Cleft Lip or Harelip

Understanding
Cleft lip is a gap in the upper lip. This gap can occur on the ceiling of the oral cavity (cleft palate), can also on the lips only (cleft lip). In some cases it can also occur in both parts. In general, however, nearly half of cleft lip cases involve cleft in the upper lip and roof of the oral cavity.

This disorder can be known through ultrasound procedures of the first trimester of pregnancy. At that time, you can see if there is interference in the process of development of the face area - including the ceiling of the oral cavity. That is why this condition is classified as a birth defect.

Diagnosis
Cleft lip can be detected since pregnancy or known by antenatal diagnosis. The inspection process is done by ultrasound procedure - either 3 dimensional or 4 dimensional ultrasound.

Doctors can see differences in the development of fetal facial structures at first trimester antenatal examination. Upon seeing this, your doctor may offer you a fluid test.

The fluid test procedure is performed by taking a sample of amniotic fluid from the uterus. This test will show whether the fetus has inherited the genetic syndrome that can cause other birth defects.

Symptoms
The main symptoms of cleft lip can be seen immediately, namely the existence of a gap in the upper lip or roof of the oral cavity. In addition, there are also some other symptoms, such as: 

• Difficult sucking milk

Babies with cleft lip will have difficulty sucking breast milk, due to difficult mouth conditions do sucking motion. This can be overcome by the use of special bottles recommended by dental specialist dentists and pediatricians.

• Difficulty speaking

Depending on the severity, on some conditions cleft lip can also cause speech impediment. However, the magnitude of the gap is not an indicator of how serious the disorder is in speaking. Even small gaps can cause difficulty in speaking.

• Hearing disorders

All normal child ears produce thick, sticky ears. However, the presence of cleft lip can make the fluid accumulate in the eardrum. This causes interference or even temporary hearing loss.
In addition, the accumulation of fluid in the middle ear can also affect the eustachian tube, the channel that connects the ears with the oral cavity. This can lead to ear infections.

• Impaired growth of the jaw and teeth

Cleft lip can also affect the growth of the jaw and the process of growing the teeth. The arrangement of teeth can be crowded due to lack of development of the jaw, resulting in speech impairment. Therefore, prompt and appropriate handling is necessary to improve the condition of cleft lip.

Treatment
Handling of children with cleft lip requires a team of special doctors. The team consists of an oral dental surgeon, a plastic surgeon, a speech therapist, audiologist, a pediatrician, a dental dental specialist, an orthodontic dentist, a psychologist and a geneticist. 

Operative action is commonly done to treat cleft lip. The timing of this operation varies, depending on the condition of cleft lip suffered. Usually the surgery used in this case is by total anesthesia.

Surgery to close the cleft in the lips can be done at the time the baby was three months old and have enough weight. Meanwhile, surgery to close the gap in the roof of the oral cavity can be done at approximately six months of age.

As the child grows up, other operations may be needed to improve the appearance of the lips and nose, as well as the function of the oral roof. If there is a gap in the gums, bone implants can be done to overcome them.

As for fixing difficulties in talking, children can undergo talk therapy with experts. In addition, dentists and orthodontic specialists can provide care related to dental care.

Prevention
Cleft lip prevention can begin during pregnancy, such as:

• Eat nutritious foods.
• Avoid smoking and drinking.
• Visit your obstetrician regularly for monitoring.
• Consumption of folic acid as much as 400 micrograms daily, at least one month before conception and during the first two months of pregnancy.
  

You also need to pay attention to the consumption of drugs that can increase the risk of this disorder, namely antiepileptic drugs such as phenytoin and sodium valproate.

Not only that, the consumption of steroid tablets and methotrexate drugs that are usually used in the treatment of certain cancers and inflammatory diseases, can also increase the risk. If you are taking these medicines, you should consult with your doctor before pregnancy.

Cause
Until now the cause of cleft lip is still unknown. However, research shows that the process of formation of this disorder has started since the early weeks of pregnancy.

When the gestational age reaches 6 weeks, the upper lip and roof of the baby's mouth in the womb will begin to form. Lips and oral cavity is formed from tissues that are on both sides until united in the middle of the mouth. When these networks fail to unite, it will form a gap in the upper lip or roof of the oral cavity. 

Although the exact cause of cleft lip is not yet known, experts suspect that a mixture of genetic and environmental factors is influential. If parents suffer from cleft lip, the risk of children to have this disorder will be higher. 

Meanwhile, environmental factors that can trigger a cleft lip in infants is the lifestyle of the mother during pregnancy. For example because of the side effects of drugs, diseases or infections that the mother suffered, smoking or consumption of alcoholic beverages during pregnancy. In fact, a deficiency of folic acid can also trigger this disorder. 

Copy X