Classification of Cleft Lip and Palate Flashcards

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.

left Signup and view all the answers

(males/females) are more vulnerable to cleft lip +/- palate; (males/females) are more vulnerable to cleft palate alone.

males; females Signup and view all the answers

What is a cleft?

An abnormal opening or a fissure in an anatomical structure that is normally closed. Signup and view all the answers

Cleft lip and/or palate is the result of...

Parts of the lip and/or roof of the mouth not coming together or fusing normally during fetal development. Signup and view all the answers

Clefts can vary in length and width.

True Signup and view all the answers

Structures may be hypoplastic or __________.

underdeveloped Signup and view all the answers

Congenital malformation that occurs in the ______ trimester of pregnancy.

first Signup and view all the answers

A cleft is due to a disruption in development and follows fusion lines.

embryological; normal embryological Signup and view all the answers

A cleft is often associated with malformations of the ___, _, and _____ structures.

nose, eyes, and other facial structures Signup and view all the answers

What is the most popular system for classification of clefts?

Based on embryological development (Kernahan and Stark, 1958): Clefts of the primary palate, Clefts of the secondary palate, Incisive foramen as the dividing point. Signup and view all the answers

What does the primary palate include?

The lip and alveolus, anterior to the incisive foramen. Signup and view all the answers

Primary palate is also called or .

prepalate or intermaxillary segment Signup and view all the answers

What does the secondary palate include?

The hard palate and soft palate, posterior to the incisive foramen. Signup and view all the answers

What is a submucous cleft?

The oral mucosa is intact, but the underlying velar musculature has failed to attach at midline. Signup and view all the answers

Clefts are usually discovered at birth.

False Signup and view all the answers

There are three signs of a submucous cleft palate, including a bifid uvula and _____.

zona pellucida Signup and view all the answers

What is the main goal of cleft palate surgery?

To correct the orientation of the muscles in order to achieve normal function. Signup and view all the answers

What are the types of clefts described?

Midline cleft Signup and view all the answers

Most clefts follow the embryological suture lines of the and .

lip and palate Signup and view all the answers

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.