Cleft Lip and Palate - 2.3

Cleft Lip and Palate Development

• Develops between weeks 6-12 of gestation
• Fusion of facial processes occurs during this time

Types of Cleft Lip and Palate

• Cleft lip with or without cleft palate
• Cleft palate only
• Submucous cleft palate

Causes of Cleft Lip and Palate

• Multifactorial etiology
• Genetic predisposition
• Environmental factors
• Maternal smoking
• Alcohol consumption
• Certain medications
• Folic acid deficiency

Epidemiology

• More common in males than females
• Higher incidence in certain ethnic groups
• Rates vary geographically

Microform Cleft

• Dent in the lip and a scar from the lip to the nostril
• May affect muscle tissue and require surgery

Submucous Cleft Palate

• Midline deficiency or lack of muscular tissue
• Often associated with a bifid or cleft uvula

Problems Associated with Cleft Lip and Palate

• Feeding difficulties
• Speech impairments
• Ear infections
• Dental problems

Dental Problems

• Missing teeth
• Malocclusion
• Tooth decay
• Gum disease
• Delayed eruption of permanent teeth

Orthodontic Issues

• Overjet
• Crossbite
• Open bite

Prenatal Diagnosis

• Ultrasound
• Amniocentesis

Management of Cleft Lip and Palate

• Birth:
  • Feeding support
  • Medical evaluation
• 10 weeks:
  • Nasal obstruction assessment
  • Ear, nose, and throat (ENT) evaluation
• 3 months:
  • Lip repair surgery
  • Speech therapy referral if required
• 1-3 years:
  • Palate repair surgery
  • Speech therapy
  • Dental evaluation
  • Hearing assessment
  • Psychological support
• 3-6 years:
  • Further dental evaluation
  • Dental treatment as needed
  • Speech therapy ongoing
• 8-9 years:
  • Orthodontic evaluation and treatment
  • Speech therapy if needed
• 10 years:
  • Secondary palate repair surgery
• 12-14 years:
  • Orthodontic treatment continued
  • Speech therapy as needed
• 17-20 years:
  • Orthognathic surgery (if necessary)
  • Dental work as needed

Surgery for Cleft Lip and Palate

• Primary Repair Surgery:
  • Performed when the child weighs at least 10 lbs
  • Haemoglobin level of at least 10g
  • White blood cell (WBC) count of no more than 10,000
  • At least 10 weeks old

Orthognathic Surgery

• Corrects jaw position and alignment
• Performed in late adolescence or adulthood
• May improve facial appearance and function
• May involve jaw bone repositioning and reshaping

This quiz covers the development, types, and causes of cleft lip and palate. It also addresses epidemiology, associated problems, and the concept of microform clefts. Test your knowledge on this important topic in craniofacial abnormalities.