Cleft

A cleft is a fissure, groove, or separation in a tissue or organ that results when parts fail to fuse properly during embryonic development. In medical contexts, cleft most commonly refers to congenital conditions affecting the facial region, such as cleft lip and cleft palate. The term can also describe a chin cleft, a vertical groove on the chin that is a normal anatomical variation rather than a defect.

Common types of clefts include cleft lip, which may occur with or without a cleft palate, and cleft palate alone. A cleft lip arises from incomplete fusion of the upper lip tissues, while a cleft palate results from failure of the palatal shelves to join. When both features are present, the condition is called cleft lip and palate. Clefts may vary in severity and can be part of broader syndromes, such as Pierre Robin sequence or Van der Woude syndrome.

Causes are typically multifactorial, involving genetic susceptibility and environmental influences. Risk factors include maternal smoking, alcohol use, certain medications during pregnancy, and nutritional factors. Incidence varies by population and other factors; advances in prenatal imaging allow earlier detection in many cases.

Diagnosis is usually made during pregnancy by ultrasound or after birth by physical examination, with additional imaging or genetic consultation as indicated. Management requires a multidisciplinary team and may include feeding support, surgical repair (lip repair around several months of age and palate repair in the first year or two), speech therapy, dental/orthodontic care, and hearing surveillance. Many individuals achieve good functional and cosmetic outcomes with modern treatment, though some require ongoing interventions.

Overall, clefts represent a spectrum of conditions with diverse causes and outcomes, best addressed through coordinated, long-term care.