This is our area of expertise, and we take it seriously.
Cleft Lip and Palate: Unilateral
A unilateral cleft affects one side. It may be fairly minor (appearing as a small nick in the lip), extensive involving the lip, alveolus (dental ridge) and palate (roof of the mouth), or at a level between these two extremes. Below are the three major categories of unilateral clefts.
Unilateral cleft lip
This may involve just a part of the lip or the entire height of the lip.
The cleft may range from affecting the colored border of the lip only to extending up two-thirds of the lip height. The horizontal lip muscle may be divided only at the lower portion of the lip while the rest of the muscle and skin remain intact. Or the lip muscle may be divided completely, creating an open groove in the skin. Because the upper lip muscle is disconnected at the cleft, the segments may bulge on both sides of the separation.
Most often, unilateral cleft lip also affects the nose. The cleft lip's separated muscles pull with an asymmetrical tension against the nostril on the cleft side, causing it to become larger with a more horizontal nostril as well. This pull also acts to shorten the central column of nose cartilage dividing the nostrils, causing the nose to be lower than usual.
Unilateral cleft lip and alveolus (dental ridge)
This occurs when the upper lip and underlying dental ridge are each divided into two segments. The cleft may extend from the lip up through the floor of the nasal area – a "complete" unilateral cleft lip and alveolus or it may affect only the lip and dental ridge.
The lip muscle is divided, creating an open groove in the skin and segments that may bulge on either side. The dental ridge is typically missing teeth, and may have teeth that are crowded and/or rotated or abnormally shaped. The dental ridge perimeter may also form a narrower than normal arch.
Most often, unilateral cleft lip and alveolus also affects the nose. The cleft lip's separated muscles pull with an asymmetrical tension against the nostril on the cleft side, causing it to become larger with a more horizontal nostril as well. This pull also acts to shorten the central column of nose cartilage dividing the nostrils, causing the nose to be lower than usual.
Unilateral cleft lip, alveolus (dental ridge) and palate (roof of the mouth)
This is similar to the unilateral cleft lip and alveolus, with additional complications from the open palate. The cleft opening is located not only on the lip and dental ridge but extends through the hard palate (sometimes back through the soft palate as well).
The extent to which the cleft continues toward the back of the mouth determines the level of correction and speech therapy required for accurate sound formation and clear speech. Often, the cleft results in teeth missing on the cleft side, and may be malformed or rotated, erupt into the palate instead of the ridge, or some variation of these problems.