CLEFT LIP OR PALATE ON AN ULTRASOUND

Can you see Cleft Lip or Palate on an Ultrasound?

Diagnosis

Most cases of a cleft lip and cleft palate are detected immediately at birth and do not require special tests in order to diagnose. In many cases, cases of a cleft lip and cleft palate are found on an ultrasound prior to the birth of the baby.

Ultrasound

A prenatal ultrasound is a test which uses sound waves in order to create images of the developing fetus. When the doctor is analyzing the pictures, they may detect an abnormality in the facial structures.

Cleft lip can be detected using a prenatal ultrasound as early as the 13th week of pregnancy. As the fetus continues to develop, it may be easier to diagnose a cleft lip. Cleft palate, when it occurs alone, can be more challenging to see using ultrasound.

When the prenatal ultrasound shows a cleft, your doctor may offer a procedure which takes a sample of the amniotic fluid from your uterus. The fluid test can help determine if the fetus has inherited a genetic syndrome which can result in additional birth defects. In most cases, however, the cause of a cleft lip and cleft palate is unknown.

The goals in treating a cleft lip and cleft palate are to improve the child’s ability to eat, speak and hear normally. The treatment also works to achieve a normal facial appearance. Treatment for children with cleft lip and cleft palate often includes a comprehensive team of doctors and experts. This team can include the following specialists:

• Surgeons with a specialty in cleft repair (plastic surgeons or ENTs)
• Oral surgeons
• Ear, nose and throat doctors
• Pediatricians
• Pediatric dentists
• Orthodontists
• Nurses
• Auditory or hearing specialists
• Speech therapists
• Genetic counselors
• Social workers
• Psychologists

Treatment for cleft lip and cleft palate typically involves surgery to repair the defect and therapy to treat any related conditions.

Surgery

The surgery which is used to correct cleft lip and palate is specific to your child and their situation. Following the initial cleft repair, the doctor may recommend follow-up surgery which is used to improve speech or the appearance of the lip and nose.

Surgery is typically performed in the following order:

• Cleft lip repair: completed within the first 3 to 6 months of age
• Cleft palate repair: completed before 12 months of age, earlier surgery is ideal
• Follow-up surgery: completed between 2 years-old and late teen years

Surgery for cleft lip and palate takes place in a hospital. Your child will receive a general anesthetic and won’t feel pain or be awake for the procedure. Several different surgical techniques and procedures are used in order to repair cleft lip and palate. These procedures work to reconstruct the affected areas and prevent or treat any related complications.

In general, these procedures can include the following:

1. Cleft lip repair – Used to close the separation in the lip. The surgeon makes incisions on both sides of the cleft and creates flaps of tissue. The flaps are then stitched closed. The repair creates a more normal lip appearance. If needed, initial nasal repair is usually completed at the same time.
2. Cleft palate repair – Various procedures can be used to close the separation and rebuild the roof of the mouth. The surgeon will make incisions on both sides of the cleft and then reposition the tissue and muscles as needed before closing with stitches.
3. Ear tube surgery – For children with cleft palate, ear tubes may be used to reduce the risk of chronic ear fluid and the resulting hearing loss. Ear tube surgery involves placing small tubes in the eardrum to create an opening which prevents fluid buildup.
4. Reconstructive surgery – Additional surgeries may be needed in order to improve the appearance of the mouth, lip and nose.

Surgery can significantly improve your child’s appearance, quality of life, ability to eat, breathe and speak. The potential risks of surgery can include bleeding, infection, healing issues, wide or raised scars, and damage to nerves, blood vessels or other structures.

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