Repair of Birth Defects

Birth defects of the mouth are common issues that ENT specialists address.  Improper development of the mouth can cause serious problems with nutrition, growth and speech.  Birth defects that affect the face and mouth can also significant alter’s one physical appearance, interfering with one’s confidence, identity and social acceptance.  Birth defects frequently treated by Dr. Bailey include cleft lip and cleft palate, the most common of all craniofacial anomalies that occur birth.  Approximately 8,000 newborns are born with either a cleft lip or cleft palate every year.

Cleft lip forms while the child is still in the uterus usually between the 4th and 7th weeks of pregnancy.  Unfortunately, as the fetus develops, sometimes the tissues that make up the lips and mouth fail to join completely and a gap or cleft forms instead of a completely formed lip.  The cleft can be a small slit or a large opening that goes through the lip up into the nose.  As you can imagine, this deformity can have serious impacts on the child’s ability to eat, drink, and even breath.

A cleft palate occurs when the roof of the mouth, also known as the hard palate, fails to completely form and a space or cleft is present in the middle of the palate.  The formation of the palate typically occurs during the 6th and 9th weeks of pregnancy.  A cleft palate can also cause significant problems with eating, drinking, breathing and the development of the teeth.

Specific causes of the orofacial clefts are not clearly understood.  Genetics seem to play a role along with other factors that are likely related to what the mother encounters during the pregnancy.  Recent findings show that possible maternal risk factors include:

  • Diabetes – Mothers with diabetes diagnosed before pregnancy are more likely to have a child with a cleft lip or palate compared to mothers who do not have diabetes.
  • Medications – Mothers who take certain medications, such as those used to treat seizures, during the first trimester, have an increased risk of having a child with a cleft lip.
  • Tobacco smoking – Mothers who smoke tobacco during pregnancy are more likely to deliver a baby with developmental problems including an orofacial cleft.

Treatment for cleft lips and cleft palates depends on the severity of the deformity along with the age and needs of the child.  Cleft lips and palates may accompany other developmental disorders and those should be taken into consideration.  Most often, surgery is recommended within the first 12-18 months of life to avoid failure to thrive from eating or drinking difficulties.  Surgery not only corrects any visible deformity but improves eating, drinking and breathing difficulties, if present.  This in turn helps improve speech and language development and the majority of children born with cleft lips and palates go on to live full and healthy lives.