References:
- Wong’s Nursing Care of Infants and Children, 11th Edition, ISBN 978-0-323-54939-4, by Marilyn J. Hockenberry, David Wilson, and Cheryl C. Rodgers (Ch. 25, pp. 862–866)
- Maternal & Child Health Nursing: Care of the childbearing & childrearing family, 8th Edition, ISBN 978-1-4963-4813-5, by JoAnne Silbert-Flagg and Adele Pillitteri (Ch. 45, pp. 2788–2791)
- Saunders Comprehensive Review for the NCLEX-RN Examination, 9th Edition, ISBN 978-032-37-9530-2, by Linda Anne Silvestri, Angela E. Silvestri, and Jessica Grimm (Ch. 34, pp. 426–427)
Cleft lip and cleft palate are congenital anomalies that occur as a result of failure of soft tissue or bony structure to fuse during embryonic development. The defect involves abnormal openings in the lip and/or palate that may occur unilaterally or bilaterally and are readily apparent at birth.
- Incidence:
- Etiology: Causes include hereditary and environmental factors—exposure to radiation or rubella virus, chromosomal abnormalities, family history, maternal smoking, and teratogenic factors such as medications taken during pregnancy.
- Clinical Manifestations:
- Cleft lip can range from a slight notch to a complete separation from the floor of the nose.
- Cleft palate can include nasal distortion, midline or bilateral cleft, and variable extension from the uvula and soft and hard palate.
- Prevention: Prenatal dietary supplementation of folic acid is important to decrease the risk of cleft lip and palate.
- Surgical Correction: Closure of a cleft lip defect precedes closure of the cleft palate and is usually performed by age 3 to 6 months. Cleft palate repair is usually performed around 1 year of age, following the successful repair of cleft lip if present; this allows for the palatal changes that occur with normal growth; a cleft palate is closed as early as possible (i.e., before speech develops) to facilitate speech development.
- Complications: A child with cleft palate is at risk for developing frequent otitis media; this can result in hearing loss.
Clinical Manifestations
An interprofessional team approach, including audiologists, orthodontists, plastic surgeons, and occupational and speech therapists, is taken to address the many needs of the child.