What is craniofacial surgery?

Craniofacial surgery is a sub-specialty of oral surgery that treats patients with birth defects such as cleft lip and palate. The craniofacial surgeon works with speech pathologists, orthodontists, and craniofacial plastic surgeons. This team plans treatments to correct cleft lip and palate, as well as other jaw and face abnormalities.

As a member of a craniofacial team, the craniofacial surgeon restores the jaw and facial structures. Their main goal is restoring normal function and appearance. This includes surgical jaw positioning, and pre/post-operative jaw surgery treatment.

What is a cleft lip and palate?

Cleft lip and cleft palate are facial malformations in which the parts of the face that form the upper lip and mouth do not join fully. Normally these would seal together before birth. Similar splits can occur in the roof of the mouth, or palate.

When there is not enough tissue in the mouth or lip area to join together properly, clefting can result. Though the defect occurs in early fetal development, the cause is unknown in most cases. However, there appears to be a link between genetics and maternal environmental exposures during pregnancy.

Although there are certainly aesthetic considerations associated with cleft lip and palate, this birth defect often affects people in more serious ways.

• Difficulty Eating – Food, and liquids can pass from the mouth back through a separated palate to the nose. Patients can use specially designed prosthetics to help keep fluids flowing downward toward the stomach, which ensures that they receive adequate nutrition.

• Speech Difficulties – Because the upper lip and palate are not properly formed, it may be difficult for children to speak clearly. When they do, they may produce a nasal sound. Their speech may be hard to understand, so the patient may consult a speech pathologist to resolve these issues.

• Ear Infections – Cleft lip and palate can lead to a buildup of fluid in the middle ear, increasing the risk for ear infections in children. If not properly treated, even deafness can occur. Small tubes may be placed in the eardrums to facilitate fluid drainage and prevent infection.

• Dental Problems – Cleft lip and palate can cause children to have missing, malformed, or displaced teeth, which causes a higher number of cavities and other dental and orthodontic issues.

Treatment

Surgery is the likely treatment for cleft lip and palate. This is where your craniofacial surgeon and a team of specialists come in. Depending on the severity of the case, more than one surgery may be necessary.

In children, surgery for cleft lip usually takes place between three and six months of age. Several surgeries spread out over the course of 18 years (or whenever growth stops) are most likely when treating cleft palate.