What is one reason why bilateral cleft of the lip and palate is considered the most severe?

Bilateral cleft of the lip and palate is considered the most severe primarily due to the lack of tissue available to facilitate proper closure and function of the lip and palate. This anatomical disruption significantly impacts various physical and functional aspects, including feeding, speech, and overall oral health. When there is a cleft on both sides, the tissue deficit is more pronounced, leading to more extensive surgical requirements and rehabilitation measures compared to unilateral clefts.

Addressing the cleft often requires multiple surgeries to repair the lip and palate, which are more complex in bilateral cases due to the greater extent of affected tissues. This lack of adequate tissue not only complicates surgical repair but can also result in more pronounced functional difficulties, making the management of bilateral clefts particularly challenging.