Cleft lip and cleft palate

Cleft lip and palate
Other names	Hare-lip, cleft lip and palate
Child with cleft lip and palate
Specialty	Oral and Maxillofacial Surgery, Otorhinolaryngology, pediatrics
Symptoms	Opening in the upper lip that may extend into the nose or palate[1]
Complications	Feeding problems, speech problems, hearing problems, frequent ear infections[1]
Usual onset	Present at birth[1]
Causes	Usually unknown[1]
Risk factors	Smoking during pregnancy, diabetes, obesity, older mother, certain medications[1][2]
Treatment	Surgery, speech therapy, dental care[1]
Prognosis	Good (with treatment)[1]
Frequency	1.5 per 1000 births (developed world)[2]
Deaths	3,800 (2017)[3]

A cleft lip contains an opening in the upper lip that may extend into the nose.^[1] The opening may be on one side, both sides, or in the middle.^[1] A cleft palate occurs when the palate (the roof of the mouth) contains an opening into the nose.^[1] The term orofacial cleft refers to either condition or to both occurring together. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections.^[1] Less than half the time the condition is associated with other disorders.^[1]

Cleft lip and palate are the result of tissues of the face not joining properly during development.^[1] As such, they are a type of birth defect.^[1] The cause is unknown in most cases.^[1] Risk factors include smoking during pregnancy, diabetes, obesity, an older mother, and certain medications (such as some used to treat seizures).^[1][2] Cleft lip and cleft palate can often be diagnosed during pregnancy with an ultrasound exam.^[1]

A cleft lip or palate can be successfully treated with surgery.^[1] This is often done in the first few months of life for cleft lip and before eighteen months for cleft palate.^[1] Speech therapy and dental care may also be needed.^[1] With appropriate treatment, outcomes are good.^[1]

Cleft lip and palate occurs in about 1 to 2 per 1000 births in the developed world.^[2] Cleft lip is about twice as common in males as females, while cleft palate without cleft lip is more common in females.^[2] In 2017, it resulted in about 3,800 deaths globally, down from 14,600 deaths in 1990.^[3][4] The condition was formerly known as a "hare-lip" because of its resemblance to a hare or rabbit, but that term is now generally considered to be offensive.^[5]