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    Cleft Lip and Cleft Palate

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    Devendra Kumar Munta
    This document discusses cleft lip and cleft palate, including the embryology, classification, problems caused, and treatment approaches. It notes that clefts occur when processes that form the lip and palate do not properly fuse during development in the embryo. Clefts can involve just the lip, just the palate, or both. Treatment involves surgery to repair the cleft, with the timing and techniques varying depending on the specific type and location of the cleft. Addressing feeding difficulties and speech problems is also important.

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    Cleft Lip and Cleft Palate

    Uploaded by

    Devendra Kumar Munta
    376 views30 pages
    This document discusses cleft lip and cleft palate, including the embryology, classification, problems caused, and treatment approaches. It notes that clefts occur when processes that form the lip and palate do not properly fuse during development in the embryo. Clefts can involve just the lip, just the palate, or both. Treatment involves surgery to repair the cleft, with the timing and techniques varying depending on the specific type and location of the cleft. Addressing feeding difficulties and speech problems is also important.

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    This document discusses cleft lip and cleft palate, including the embryology, classification, problems caused, and treatment approaches. It notes that clefts occur when processes that form the lip and palate do not properly fuse during development in the embryo. Clefts can involve just the lip, just the palate, or both. Treatment involves surgery to repair the cleft, with the timing and techniques varying depending on the specific type and location of the cleft. Addressing feeding difficulties and speech problems is also important.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    376 views30 pages

    Cleft Lip and Cleft Palate

    Uploaded by

    Devendra Kumar Munta
    This document discusses cleft lip and cleft palate, including the embryology, classification, problems caused, and treatment approaches. It notes that clefts occur when processes that form the lip and palate do not properly fuse during development in the embryo. Clefts can involve just the lip, just the palate, or both. Treatment involves surgery to repair the cleft, with the timing and techniques varying depending on the specific type and location of the cleft. Addressing feeding difficulties and speech problems is also important.

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    CLEFT LIP & CLEFT

    PALATE
    CONTENTS
     EMBRYOLOGY
     CLASSIFICATION

    - CLEFT LIP
    - CLEFT PALATE
     PROBLEMS WITH CLEFT LIP &

    PALATE
     TREATMENT
    EMBRYOLOGY
     Face is formed by 5 processes which
    surround the opening- ‘stomodeum’
     These 5 processes are:

    - Frontonasal Process (single process)


    - Maxillary Processes (one on each
    side)
    - Mandibular Process (one on each
    side)
     Frontonasal process-divided into a
    central part called Median nasal
    process (MNP) & 2 Lateral nasal
    processes (LNP) ,by olfactory pits.
    - Olfactory pits form nostrils
    - MNP develops a ‘globular process’
    on each side.
    -MNP & Globular process form,
    1.Septum of nose
    2. Philtrum of upperlip
    3. Premaxilla
    - LNP forms side of the nose.
     Maxillary Process-forms,
    1.Cheek
    2.Whole upperlip except the
    philtrum
    3.Most of the upper jaw
    4.Palate
     Mandibular process-forms lower jaw.
     The ‘upper lip’ is thus formed
    centrally from the superficial part of
    MNP (Philtrum) ,lateral part is
    formed by Maxillary process from
    each side which fuses with MNP.
     Therefore defect in fusion of MNP
    with Maxillary process will lead to
    development of ‘Cleft lip.’
     The Palate develops from 3
    components:
    - premaxilla
    - 2 palatine process of maxilla
    come from each side and fuse in the
    centre. The line of fusion is ‘Y’
    shaped, and defect in this leads to
    Cleft palate.
    CLEFT LIP
     Developmental error in the formation of
    the upper lip will lead to the formation of
    cleft lip.
     Classification (A)

    CLEFT LIP

    INCOMPLETE COMPLETE
    CLEFT LIP
    (B)

    CENTRAL LATERAL

    UNILATERAL BILATERAL
    Unilateral complete Unilateral incomplete

    Bilateral
    complete
    UNILATERAL CLEFT LIP
    (C)
    CLEFT
    LIP

    SIMPLE COMPOUND
    (D)

    CLEFT LIP

    UNCOMPLICATED COMPLICATED
    CLEFT PALATE
     It is due to failure of fusion of premaxilla
    and 2 palatine process.
     Classification:

    CLEFT
    PALATE

    COMPLETE INCOMPLETE
    Incomplete cleft palate Unilateral complete Cleft
    lip and palate

    Bilateral complete cleft


    lip and palate
    BILATERAL COMPLETE CLEFT

    LIP& PALATE
    UNILATERAL COMPLETE
    CLEFT LIP & PALATE
    PROBLEMS WITH CLEFT LIP
     Cosmetic problem
     Difficulty in sucking
     Defective Dentition
     Defective Speech-
    esp., with labial
    words like ‘B’, ‘F’,
    ‘M’, ‘P’, ‘V’
     Deformed nostril
    Root development of
    permanent lateral incisor
    in cleft lip &palate
    Root development of permanent lateral incisor in
    cleft lip & palate children:
    PROBLEMS WITH CLEFT
    PALATE
     Difficulty in sucking
     Difficulty in eating-due to
    regurgitation of food into nose
     Difficulty in speech- cannot
    pronounce palatal consonents like
    B,D,K,P,T.
     Recurrent otitis media leading to
    deafness.
    A baby being fed
    using the Cleft
    Nurser by Mead
    Johnson.
     Dental problems
     Defect in smelling
     Repeated respiratory tract infections

    There are chances of aspiration


    bronchopnuemonia.
    TREATMENT
    (A) Treatment of cleft lip:
     Optimum time for repair is at the
    age of 3 months when the baby is 5
    to 6 kg wt. This is always
    performed before the time for
    primary dentition to avoid defective
    dentition.
     Technique of surgery- ‘Mirault Blair
    operation.’
     Postop care- Suture are removed on
    5th post op day . Pt’s hands should be
    fixed in splints , so that he will not
    be able to touch the operation site.
    6 month old girl
    before going into The same girl,1 month after
    surgery the surgery.
    Again the same girl, age 5.4 years
    old
    B) Treatment for cleft palate:
     Optimum time for surgery is at the
    age of 1 to 1 ½ yrs i.e., before the
    child acquires bad habit of nasal
    speech.Too early repair may lead to
    maldevelopment of maxillae in later
    life.so closure of hard palate defect
    should not be performed till the time
    of secondary dentition
     Type of Surgery
    -Langenbeck’s operation
    -Wardill’s Operation
     An infant with a cleft palate will have
    greater success feeding in a more
    upright position. Gravity prevents
    regurgitation
     Gravity feeding can be accompanied

    By using specialized equipment like


    Habermann Feeder.

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