A cleft refers to a split or gap in the upper lip, roof of the mouth (the palate) or sometimes both. Cleft lips and palates develop during pregnancy and it is thought a combination of genetic and environmental factors contribute to their development. They are the most common facial birth abnormalities in the UK.
Children usually undergo surgery for a cleft, carried out under general anaesthetic, from the age of three months. Surgery aims to close the clefts, which allows the child to develop normal feeding and speech. Surgery is often done in stages and surgical plans are different for every child with a cleft; your cleft surgeon and cleft specialist nurses will talk you through the process so that you can understand why the operations are carried out.
The Cleft Team based at Royal Manchester Children’s Hospital is part of the national cleft network, offering a full range of surgical interventions for patients. Surgeon David Whitby offers a range of adult surgery including surgery on the nose (“rhinoplasty”) at the MFT Plastic Surgery unit at Wythenshawe Hospital, and Victoria Beale offers jaw surgery (orthognathic surgery, including alveolar bone grafting and Le Fort osteotomies) for older children and teenagers.
Patients with clefts often have related conditions affecting areas such as their hearing, speech and language, and teeth, and we work closely with colleagues in other specialties such as speech therapy and ENT surgery as part of our patients’ treatment.
Referrals into the cleft lip and palate service are almost always made before a child is born by their obstetrician, or after a child is born by their midwife or paediatrician. Patients can also be referred later by their GP, but most patients with a cleft are looked after by the cleft team for their whole life.