Cleft malformations and malformation surgery

The most common congenital malformations in the head and neck region and malocclusions caused by them are treated and cared for by our experienced team. We have highly developed therapies and surgical techniques that ensure that hardly any scars are visible afterwards and that the face and dentition continue to develop in a healthy and harmonious way.

Patient videos – jaw

Patient videos – face

Malformation surgery

The most common congenital malformation in the head and neck region is the cleft lip, jaw and palate. Cleft lips, jaws and palates are the most common neonatal malformation, with one newborn with a cleft per 500 births. We can correct them so that almost no visible scars remain.

In the vast majority of cases, a cleft is detected during the ultrasound examination in pregnancy. We will be happy to advise you on this even before the birth of your child. Please simply make an appointment by calling +49 (0)69 8405-1380 or sending an e-mail

Cleft lip and jaw develop around the 30th day of development of the human embryo, cleft palate around the 60th day of development during pregnancy.

Cleft formations occur as a “freak of nature” – partly due to genetic predisposition and partly due to external factors such as X-ray radiation or the effects of medication. Even if there are cleft children in the parents’ families, this only slightly increases the probability that children will also have this malformation.

  1. Compensating for problems with suckling and drinking
    Shortly after the birth of your child with a cleft palate, an impression of the small upper jaw is taken and a drinking plate is made from it, which mechanically closes the cleft in the mouth. This supports the child when sucking on the mother’s breast or the bottle and also stimulates the tongue and its correct positioning.
  2. Ensure pressure equalisation and middle ear ventilation
    The muscles of the palate are interrupted by the cleft, so they cannot contract normally. As a result, pressure equalisation in the middle ear does not function correctly. (We perceive the pressure equalisation as a liberating “pop” in the ear, e.g. when diving, during take-off or landing in an aeroplane, or when we hold our nose while swallowing. Because the pressure equalisation and thus the middle ear ventilation does not function properly, an effusion of fluid can build up in the ear. This can thicken more and more over the years and lead to hearing loss due to subsequent fusion with the ossicular chain. For this reason, all affected children undergo regular ear, nose and throat (paediatric audiology) check-ups. Thanks to the modern technique of inserting a tube into the eardrum during the operation to close the cleft, this complication no longer exists today.
  3. Surgical cleft closure
    The operation for unilateral cleft closure is performed from the third month of life, as soon as your child has reached five kilograms of body weight and has become accustomed to life outside of mum.
    If a cleft is very wide, it may be necessary for lip repair via stitching and soft palate closure to be performed surgically first. Three months later, the cleft closure can be completed.
    Residual clefts of the upper jaw sometimes have to be closed later, at the age of 9-11 years, before the permanent canine tooth erupts. A lip-nose correction at around 16 years of age is only occasionally necessary.

Children with a Pierre Robin sequence are affected by reduced mandibular growth in the womb before birth. The causes of this condition are so far not known.

With this malformation, the palate cannot close in the posterior upper region due to the incorrect position of the tongue, and a wide, round cleft palate results from the failure of the palatal ridges to unite. This malformation is also treated directly after the birth of your child with a palate cover, identical to the cleft palate drinking plate, but which also carries a tongue spur which mobilises the tongue forwards with the lower jaw. This makes alternative therapies, such as surgical mandibular bone lengthening, initially unnecessary in the vast majority of cases. Due to the peculiarity of the recessed position of the lower jaw and the resulting restricted breathing, which takes place partly through the cleft palate, the surgery to close the palate is usually scheduled later.

Example of a course of treatment for the Pierre Robin sequence

Cleft rhinoplasties

Jaw realignments in cleft patients

These patients first had a jaw realignment followed by a lip and nose operation (lip rhinoplasty). Figure A shows the before and after comparison of the jaw realignment, Figure 1C, 1D, 2B and 2C show the patients before and after the lip rhinoplasty.

We treat bones with gentle ultrasound (demonstrated here on a raw egg)

Are you looking for help?

We will be happy to advise you on the possibilities of conservative or surgical treatment of your health problem affecting the mouth, jaw or facial area. We’re happy to help! You can reach the Landes & Kollegen Clinic and Ambulantory Surgery Center by telephone on +49 (0) 69 8405-1380 or by e-mail.

All planned surgical treatments are preceded by a detailed consultation, which can also take place several times and repeatedly.
We speak German, English, French, Spanish, Arabic and Portuguese.

Our regular office hours are:
Monday, Tuesday, Thursday: 8:00 – 17:00, Wednesday: 8:00 – 13:00, Friday: 8:00 – 16:00
as well as our fast-track consultations on Tuesday, Thursday and Friday, between 8:00 and 9:00 each day!

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