There are different types of congenital facial anomalies. The most frequent are the clefts of the lip and/or the palate – 1:700 childbirths, the cranio or craniofaciostenoses – 1:3000 childbirths and the otomandibular syndrome (hemifacial microsomia, syndrome of the first and second branchial arc) – 1:3500 childbirths.
Less frequent but socially important are the isolated cases of lack of ear, of eye-ball, lateral facial clefts, vessel malformations, etc.
Clefts of the lip and/or the palate
In the early pregnancy the separate parts of the face develop independently and then joint together. Sometimes some parts do not joint completely and the result is a cleft. There are different types of clefts with different severity.
The cleft lip is a condition in which the upper lip is not fully completed. It seems as though there is a cut in the lip. It may vary from a slight cut on the red part of the lip to its complete separation on one or both cut edges of the lip upwards to the nose. The cleft may be unilateral or bilateral depending on whether one or both parts of the upper lips are affected.
It may be possible to have a gum cleft together with the lip cleft. It may also vary from a slight cut to a compete division of the gum into separate parts.
The cleft palate occurs when the upper part of the mouth (the palate) has not closed completely. The rear part of the palate (right before the throat) is called a soft palate, and the front part – a hard palate. If you move your tongue along your palate you will sense the difference between the soft and the hard palate. The cleft palate may be small opening in the rear part of the soft palate to almost a full separation of the upper part of the mouth (soft and hard palate).
Although very rare, a baby with a palate cleft may have an excessively small lower jaw (mandible) and a tongue that slips back into the throat which leads to difficult breathing. This state is called Pierre-Robin Sequence.
Why do clefts appear?
The reasons of cleft appearance are not clear yet. We know well what happens, and not why it happens. Sometimes clefts run the family but more often they occur without any other representative in the family a cleft.
Оtomandibular syndrome, or hemifacial microsomia, or syndrome of the first and second branchial arc.
It is a syndrome where in different degrees unilaterally the lower jaw, the ear and the soft tissues of the cheek are affected. This condition affects mainly the symmetry of the face. The affliction of the ear may be combined with hearing problems of that ear.
Cranio or cranio-faciostenoses
In these states the cranial and/ or facial sutures knit together prematurely, prior to the birth of the child. This leads to changes in the form of the skull and/or the face. When all sutures are affected at the same time, the growth of the brain may be violated. In the rest of the cases there are only changes in the form and the outlook of the head and the face.