Cleft and Craniofacial Surgery

Cleft and craniofacial surgeries improve quality of life by enabling basic, everyday functions like eating and speaking without pain or difficulty. These procedures also boost patients’ self-esteem by enhancing the form and appearance of the face.

Cleft lip, cleft palate and craniosynostosis are usually addressed during childhood, but sometimes require corrective surgery during adulthood. Optimal treatment requires a multidisciplinary approach, with coordination between pediatricians, pediatric dentists, maxillofacial surgeons, otolaryngologists and other professionals.

What is a cleft lip?

During early pregnancy, different areas of the face develop independently and then join together. This includes the left and right sides of the lips and the roof of the mouth. When these parts don’t join properly, it could result in a cleft, or opening, in the upper lip.

This cleft can range from a slight notch in the colored portion of the lip to a complete separation on one or both sides of the lip that extends into the nose. A cleft lip may correspond with a cleft in the gum, which can range from a small notch to a complete division of the gum. Surgery for a cleft lip removes any gaps or openings in the upper lip, gum or the roof of the mouth to improve speech and appearance.

What is a cleft palate?

Similar to a cleft lip, a cleft palate occurs during early pregnancy when different areas of the face don’t join together properly, causing an opening in the roof of the mouth. The back of the palate is called the soft palate and the front is the hard palate.

A cleft palate can range from an opening at the back of the soft palate to a nearly complete separation of the entire roof of the mouth, including both the soft and hard palate. Surgery for a cleft palate closes any separation in the hard and soft palate, making it easier for patients to eat and speak.

What is craniosynostosis?

Craniosynostosis is the early fusion of the cranial suture lines. Cranial suture lines are incompletely calcified junctions between bones that allow the cranial vault to expand, creating room for the brain to grow during the first several years of life.

Craniosynostosis disrupts cranial vault expansion, causing craniofacial deformity, while the fusion of multiple suture lines can restrict growth and apply pressure on the brain. This can lead to neurological issues, including developmental problems, cognitive impairment, seizures and mental retardation. Craniofacial surgery recreates suture lines at an early age to facilitate growth, correct deformity and reduce the risk of neurological issues.