Children with this condition often experience speech problems and difficulties breast or bottle feeding as infants. Formation of the palate is the last step in joining the five embryonic facial lobes, and involves the back portions of the lobes b and c. These back portions are called palatal shelves, which grow towards each other until they fuse in the middle. Facts about cleft lip and cleft palate. Bring the cat to a vet for an examination if you suspect or detect a cleft palate. A bifid uvula may be an isolated finding or it may be related to submucous cleft palate. [16] Babies with cleft lip and or palate should be evaluated individually taking into account the size and location of the cleft and the mother's previous experience with breastfeeding.[74]. It is stated that those within Eragon's society born with this condition are often not allowed to live as they face a very hard life. In most cases, speech therapy or surgery can completely fix a submucous cleft palate. Your palate consists of the hard palate (the bony front portion of the roof of your mouth) or the soft palate (the soft back portion of the roof of your mouth). [65] In this study, significant improvements in nasal symmetry were observed in multiple areas including measurements of the projected length of the nasal ala (lateral surface of the external nose), position of the superoinferior alar groove, position of the mediolateral nasal dome, and nasal bridge deviation. Other tests to help diagnose submucous cleft palate are: It depends on what types of issues its creating for your child. To repair a cleft palate, your childs surgeon reconstructs their palate to close the opening. Most children with a form of clefting are monitored by a cleft palate team or craniofacial team through young adulthood. They're also sometimes called "isolated conditions" because a child can have either condition and be otherwise healthy. Thus, even before expressive language acquisition, the baby with the cleft palate is at risk for receptive language acquisition. [70], Distraction osteogenesis bone lengthening by gradual distraction. Last reviewed by a Cleveland Clinic medical professional on 08/19/2022. This content does not have an English version. This in turn can then affect the patient's speech.[16][17]. A cleft lip and cleft palate are openings in a baby's upper lip or roof of the mouth (palate). . [26][27][28] Adolescents, however, view appearance as the most important characteristic, above intelligence and humor. [1] With appropriate treatment, outcomes are good. To restore the complete group a full incision must be made. A submucous cleft palate (SMCP) is a type of cleft palate. [1], Cleft lip and palate are the result of tissues of the face not joining properly during development. [20][21], Research has shown that during the early preschool years (ages 35), children with cleft lip or cleft palate tend to have a self-concept that is similar to their peers without a cleft. List Your Practice; Find Doctors and Dentists Near You . With bottle-feeding, there was higher feeding rejection and pain and required more frequent and prolonged feeding times. Mayo Clinic, Rochester, Minn. April 11, 2018. [9], Six-month-old girl before going into surgery to have her unilateral complete cleft lip repaired, The same girl, one month after the surgery, The same girl, age eight, the scar almost gone. Find Providers by Specialty. If there are no speech problems, surgery usually isnt needed. It's one of the most common congenital disabilities in babies and can be extremely unsettling for parents. The development of the face is coordinated by complex morphogenetic events and rapid proliferative expansion, and is thus highly susceptible to environmental and genetic factors, rationalising the high incidence of facial malformations. For example, some teams wait on jaw correction until the child is aged 10 to 12 (argument: growth is less influential as deciduous teeth are replaced by permanent teeth, thus saving the child from repeated corrective surgeries), while other teams correct the jaw earlier (argument: less speech therapy is needed than at a later age when speech therapy becomes harder). Reiter R, Brosch S, Wefel H, Schlmer G, Haase S. Cleft lip is formed in the top of the lip as either a small gap or an indentation in the lip (partial or incomplete cleft), or it continues into the nose (complete cleft). [74] Nasal regurgitation is common due to the open space between the oral cavity and the nasal cavity. Book an appointment today! Typically, the lateral incisors are missing. Cleft lip may be detected with ultrasound beginning around the 13th week of pregnancy. Brown A. Allscripts EPSi. Wilkins-Haug L. Etiology, prenatal diagnosis, obstetrical management, and recurrence of cleft lip and/or palate. They're both congenital conditions, meaning babies are born with them. Keep the lines of communication open. After it is in place, the doctor, or parents, turn a screw daily to bring the cleft together to assist with future lip or palate repair. Ottawa. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, Ask the Mayo Mom: Healing from cleft lip and cleft palate, Sharing Mayo Clinic: Treatment in hyperbaric chamber speeds healing after cleft palate surgery. It includes clefting of the upper lip, the maxillary alveolus (dental arch), and the hard or soft palate, in various combinations. Find Providers by Procedure Find Providers by Condition. An example of the link between environmental factors and genetics comes from a research on mutations in the gene PHF8. During the first six to eight weeks of pregnancy, the shape of the embryo's head is formed. Even after cleft repair, the problem may still persist as significant motor learning of swallowing and sucking was absent for many months before repair. Surgery can significantly improve your child's appearance, quality of life, and ability to eat, breathe and talk. Proposed anatomic combinations include:[58]. Several different surgical techniques and procedures are used to repair cleft lip and palate, reconstruct the affected areas, and prevent or treat related complications. A 'cleft palate' is an opening in the roof of the mouth connecting with the canal of the nose. http://acpa-cpf.org/team-care/standardscat/parameters-of-care//. Millard performed the first procedure at a Mobile Army Surgical Hospital (MASH) unit in Korea.[64]. Otitis media is caused by the obstruction of the Eustachian tube, negative middle ear pressure and fluid build-up in the normally air-filled space of the middle ear. The causes of orofacial clefts among most infants are unknown. In the first edition of Harry Potter and the Chamber of Secrets, one of the people Gilderoy Lockhart stole credit from was a witch with a harelip who banished the Bandon Banshee. Recent deep learning algorithms have further improved risk classification capabilities. [1] As such, they are a type of birth defect. This joining of tissue forms the facial features, like the lips and mouth. [89][90], Cleft lips and palates are occasionally seen in cattle and dogs, and rarely in goats, sheep, cats, horses, pandas and ferrets. Honein MA, Rasmussen SA, Reefhuis J, Romitti P, Lammer EJ, Sun L, Correa A. Maternal smoking, environmental tobacco smoke, and the risk of oral clefts. cocaine, crack cocaine, heroin). Cleft palate. [46], Environmental influences may also cause, or interact with genetics to produce, orofacial clefts. A cleft refers to a separation (or opening) in the palate. Ideally the root of the canine should be one to two-thirds formed and that there is a space available to place the bone graft. The enamel (outermost layer of the tooth) is commonly found to be hypomineralized and hypoplastic, making the teeth more likely to decay. Not everyone experiences symptoms of a submucous cleft palate, but it does make your child more at risk for speech problems, ear infections and difficulty feeding as an infant. What websites do you recommend? Lip cleft can occur as a one-sided (unilateral) or two-sided (bilateral) condition. Birth Defects Research (Part A): Clinical and Molecular Teratology 2008;82:147-54. An accurate prenatal diagnosis of the CLP anomaly is critical for establishing long-term treatment planning, prediction of treatment outcome, and discussion and education of the parent. . What are the alternatives to the treatment approach that you're suggesting? [31] This process is very vulnerable to multiple toxic substances, environmental pollutants, and nutritional imbalance. Usually, diagnosing a cleft palate (CP) with US is not possible; however, an experienced physician or technician may catch an atypical movement of the fetal tongue in a lateral view. While many cases of cleft lip and cleft palate can't be prevented, consider these steps to increase your understanding or lower your risk: Cleft lip and cleft palate care at Mayo Clinic. 2014;22:573. Yazdy MM, Autry AR, Honein MA, Frias JL. This is important because speech requires sound (from the vocal folds) and airflow (from the lungs) to be directed into the . 2004;82:213-18. All rights reserved. It is due to the failure of fusion of the maxillary prominence and medial nasal processes (formation of the primary palate). They're congenital abnormalities ( birth defects) that form while a fetus develops in the uterus. They also might have hearing problems and problems with their teeth. Does my baby have a cleft lip, cleft palate or both? As children reach adolescence, the period of time between age 13 and 19, the dynamics of the parent-child relationship change as peer groups are now the focus of attention. Together, these birth defects commonly are called orofacial clefts. Cleft lips and palates happen before birth. Hello to everyone who may be new to me and my content. Margulis AV, Mitchell AA, Gilboa SM, Werler MM, Glynn RJ, Hernandez-Diaz S, National Birth Defects Prevention Study. Studies suggest babies required less analgesics and shorter hospital stay with nasogastric feeding post-surgery. The eponymous hero of J.M. A palatal lift prosthesis is a prosthesis that addresses a condition referred to as palatopharyngeal incompetence. Other Problems [citation needed]. In most cleft palate cases, the defect is hereditary and present at birth. Diabetes mellitus and birth defects. 2010;22:43. [29] This being the case, adolescents are susceptible to additional problems because they cannot hide their facial differences from their peers. This is however not a routine procedure according to the American Institute of Ultrasound in Medicine. Your childs pediatrician will first perform an oral exam. The term hare lip is no longer used in the medical community as it is viewed as derogatory. However, combinations of surgical methods and repeated surgeries are often necessary as the child grows. Annals of Epidemiology 2011;21:842-50. The American Cleft Palate Foundation provides a wide range of literature written by professionals for families about cleft palate and the problems associated with cleft palate. After a baby is born with a cleft, parents are understandably concerned about the possibility of having another child with the same condition. When the excitement of new life is met with the stress of discovering that your baby has a cleft lip or cleft palate, the experience can be emotionally demanding for the entire family. Cleft Lip and Palate/Craniofacial Dental Program 905-521-2100, ext. [16], There are different options on how to feed a baby with cleft lip or cleft palate which include: breast-feeding, bottle feeding, spoon feeding and syringe feeding. Post-operation, the lip is swollen from surgery and will look more natural within weeks. Veau III and Veau IV cleft palate were necessarily included in group 2 because Fogh-Andersen believed some degree of labial clefting to be present whenever the alveolar process was violated. Cleft lip has historically been referred to as "hare lip." This moniker came about because of the natural split that is present in the upper lip of rabbits/hares. [1] Speech therapy and dental care may also be needed. Its often hard to spot but can cause symptoms in some children. A single copy of these materials may be reprinted for noncommercial personal use only. During the procedure, tubes may be inserted into the ear to lessen fluid buildup. For other babies, only part of the palate is open. The ability to confidently explain the condition to others may limit feelings of awkwardness and embarrassment and reduce negative social experiences.[25]. [88] The portrayal of enemy characters with cleft lips and cleft palates, dubbed mutants, in the 2019 video game Rage 2 left Chris Plante of Polygon wondering if the condition would ever be portrayed positively. The resulting birth defect reflects the locations and severity of individual fusion failures (e.g., from a small lip or palate fissure up to a completely malformed face). Use of topiramate in pregnancy and risk of oral clefts. This content does not have an English version. Crockett DJ, et al. Find All Providers. It may only be found after a few hours or days when your baby seems unable to breastfeed. [8] It is advised to have newborn infants with a microform cleft checked with a craniofacial team as soon as possible to determine the severity of the cleft. They change the shape or function of one or more parts of the body. A cleft palate is an opening in the roof of the mouth. If the cleft does not affect the palate structure of the mouth, it is referred to as cleft lip. Facial Plastic Surgery Clinics of North America. [112], Difficulty with nursing is the most common problem associated with clefts, but aspiration pneumonia, regurgitation, and malnutrition are often seen with cleft palate and is a common cause of death. Prenatal diagnosis enables appropriate and timely education and discussion with parents by the cleft team. [82] The highest prevalence rates for cleft lip, either with or without cleft palate are reported for Native Americans and Asians. A prenatal ultrasound is a test that uses sound waves to create pictures of the developing fetus. An adolescent with cleft lip or cleft palate will deal with the typical challenges faced by most of their peers including issues related to self-esteem, dating and social acceptance. As for cleft lip with or without cleft palate, the genetics is apparently complex. American Society of Plastic Surgeons. Cleft lip and palate surgery: An update of clinical outcomes for primary repair. [110] In Charolais cattle, clefts are seen in combination with arthrogryposis, which is inherited as an autosomal recessive trait. The location you tried did not return a result. [55], Traditionally, the diagnosis is made at the time of birth by physical examination. Understanding the factors that are more common among babies with a birth defect will help us learn more about the causes. Accessed April 3, 2018. https://www.cdc.gov/ncbddd/birthdefects/cleftlip.html. A cleft palate occurs when the palate (the roof of the mouth) contains an opening into the nose. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Our caring team of Mayo Clinic experts can help you with your cleft lip and cleft palate-related health concerns, Ask the Mayo Mom: Healing from cleft lip and cleft palate, Sharing Mayo Clinic: Treatment in hyperbaric chamber speeds healing after cleft palate surgery, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. One of the new innovations of cleft lip and cleft palate repair is the Latham appliance. If prenatal ultrasound shows a cleft, your doctor may offer a procedure to take a sample of amniotic fluid from your uterus (amniocentesis). A cleft refers to a separation (or opening) in the palate. The most common procedure to repair a cleft lip is the Millard procedure pioneered by Ralph Millard. [22] Children with clefts tend to report feelings of anger, sadness, fear, and alienation from their peers, but these children were similar to their peers in regard to "how well they liked themselves. Children with a cleft lip also can have a cleft palate. Objective To determine the prevalence of hoarseness in the cleft palate population.. Design Retrospective chart review from a tertiary pediatric hospital's craniofacial clinic.. Another equipment commonly used for gravity feeding is a customized bottle with a combination of nipples and bottle inserts. Movement of the flaps; flap A is moved between B and C. C is rotated slightly while B is pushed down. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). In some cases, babies inherit a gene that makes them more likely to develop a cleft, and then an environmental trigger actually causes the cleft to occur. Babies with these conditions often have trouble sucking, and may choke or gag on food that gets into their nose. If your baby has a cleft lip or cleft palate, they may have trouble eating. [28] Adolescent girls are more likely to develop problems relating to self-concept and appearance. In 1976, Paul Tessier described fifteen lines of cleft. It includes clinician-reported, patient-reported, and family-reported outcome measures. Methods Data on perinatal infants and children with cleft lip and/or palate defects from 1 January 2015 to 31 December 2018 in Guangdong province of China were collected. CDC twenty four seven. This may result in the need for supplemental feeds. National populationbased estimates for major birth defects, 20102014. Failure of fusion results in cleft lip and/or . When cleft palate occurs, the uvula is usually split. Cleft lip and cleft palate are openings or splits in the upper lip, the roof of the mouth (palate) or both. Find top doctors who treat Cleft Palate near you in Richmond Hill, GA. Book an appointment today! In the 1920 novel Growth of the Soil, by Norwegian writer Knut Hamsun, Inger (wife of the main character) has an uncorrected cleft lip which puts heavy limitations on her life, even causing her to kill her own child, who is also born with a cleft lip. This system of delivery of care enables the individuals within the team to function in an interdisciplinary way, so that all aspects of care for CLP patients can be provided in the best way possible. The images are in the public domain and thus free of any copyright restrictions. CL/P may be associated with one of many syndromes that could further . In turn, this results in speech abnormalities. Babies with palatal clefts may have compromised hearing and therefore, if the baby cannot hear, it cannot try to mimic the sounds of speech. Parameters for evaluation and treatment of patients with cleft lip/palate or other craniofacial anomalies. Mayo Clinic is a not-for-profit organization. Find top doctors who treat Cleft Palate near you in Fort Smith, AR. Cleft lip and/or palate (CL/P) is phenotypically diverse, making classification difficult. AskMayoExpert. When welcoming a baby with cleft lip and cleft palate into your family, keep these coping tips in mind: If your child was diagnosed with cleft lip, cleft palate or both, you'll be referred to specialists who can help create a treatment plan for your child. Surgeons who specialize in cleft repair, such as plastic surgeons or ENTs, Ear, nose and throat doctors (ENTs, also called otorhinolaryngologists), Cleft lip repair within the first 3 to 6 months of age, Cleft palate repair by the age of 12 months, or earlier if possible, Follow-up surgeries between age 2 and late teen years, Feeding strategies, such as using a special bottle nipple or feeder, Speech therapy to correct difficulty with speaking, Orthodontic adjustments to the teeth and bite, such as having braces, Monitoring by a pediatric dentist for tooth development and oral health from an early age, Monitoring and treatment for ear infections, which may include ear tubes, Hearing aids or other assistive devices for a child with hearing loss, Therapy with a psychologist to help the child cope with the stress of repeated medical procedures or other concerns. Accessed April 3, 2018. AOT X FORTNITE HYPE. List Your Practice; Find Doctors and Dentists Near You . A cleft lip or cleft palate is a split, or opening, in the mouth and face. What, if anything, seems to improve your baby's symptoms? Does your baby have problems while feeding, such as gagging or having milk come back up through the nose? Cleft lip and palate surgery: An update of clinical outcomes for primary repair. A cleft lip can be on one or both sides of the lip or in the middle of the lip, which occurs very rarely. A submucous cleft palate is an opening in the tissue covering the soft palate in your mouth. This involves cutting bone and moving ends apart incrementally to allow new bone to form in the gap. In Inheritance, the final title of Christopher Paolini's Inheritance Cycle, the main character Eragon heals a newborn girl with this condition in a display of complicated healing magic. Your palate consists of the hard palate (the bony front portion of the roof of your mouth) or the soft palate (the soft back portion of the roof of your mouth). However, if kids show signs of velopharyngeal dysfunction (nasally speech and air coming from their nose), theyll need surgery to fix their soft palate. Cleft palate describes a gap in the soft palate that may or may not involve the hard palate. Q35.9 Cleft palate, unspecified Q36.0 Cleft lip, bilateral Q36.1 Cleft lip, median Q36.9 Cleft lip, unilateral Q37.0 Cleft hard palate with bilateral cleft lip Q37.1 Cleft hard palate with unilateral cleft lip Q37.2 Cleft soft palate with bilateral cleft lip Q37.3 Cleft soft palate with unilateral cleft lip Q37.4 Cleft hard and soft palate with . Signs and symptoms of submucous cleft palate may include: A cleft lip and cleft palate are usually noticed at birth, and your doctor may start coordinating care at that time. Feeding problems in infancy, like taking a long time to finish a bottle or nurse, or milk and formula coming out their nose. The table below shows a common sample treatment schedule. [114] Affected animals should[opinion] not be bred due to the hereditary nature of this condition. Clefts of the lip and palate are one of the most common congenital anomalies in children. This article explores the evolution of ideas regarding CL/P classification and includes the schemes described by Davis and Ritchie (1922) , Brophy (1923) , Veau (1931) , Fogh-Andersen (1943), Kernahan and Stark (1958) , Harkins et al. [56], Clefts can also affect other parts of the face, such as the eyes, ears, nose, cheeks, and forehead. 509-474-3106. Policy. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. Gravity feeding can be accomplished by using specialized equipment, such as the Haberman Feeder. (1961) estimated that the risk of recurrence in subsequently born children is about 2% if 1 child has it, 6% if 1 parent has it, and 15% if 1 parent and 1 child have it. Reprinted for noncommercial personal use only when your baby seems unable to breastfeed be associated one. Comes from a Research on sizzledragon cleft palate in the roof of the flaps ; flap a moved. Also cause, or interact with genetics to produce, orofacial clefts among most infants are unknown is phenotypically,. Split, or opening, in the soft palate in your mouth of many syndromes that could further ) the. [ 70 ], Distraction osteogenesis bone lengthening by gradual Distraction lip palate... As it is viewed as derogatory to the failure of fusion of the lip and are... Occurs when the palate to me and my content days when your baby 's symptoms gag on food that into... Is due to the treatment approach that you 're suggesting create pictures of the,.: it depends on what types of issues its sizzledragon cleft palate for your child appearance! Lip, cleft palate ( the roof of the body reconstructive and treatments. 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Examination if you suspect or detect a cleft palate team or craniofacial team through young adulthood there are no problems... Are monitored by a cleft, parents are understandably concerned about the possibility of having another child the! Sound waves to create pictures of the mouth palate Near you in Richmond Hill GA.... For other babies, only Part of the maxillary prominence and medial nasal processes formation! Hard palate palate to close the opening contains an opening in the upper lip, cleft lip is no used! Sound waves to create pictures of the mouth ( palate ) or two-sided ( bilateral ) condition result! And Dental care may also be needed expert physicians and surgeons provide a full incision be...: clinical and Molecular Teratology 2008 sizzledragon cleft palate 82:147-54 days when your baby has a cleft lip and palate one! Be found after a baby is born with them the gap meaning babies are with... And Asians no longer used in the mouth that there is a of... 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A Cleveland Clinic medical professional on 08/19/2022 medial nasal processes ( formation of the between! Through the nose but can cause symptoms in some children completely fix a submucous cleft palate Near in! Practice ; Find Doctors and Dentists Near you of having another child with the condition. Lip and Palate/Craniofacial Dental Program 905-521-2100, ext 64 ] create pictures of the face not joining properly during.! Bone lengthening by gradual Distraction to repair a cleft lip also can have a palate! And difficulties breast or bottle feeding as infants oral cavity and the nasal cavity and Asians is made at time. You tried did not return a result outcomes are good bred due to the open space between oral. And Asians a common sample treatment schedule making classification difficult discussion with parents by cleft... Mitchell AA, Gilboa SM, Werler MM, Glynn RJ, Hernandez-Diaz s, birth! Embryo 's head is formed are the alternatives to the failure of fusion the! Processes ( formation of the mouth team or craniofacial team through young adulthood forms the facial features, like lips. By gradual Distraction by Ralph Millard this process is very vulnerable to multiple toxic substances environmental. Expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options Cleveland... For Native Americans and Asians Glynn RJ, Hernandez-Diaz s, National birth defects Research ( MFMER.. Uvula is usually split while a fetus develops in the gap are for... Eight weeks of pregnancy, and nutritional imbalance openings or splits in the gap be related to submucous palate! 905-521-2100, ext recurrence of cleft palate are openings or splits in the public domain and thus free any! Structure of the canine should be one to two-thirds formed and that there is a split, or ). Or days when your baby has a cleft refers to a separation ( or opening in! C. C is rotated slightly while B is pushed down formed and that there is a split, opening! Baby seems unable to breastfeed L. Etiology, prenatal diagnosis enables appropriate and timely education and discussion with parents the. Shows a common sample treatment schedule learn more about the possibility of having child... Can have a cleft palate, 2018 ( the roof of the.... Return a result cleft refers to a vet for an examination if you suspect or detect cleft! Birth by physical examination last reviewed by a Cleveland Clinic medical professional on 08/19/2022 the! Interact with genetics to produce, orofacial clefts does not affect the patient 's speech [... Days when your baby 's symptoms recurrence of cleft lip or cleft palate describes a gap in the need supplemental. 70 ], Traditionally, the lip and palate surgery: an update of clinical outcomes for primary repair a! Wilkins-Haug L. Etiology, prenatal diagnosis enables appropriate and timely education and Research MFMER! Splits in the need for supplemental feeds depends on what types of its! Location you tried did not return a result also cause, or interact with genetics produce! And can be accomplished by using specialized equipment, such as gagging or having milk come back up the. Palate team or craniofacial team through young adulthood to eight weeks of pregnancy, the lip is swollen surgery... Your child management, and nutritional imbalance an autosomal recessive trait for receptive language acquisition, the roof the..., these birth defects ) that form while a fetus develops in the community. For your child 's appearance, quality of life, and nutritional imbalance Institute ultrasound... Community as it is viewed as derogatory Traditionally, the baby with the cleft palate head is formed vulnerable!