A kinder treatment for cleft lip and palate

Every year, 1,000 babies are born with a cleft lip or palate – a gap in the lop of roof of the mouth. Dr Richard Shelton and his team from the University of Birmingham, will develop and test a kinder treatment for the condition.

Dr-Shelton-laboratory

In March, Sparks awarded £147,000 to Dr Shelton and his team to work on a pioneering treatment to correct cleft lips and palates.

The ultimate aim of the research is to close the gap in the roof of the mouth, with a special material that will grow with children, reducing the need for multiple operations and improving the lives of children and families affected.

The team are testing a state-of-the art technique using hydrogels – a solid, jelly-like material. “What we’re looking to do is find a hydrogel that’s liquid at room temperature but solid at body temperature,” says Dr Shelton. “As a liquid it can be injected into the jaw, then at body temperature it sets to provide support to the edges of the wound.”

But the hydrogel won’t just ‘close up’ the cleft. It contains special cells reprogrammed to form bone tissue.

Gaps in the lip and palate tend to be treated with surgery in the first year of life. Then, if the cleft involves the gum, there’s usually another operation around the age of eight.

“Typically, that requires using bone from the patient’s own hip,” says Dr Shelton. “Removing bone from the hip of an eight-year-old obviously causes pain and unpleasantness, and they’re left with another scar.”

“We’re hoping we can take the patient’s own cells, either from the umbilical cord at birth or during an operation, grow and freeze them until they’re needed, and add them to the gel. The idea is that over time the child’s own tissue will grow from the cells and eventually completely replace the hydrogel.”

Developing tomorrow’s treatments

As far as Dr Shelton is aware this process has never been used to treat cleft palate. This exciting research came about following his conversations with surgeons about the challenges they faced working with babies and children with the condition.

“Our laboratory used to be in the centre of Birmingham, right next to the children’s hospital,” says Dr Shelton. “We had regular research meetings with the cleft lip and palate surgeons and asked: “What would be the one thing that would help you in this area?” The answer was: a setting gel that could deliver cells to help avoid a later, more painful operation for children and hopefully improve their lives.”

Preventing pain and discomfort So could this research be the first step to preventing a major operation?
Dr Shelton believes so. “Finding an alternative like this could help avoid huge difficulties for children later in life.”

Facts about cleft lip and palate

  • Babies can be born with a cleft lip, a cleft palate, or both.
  • The gap is there because parts of the baby’s face didn’t join together properly during development in the womb.
  • No one knows exactly what causes a cleft. Research shows it’s often caused by a combination of different genetic and environmental factors.
  • It can be difficult for babies with a cleft lip or palate to feed.
  • A cleft palate can make speech sound nasal or make certain sounds unclear.
  • Many children with a cleft palate will have issues with their hearing and can have a higher risk of tooth decay because of the position or shape of some of their teeth.
  • As well as physical problems, they may face bullying and teasing, and have difficulties building confidence and self esteem.

More information
Cleft Lip and Palate Association website
NHS Conditions

Research is still at an early stage, but Dr Shelton is hopeful it could lead to a new standard treatment for cleft lip and palate. “We’ve already done a fair amount of research with bone marrow cells and hydrogels. Now it’s about testing a range to identify which is the most suitable and effective.”

This research has been made possible by funding from Sparks. “The support from Sparks is incredibly important,” says Dr Shelton. “It means we can further develop research that could lead to a solution for many thousands of patients in the long run.”

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