Questions and Answers
What is the incidence of cleft lip and palate?
1 out of 750
What is the 4th most common congenital defect of the face?
Cleft lip and palate
List at least three factors to remember regarding cleft lip and palate.
- Studies depend upon birth certificates and birth defects are underreported. 2. More than half of all clefts are accompanied by at least one minor or major additional anomaly. 3. Difficult to identify presence of cleft lip +/- palate on a post hoc basis.
Unilateral clefts are more likely to occur on the ______ side.
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________ (males/females) are more vulnerable to cleft lip +/- palate; ________ (males/females) are more vulnerable to cleft palate alone.
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What is a cleft?
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Cleft lip and/or palate is the result of...
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Clefts can vary in length and width.
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Structures may be hypoplastic or __________.
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Congenital malformation that occurs in the ______ trimester of pregnancy.
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A cleft is due to a disruption in __________ development and follows __________ fusion lines.
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A cleft is often associated with malformations of the _______, _______, and _______ structures.
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What is the most popular system for classification of clefts?
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What does the primary palate include?
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Primary palate is also called ________ or ________.
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What does the secondary palate include?
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What is a submucous cleft?
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Clefts are usually discovered at birth.
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There are three signs of a submucous cleft palate, including a bifid uvula and _____.
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What is the main goal of cleft palate surgery?
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What are the types of clefts described?
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Most clefts follow the embryological suture lines of the ______ and ______.
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Study Notes
Incidence and Characteristics
- Cleft lip and palate occur in approximately 1 out of every 750 births.
- They are the 4th most common congenital facial defects.
Reporting and Anomalies
- Data on incidences often rely on birth certificates, leading to underreporting of clefts.
- Over 50% of clefts have additional minor or major anomalies.
- Challenges exist in identifying cleft presence after birth and accounting for undetected submucous clefts.
- Economic factors in healthcare can lead to reluctance in recognizing birth defects.
Gender Differences
- Males are more likely to be affected by cleft lip with or without palate.
- Females are more susceptible to isolated cleft palate.
Definition and Development
- A cleft is defined as an abnormal opening in normally closed structures, resulting from interrupted fetal development.
- Clefts can vary in length and width.
Classification of Clefts
- The most established classification system is based on embryological development and was proposed by Kernahan and Stark in 1958.
- The classification divides clefts into primary palate clefts and secondary palate clefts, using the incisive foramen as a dividing point.
Primary Palate Features
- The primary palate includes the area anterior to the incisive foramen, encompassing the lip and alveolus.
- It fuses around the 7th week of gestation; clefts can be complete or incomplete, unilateral, or bilateral.
Secondary Palate Characteristics
- The secondary palate extends posterior to the incisive foramen, encompassing the hard and soft palate.
- Clefts can be complete, incomplete, or submucous, with implications for structural and functional outcomes.
Effects of Clefts on Structures and Function
- Primary palate clefts may adversely affect the nose, leading to flattened features and altered columella.
- Secondary palate clefts may alter muscle orientations in the velum and affect speech, breathing, and ear health.
- Submucous clefts often go unnoticed until speech develops, affecting palatine structures without visible clefts.
Indicators of Submucous Clefts
- Signs include a blue discoloration (zona pellucida), bifid uvula, and a bony notch on the hard palate.
- Submucous clefts can lead to variable speech and hearing outcomes.
Treatment Approaches
- Prophylactic surgical correction of submucous clefts is generally not advised; intervention is often delayed until speech patterns are established.
- Surgical corrections aim to improve velopharyngeal function for optimal speaking capabilities.
Other Types of Clefts
- Facial clefts may result from failed neural crest cell migration, impacting facial processes and typically accompanied by other abnormalities.
- Types include oblique and midline clefts, showing a variety of severities.
Summary of Cleft Classifications
- Clefts are categorized based on structures involved, laterality, severity, and whether they exist in isolation or in combination with other anomalies.
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Description
This quiz covers key facts and definitions about cleft lip and palate. It highlights the incidence, classification, and factors associated with this congenital defect. Test your knowledge on important aspects of this medical condition.