Cleft Palate

Cleft palate, also known as palatoschisis, is a congenital defect of the roof of the mouth. This defect happens when palates of the skull do not completely join or fuse at the roof of the mouth during foetal development. This leaves an opening or cleft in the palate, which may go all the way through to the nasal cavity.

The roof of our mouth is made up of two types of palates:
Hard palate
The hard palate is the bony part (made of two bones- the maxilla and the palatine) of the roof of the mouth. It is situated towards the anterior portion of the roof, and is covered by a mucous membrane. The hard palate separates the oral cavity and the nasal cavities. Impairment or clefts in this palate results in problems in feeding, as the food can accidentally enter the nasal cavity instead of the oral cavity.

Soft palate
Soft palate is the posterior region of the roof of your mouth. This palate is made up of muscular tissue, is covered by epithelial tissue, and can move up and down due to muscular actions. The soft palate is responsible for speech. Cleft in this palate causes the air to enter the mouth instead of nose. The cleft may also make it difficult to eat and swallow.

The cleft may either be unilateral – on only one side or bilateral – on both sides of the palate. The cleft may be complete, partial or asymmetrical, and may affect only the hard palate or both the palates. In many cases, babies born with a cleft palate also have a cleft lip.

Causes:

  • A combination of genetic and environmental factors can lead to the condition
  • Women who smoke and drink are at a greater risk of delivering a baby with a cleft palate
  • Drug abuse by the pregnant woman can also cause this congenital defect
  • Medicines like anticonvulsants, methotrexate, if taken by the expectant mother, can cause a cleft palate in the child
  • Nutritional deficiency during pregnancy may be one of the factors responsible for this congenital defect.

Complications involved:

  • Cleft palate is accompanied by teeth that are not properly aligned
  • Having a cleft palate makes it difficult to swallow and breathe
  • It can also affect the hearing ability of the person, and he/she is also prone to middle ear infections
  • A child with a cleft palate also finds it difficult to speak properly. The speech might not be clear, and may be difficult to comprehend.

Treatment
A cleft palate can be temporarily rectified by covering it with a prosthetic device known as palatal obturator. This device fits on to the roof of the mouth, covering the cleft. It can also be corrected by surgery, in which the tissues of the roof of the mouth can be sewed together by a surgical procedure.  This surgery can be performed when the child is between 6 to 12 months old. Depending on the severity, the rectification may require just one or multiple surgical procedures.
The Latham’s appliance is used to repair cleft palate. It is surgically inserted into the roof of the mouth when the child is around four to five months old. After it is in place, a screw which is fixed needs to be tightened to bring the cleft together and repair the palate. If the cleft extends upto the maxillary alveolar ridge it can also be corrected by filling the gap with bone tissue acquired from the patients chin, hip or rib.

The indentation in the area between the nose and the upper lip is known as philtrum. The exact function about this part is yet unknown. However, it is discovered that philtrum is one of the most erogenous places in the body!