from parents through the transfer of genes.

Treatment

  • It is essential to report cases of cleft palates to the nearest medical facilities. If treatment is sought early, children can undergo various clinical procedures with few complications.
  • Cleft palate treatment involves a multidisciplinary approach comprising physical palatal correction, feeding and orthodontic management, and speech-language services (Ha et al., 2015). These services are offered by medical professionals equipped with the knowledge and skills of cleft palate management.
  • The physical palatal correction involves surgery, which is performed on children at the age of 12 months (Ha et al., 2015). However, additional diagnosis is conducted before this form of treatment to determine the presence of associated syndromes and complexity of the cleft, which may affect the procedure (Hlongwa, Levin & Rispel, 2019). After passing these subsequent examinations, the child can undergo an orofacial cleft operation.
  • Some of the few complications associated with surgical management include oronasal fistula and velopharyngeal insufficiency (Ha et al., 2015). Oronasal fistula is characterized by nasal regurgitation, whereby food particles swallowed by the child enter the nasal cavity. Velopharyngeal insufficiency involves failure of the lip palate to function effectively, thus interfering with speech.
  • While chances of medical complications occurring are substantial, patients should not hesitate to seek treatment because improved surgical techniques have been developed to reduce such adversities.

Prevention

  • Pregnant women are encouraged to be vigilant about the following practices to avoid the development of cleft palates among unborn children:
    • Avoid alcohol abuse and smoking.
    • Consume products rich in folate. Some of the natural sources of folic acid include broccoli, chickpeas, and lentils. Alternatively, one can consume manufactured foods fortified with folic acid. In the United States, such products include bread, white rice, and cornmeal. The folic acid can also be taken as a supplement during pregnancy in the correct dosage as prescribe during clinical visits.
    • Consume food rich in vitamin B6. Some of the most common sources of vitamin B6 include pork, vegetables, fish, and wholegrain.
    • Ensure that conditions related to hypoxia are kept under control. Patients who experience hypoxia symptoms should also visit their physicians to prevent an improper formation of the baby’s lip palate.

Implications of delayed Treatment

Delay to seek treatment can result in the following adversities:

  • Morbidity

Clinical studies reveal that the prevalence of cleft palate among young children can result in multiple diseases, including anemia and malnutrition (Hlongwa et al., 2019). This may arise from poor feeding habits, especially when the child experiences nasal regurgitation.

  • Mortality

In severe cases, untreated cleft palates can result in death among infants due to starvation (Hlongwa et al., 2019). However, studies also show that a small fraction of children born with this condition may die during birth.

Delayed treatment can also inhibit jaw development among children (Hlongwa et al., 2019). The condition may eventually interfere with speech production as the child grows.

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