Cleft and Craniofacial Deformities

Cleft and Craniofacial Deformities

Cleft Lip and Palate

A cleft is an opening in the lip and roof of the mouth that an infant is born with. Cleft lip and cleft palate are among the most common congenital defects in infants. The conditions may occur individually or together. Cleft lip and palate can cause problems with chewing, swallowing and speaking. The cleft can be corrected with plastic surgery. The aim of the surgery is to reconstruct the anatomy to allow for proper function of the mouth and restore an aesthetic appearance to the face. The surgical approach for cleft palate is highly customised to the child. The doctors need to consider the patient’s facial structure and extent of cleft while planning the treatment. Cleft lip is usually corrected in a cheiloplasty procedure. The Cleft palate is repaired using a palatoplasty procedure.

Apart from the clinical condition, it gives an immense pressure on the child’s parents and also peer pressure as the child grows. Well defined protocols are available for management of child with cleft. Cleft lip is usually operated around 10 weeks after birth and cleft palate at around one year of age. Multiple surgeries may be required at specified ages, to give the best possible result. Child may also require dental braces for teeth alignment.


Craniosynostosis is a condition in which the bones of the skull fuse too early in the development of the foetus. This means that as the brain grows and expands, it is limited by the fused skull bones. This results in slow growth of the brain and also pushes against the skull, causing it to become misshapen. Intracranial pressure also increases. Craniosynostosis is of four types, according to the skull suture that has prematurely fused – Sagittal craniosynostosis, Coronal craniosynostosis, Lambdoid craniosynostosis and Metopic craniosynostosis. Most cases of craniosynostosis require surgical correction within the first year of the infant’s life. The surgery will relieve pressure on the brain and produce a more aesthetic appearance of the skull.

Craniofacial Clefts

A craniofacial cleft is a malformation in the skull and facial bones. The other soft tissues that make up the face are also affected. Craniofacial clefts are very rare congenital abnormalities. There are many types of craniofacial clefts including intranasal dysplasia, nasal dysplasia, maxillary dysplasia and nasomaxillary dysplasia. The cause of craniofacial clefts in infants is still unclear, but a healthy folic acid consumption by the pregnant mother appears to prevent it. The treatment of each craniofacial cleft is unique. The surgeon studies the patient’s facial structure and reconstructs it without the cleft. The correction may be done in steps as the child grows.

Deformities of the Ear & Nose

The anatomy of the ears and the nose could become deformed by injury, congenital developmental disorders or diseases like cancer. Deformities in the outer ear could be purely aesthetic or also cause functional deficits. The anatomy of the ear is corrected in an otoplasty procedure. Deformities of the nose can be an isolated entity or part of the craniofacial cleft. The deformity could be in the septum, bone, skin or combination of these. The corrective surgery is done after thorough assessment of the deformity.

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