Cleft Lip and Palate (Cheilognathopalatoschisis)

According to, the cleft lip and palate is a relatively common malformation of the mouth. The medical term for this is cheilognathopalatoschisis. Colloquially, the cleft lip and palate used to be called the harelip. Around 1,500 children are born in Germany with this malformation every year.

What is a cleft lip and palate?

If the facial parts of the embryo do not close completely during growth in the womb, visible deformities in the mouth area occur. A cleft lip and palate usually develops on the left side.

Lips, jaw and palate are not completely closed at the same time. But there are also cleft lip, cleft lip and cleft palate. All types of cracks can also occur on both sides. The colloquial term harelip or wolfslip is rarely heard today because it can be discriminatory.

Boys are affected more often than girls. A cleft occurs in 1 in 500 births. This makes the cleft lip and palate one of the most common malformations.


The cause of a cleft lip and palate is not known. Doctors suspect that genetic factors are responsible, because 15 percent have other cases of cleft formation within the family. A special variant of hereditary traits can also be seen in people with cleft formation.

In addition to heredity, other factors also come into play. Vitamin deficiency, overdose of vitamin A and vitamin E, lack of oxygen, smoking and alcohol can all contribute to the formation of a cleft lip and palate.

The embryo develops the face during the first embryonic weeks. If there are negative influences during this time, it can happen that the face does not fully develop. A cleft lip and palate can be the result. Cleft lips or jaws are caused by disorders in the 5th to 6th week of pregnancy. Cleft palate develops due to disorders in the 10th to 12th week of pregnancy.

Symptoms, Ailments & Signs

The cleft lip and palate can be recognized by the characteristic malformation of the mouth area. The lips, upper jaw, palate, mouth and nose show severe deformities, with the actual cleft usually only appearing on one side. The deformity causes various symptoms such as misaligned teeth, nasal and speech problems.

Affected children usually develop an unclear pronunciation as a result of the malformation and then mumble a lot, for example. The cleft also causes problems with feeding, which can lead to deficiency symptoms. Rarely does the cleft develop within the oral cavity, which can result in problems with swallowing and ear infections, among other things.

The fissure can vary in size, severity and localization. It occurs predominantly on the left side and can range from simple skin defects of the upper lip to severe deformities. The cleft lip and palate often occurs in connection with other deformities. This can contribute to the development of psychological problems in those affected.

Many people who suffer from cleft lip and palate develop depression or social anxiety at some point in their lives. The deformity itself is not life-threatening, but the psychological consequences can greatly reduce the quality of life. With early therapy, a large part of the deformities can be surgically removed.

Diagnosis & History

The diagnosis can be easily made based on the typical symptoms. The cleft lip and palate can be recognized at first glance in newborns. If the lips are not affected, the doctor must examine the baby’s mouth to make a diagnosis.

From the 18th week of pregnancy, a cleft lip and palate can already be detected by an ultrasound examination.

Thanks to the very good surgical options, both aesthetic and functional results can be achieved. The course of a cleft lip and palate is very positive today because the cleft can be completely closed. Speech therapy support succeeds in bringing about normalization in 90 percent of all cases.


As a result of the cleft lip and palate, most of those affected suffer from various malformations that can significantly restrict the patient’s everyday life and significantly reduce their quality of life. As a rule, the malformations primarily affect the palate and the upper jaw. The lips can also be affected by this condition, so the intake of liquids and food is restricted by this condition.

Misalignments of the patient’s teeth and jaw also occur, which can often lead to pain and other limitations in everyday life. The mouth and nose are also deformed. Furthermore, the cleft lip and palate often leads to bullying or teasing in children and can thus also trigger psychological problems or depression. In addition, most patients with cleft lip and palate also suffer from speech disorders and cannot easily communicate with other people.

Unfortunately, a causal treatment of this disease is not possible. Those affected are therefore dependent on various surgical interventions that can alleviate and limit the symptoms. Complications usually do not arise. The life expectancy of the patient is usually not reduced by this disease. It is not uncommon for the parents and relatives of those affected to suffer from the symptoms of cleft lip and palate.

When should you go to the doctor?

The cleft lip and palate is usually diagnosed immediately after the birth of the child by doctors, pediatric nurses or nurses who are present. Since various obstetricians are present in the inpatient environment, they take over the further medical care of the newborn. It is therefore not necessary for the parents to initiate a visit to the doctor. If the birth takes place at home, the midwife present will take care of the child. In the event of irregularities, she establishes contact with a doctor and initiates the necessary steps for treatment.

If, in exceptional cases, a sudden birth takes place without the presence of nursing staff or under medical supervision, a doctor must be consulted immediately after the birth. Calling an ambulance is recommended so that the mother and child can be transported to a hospital as quickly as possible. The optical changes in the cleft lip and palate can be seen immediately during childbirth through visual contact with the child.

In order to avoid further complications, medical treatment should always be sought immediately. In severe cases, the newborn’s airways are compromised. In these situations, first aid measures must be taken. Since the cleft lip and palate can be diagnosed before birth, the expectant mother should take part in all check-ups offered during pregnancy.

Treatment & Therapy

The treatment of the cleft lip and palate can drag on into adulthood. The first goal is to have the child’s appearance normalized before it starts school. In addition, speaking, chewing, hearing and breathing should be possible.

Several doctors work together to treat cleft lip and palate: paediatricians, dentists, orthodontists, oral and maxillofacial surgeons, ENT doctors and speech therapists. In some cases, treatment by a psychotherapist is advisable.

The first treatment measures should be initiated in the first few days after the birth. In order to promote the growth direction of the palate, tongue position and tongue function and to enable relatively normal drinking, the doctor first takes an impression of the jaw. A palatal plate is then made. This separates the nasal cavity from the mouth. Other malformations must be ruled out.

The doctor examines the heart and kidneys. The cleft lip and palate is surgically corrected with increasing age. Speech therapy treatment is important so that the child learns the formation of sounds and language properly. Orthodontic measures are necessary in addition to proper dental care so that the teeth are set correctly and form properly. Psychological therapy helps the child and its parents to cope with the psychological stress.

The first surgical intervention occurs between the ages of three and six months. The soft palate, upper jaw and lips are closed. The hard palate is corrected between the ages of 12 and 18 months. Further operations may then be necessary up to adulthood. For example: rhinoplasty, correction of the position of the teeth, correction of the lip and correction of the soft palate.

Outlook & Forecast

The malformation in the area of ​​the mouth or jaw can be treated well in most patients thanks to the medical possibilities. Nevertheless, the prognosis depends on the extent of the cleft palate and the start of treatment. If the birth takes place in an inpatient environment, a correction is initiated immediately after the birth process. If you give birth in a birthing center or at home, the procedure can only be carried out with a delay after transport to the hospital. This often results in the suture becoming more visible as the child develops and grows due to the time delay in the procedure.

Basically, the cleft lip and palate can be treated so well nowadays that there are hardly any physical impairments to speech or the chewing process. Malfunctions are therefore not to be expected in the long term. Nevertheless, despite all efforts, an optical flaw remains due to the malformation due to the corrective intervention.

Follow-up treatments can be used that lead to an improvement. However, the severity of the abnormalities remains individual and can lead to strong emotional stress. An unfavorable course of the disease can lead to psychological sequelae. This circumstance must be taken into account when making the overall prognosis. In addition, there is an increased risk of developing inflammation in the head area more frequently over the lifetime.


A cleft lip and palate can only be prevented to a limited extent. However, the risk can be reduced by women avoiding alcohol, cigarettes, lack of oxygen, vitamin deficiencies, malnutrition, vitamin E overdose and stress before and during pregnancy.


Cleft lip and palate causes those affected to suffer from various malformations that significantly limit their everyday life and reduce their quality of life. As a result, those affected suffer from their external appearance. In most cases, the condition is treated surgically in early childhood. Follow-up care in the true sense of the word is largely omitted, provided that no further physical symptoms occur.

Rather, it is about promoting a self-confident way of dealing with the disease over the long term. In more serious cases, the help of a professional psychologist can be supportive. This can sometimes also prevent the development of severe depression and other mental illnesses and rather ensure that you can live well with the restriction.

You can do that yourself

In the case of a cleft lip and palate, a lifelong cosmetic blemish often remains despite good and quick medical care. The health impairments can be very well healed and remedied by medical advances. Nevertheless, many of those affected suffer from the permanent optical change.

Men can often help themselves in everyday life by using their beard growth to cover up the irregularity. Depending on the individual circumstances, the abnormality can be almost completely covered. Bystanders do not notice any difference to other people and unpleasant looks or formulations are avoided. For girls and women, there is an opportunity to use cosmetic products to relieve the seam on the lip.

However, since the optical changes in a cleft palate do not completely disappear with this method, it is helpful to show self-confidence. Relaxation techniques can be used to strengthen mental strength. These lead to a reduction of internal stressors and strengthen vitality. Through yoga or meditation, the focus of perception is placed on other areas of life and on one’s own strengths. Many sufferers also find it helpful to talk to other sufferers. Experiences and adventures are discussed with each other. In addition, helpful tips on how to deal with the symptoms in everyday life can be given.

Cleft Lip and Palate (Cheilognathopalatoschisis)