The Prevalence of Cleft Lip and Palate and Their Effect on Growth and Development: A Narrative Review

Abstract

Cleft lip and/or cleft palate (CL±P) in addition to the cleft palate (CP) are a category of anomalies known as orofacial clefts (OC). These anomalies are accompanied by several aesthetic and functional problems. Information on the prevalence of OC showed different values between studies worldwide. In addition, the presence of cleft lip and/or cleft palate is determined by several changes during the embryonic stage. Besides, cleft repair may lead to a significant impact on the overall aesthetic and function and could negatively affect maxillary growth on certain occasions. Therefore, having the background and knowledge on this phenomenon is essential in designing the overall treatment and obtaining outcomes that are as close to normal as possible. This article reviews the maxillary development, occurrence of cleft lip and/or palate and their prevalence, facial growth in the presence of clefts, effect of cleft repair, an overview of alveolar cleft treatment, as well as the essential information related the prevention of cleft lip and palate.

Dilemma of Postoperative Scarring in Cleft Lip and Palate: A Narrative Review

“…That is why feeding is one of the most important factors requiring repair. [2,8,13] Difficulty in speaking and pronunciation is a very common to occur having hypernasality in their voice due to impaired functioning of the palate and pharyngeal muscles caused by cleft palate. [13] Irregularities in speech are seen due to; altering in orofacial growth, anomalies in oronasal function.…”

“…[13] Irregularities in speech are seen due to; altering in orofacial growth, anomalies in oronasal function. [2] Besides, breathing, hearing issues due to deformed palatal muscles [8] and malocclusion commonly occur. Not to mention the unappealing esthetic appearance they face caused by CL.…”

“…(14) As for general growth of clefted children, it was reported that patients suffer from weight loss, compared to children with no clefts thereby, disturbing growth in early infancy. [2] Cleft palate affect growth in the transverse and sagittal dimension as a consequence from the palatal scar tissue. [15] Another distressing consequence of the cleft palate is the formation of palatal fistula which would result in nasal regurgitation of foods and speech disturbance.…”

“…Including: lip discontinuity, tooth eruption within the clefted region, speech and phonetic issues, abnormal muscle attachments, infections, oronasal fistula and deviation of alveolar segments. [2] Moreover; feeding, hearing, growth hinderance and eventually low self-esteem with poor communication skills in the society. [3] Clefts usually present in different forms in the orofacial region either unilateral or bilateral, mostly in unilateral forms.…”

“…[1,3] Therefore, a teamwork of multidisciplinaries is organized with the full understanding of this defect, its etiology, its consequences, manifestation and complications to address this abnormality to be able to offer the infant and his family the optimal treatment. [2,4] Therefore, to achieve the required goals of treatment in gaining acceptable esthetic appearance, normalized speech and normal masticatory function eventually allowing the child to have a stable personality. [4] Despite the presence of various surgical repair techniques in the literature, yet scarring result which cause extra burden to the patient and family which require another set of surgeries.…”