The commonest deformity of the PALATE is cleft palate, which is a result of faulty embryonic development in which the two sides of the palate fail to fuse or only fuse in part. If the cleft extends the full length with bilateral clefts at the front of the MAXILLA, it may be accompanied by a cleft lip (also called hare-lip) and disruption in the development of the front teeth. About 1 in 500 babies is born with a cleft lip and 1 in 1,000 has a cleft palate. If the parents are affected, the risk is three times that of the normal population; if one child has a deformity, the risk for a subsequent child is higher. Associated abnormalities include tongue tie, malpositioning of the MANDIBLE and ?uid in the middle EAR.
Cleft palate and hare-lip should be recti?ed by operation, because both are a serious drawback to feeding in early life – while later, harelip is a great dis?gurement, and the voice may be affected. The lip may be dealt with at any time from the neonatal period to a few weeks, depending on the individual surgeon’s view of when the best result is likely to be achieved. Prior to operation, special techniques may be necessary to ensure adequate feeding such as the use of special teats in formula-fed babies. The closure of a large cleft in the palate is a more formidable operation and is better performed when the face has grown somewhat, perhaps at 6–12 months. The operations performed vary greatly in details, but all consist in paring the edges of the gap and drawing the soft parts together across it.
Further operations may be required over the years to improve the appearance of the nose and lip, to make sure that teeth are even, and to improve speech.
Parents of such children can obtain help and advice from the Cleft Lip and Palate Association (CLAPA).
The partition between the cavity of the mouth, below, and that of the nose, above. It consists of the hard palate towards the front, which is composed of a bony plate covered below by the mucous membrane of the mouth, above by that of the nose; and of the soft palate further back, in which a muscular layer, composed of nine small muscles, is similarly covered. The hard palate extends a little further back than the wisdom teeth, and is formed by the maxillary and palate bones. The soft palate is concave towards the mouth and convex towards the nose, and it ends behind in a free border, at the centre of which is the prolongation known as the uvula. When food or air is passing through the mouth, as in the acts of swallowing, coughing, or vomiting, the soft palate is drawn upwards so as to touch the back wall of the throat and shut o? the cavity of the nose. Movements of the soft palate, by changing the shape of the mouth and nose cavities, are important in the production of speech.... palate
A ?ssure in the roof of the mouth (palate) and/ or the lip which is present at birth. It is found in varying degrees of severity in about one in 700 children. Modern plastic surgery can greatly improve the functioning of lips and palate and the appearance of the baby. Further cosmetic surgery later may not be necessary. The parent of the child who has cleft lip and/ or palate will be given detailed advice speci?c to his or her case. In general the team of specialists involved are the paediatrician, plastic surgeon, dentist or orthodontic specialist, and speech therapist. (See PALATE, MALFORMATIONS OF.)... cleft palate
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