The most common congenital malformations in our discipline are the so-called cleft lip and palates (orofacial clefts). Today we know much more about the origin of these malformations and we can operate it in such a way that only small traces remain. Orofacial clefts occur approximately one in 500 births.
Lip and jaw clefts form on the 30th day, palate on the 60th day of pregnancy. Responsible for this are genetic predispositions or external factors such as X-rays or influence of medication. If there are already orofacial clefts in the families of the parents, the chances of the children also being affected by a cleft formation are increasing.
The diagnosis is often made with ultrasound and already before birth. Parents can therefore prepare themselves for the special appearance of their babies. In addition, we have enough time to advise parents about the therapy before birth. After birth, an impression of the upper jaw is immediately taken, so that a plate can be made that closes the cleft in the mouth. This allows the child to suck and thus to drink at the breast or from the bottle. Since the muscles of the soft palate can not contract normally, the pressure equalization in the middle ear does not work properly. An effusion occurs in the middle ear, which leads to deafness in the course of time. Here, the ENT physician can help by inserting a tympanic tube, so that this complication nowadays no longer occurs.
Lip clefts are already operated in the third to fourth months of life. Clefts of the soft palate are performed at the age of nine to twelve months to allow the young patient to develop a normal speech from the beginning. If the hard palate is also splitted and the cleft is too wide for an occlusion together with the soft palate, this part is occluded in the infant to kindergarten age. Clefts of the jawbone with teeth are only occluded before the permanent canine comes to the surface. This is generally the case with nine to eleven years. The last operative step in lip or jaw clefts is a nasal correction when the growth is completed at about 18 years.