Repair of the Cleft Lip
ONE out of every eight hundred children in the United States is born with a cleft lip, a cleft palate, or both. Within this group of congenitally deformed infants, 25 per cent will have only a cleft lip, 50 per cent a cleft lip associated with cleft palate, and the remaining 25 per cent a cleft palate alone.1 The cosmetic deformity of the cleft lip, often mistakenly called “harelip,” even today carries with it a social stigma of major proportions. During recent years, improved surgical technics and their widespread use by well-trained plastic surgeons have succeeded in reducing the degree of deformity to the point where in most cases it should not be a serious problem to the patient.
The mechanism by which the defect is produced may be explained as the failure of the median nasal and maxillary processes to fuse during the second fetal month. While objection can be raised to this theory, no more reasonable explanation has been offered. The cause of this noncoalescence remains obscure, though experiments with animals have shown that many congenital anomalies may be reproduced by modifying the chemical environment of an embryo during specific periods of its growth. The concept that inheritance is a major factor in the appearance of the defect is increasingly accepted, since 30 to 40 per cent of these patients present a family history of the same deformity.1
It is important to understand that a congenital deformity involving the mouth and face is a problem requiring integrated medical . . .