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    Cleft Lip & Palate

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    Mahsa
    This document provides an overview of cleft lip and palate. It describes the embryology, causes, classifications, complications and treatments. Cleft lip and palate is a congenital abnormality where there is a space or gap in the upper lip, alveolus and/or palate. It occurs when the facial prominences fail to fuse properly during embryonic development. Treatments include surgery to repair the cleft lip and palate at various stages of development, as well as subsequent procedures to address dental, speech and nasal issues. The goal of treatment is to restore normal form and function.

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    Cleft Lip & Palate

    Uploaded by

    Mahsa
    84 views13 pages
    This document provides an overview of cleft lip and palate. It describes the embryology, causes, classifications, complications and treatments. Cleft lip and palate is a congenital abnormality where there is a space or gap in the upper lip, alveolus and/or palate. It occurs when the facial prominences fail to fuse properly during embryonic development. Treatments include surgery to repair the cleft lip and palate at various stages of development, as well as subsequent procedures to address dental, speech and nasal issues. The goal of treatment is to restore normal form and function.

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    This document provides an overview of cleft lip and palate. It describes the embryology, causes, classifications, complications and treatments. Cleft lip and palate is a congenital abnormality where there is a space or gap in the upper lip, alveolus and/or palate. It occurs when the facial prominences fail to fuse properly during embryonic development. Treatments include surgery to repair the cleft lip and palate at various stages of development, as well as subsequent procedures to address dental, speech and nasal issues. The goal of treatment is to restore normal form and function.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    84 views13 pages

    Cleft Lip & Palate

    Uploaded by

    Mahsa
    This document provides an overview of cleft lip and palate. It describes the embryology, causes, classifications, complications and treatments. Cleft lip and palate is a congenital abnormality where there is a space or gap in the upper lip, alveolus and/or palate. It occurs when the facial prominences fail to fuse properly during embryonic development. Treatments include surgery to repair the cleft lip and palate at various stages of development, as well as subsequent procedures to address dental, speech and nasal issues. The goal of treatment is to restore normal form and function.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 13

    Cleft lip & palate

    Maxillofacial Surgery
    Children & Adolescent
    10thSemester
    Koorosh Arshi
    Introduction
    ● Congenital abnormal space or gap in the upper lip, alveolus & palate.
    ● Most common of the craniofacial anomalies.
    ● Clefts of the lip occur more commonly in males than in females.
    ● Left side are more involved than right side.
    ● unilateral cleft lips are more common than the bilateral cleft of the lip.
    ● Bilateral clefts of the lip are most often associated with clefting of both
    the primary and secondary palates.
    Embryology
    ● At approximately 6 weeks of embryologic development the median nasal
    prominence fuses with the lateral nasal prominences and maxillary prominences
    to form the base of the nose, nostrils, and upper lip (primary palate).
    ● When this mechanism fails, clefts of the lips occur.
    ● At approximately 8 weeks the palatal shelves elevate and fuse with the septum
    to form the intact secondary palate.
     When one palatal shelf fails to fuse with the other components, then a unilateral
    cleft of the secondary palate occurs.
     If both of the palatal shelves fail to fuse with each other and the midline septum,
    then a bilateral cleft of the palate occurs.
    Classification
    ● Isolated cleft lip
    ● Cleft lip & palate:
     Unilateral or bilateral
     Complete or incomplete
    ● Isolated cleft palate
    Cleft lip classification

    ● Class I: a unilateral notching of vermilion not


    extending into lip.
    ● Class II: a unilateral notching of vermilion border,
    with cleft extending into lip but not including the
    floor of the nose.
    ● Class III: a unilateral clefting of the vermilion border
    of the lip extending into the floor of the nose.
    ● Class IV: any bilateral clefting of the lip, whether it
    be incomplete notching or complete clefting.
    Veau Classification cleft lip & palate
     Class I : Defects of the soft palate only
     Class II : Defects involving the hard palate and soft palate.
     Class III : Defects involving the soft palate to the alveolus
    on one side, usually involving the lip.
     Class IV : Defects involving both soft and hard palates
    and continues through the alveolus on both sides.
    Etiology
     Main cause is unknown.
     Multiple factors:
     Genetic
     Chemical exposures: alcohol consumption , smoking
     Radiation
     maternal hypoxia
     Teratogenic drugs: Retinoic acid, anti epileptic drug ,methotrexate
     Nutritional deficiencies : folic acid & vitamin A deficiency
     Physical obstruction,
     Infections: rubella virus during pregnancy
     Syndromes are associated cleft palate & lip: Vander Woude’s syndrome,
    Treacher collins syndrome , Pierre Robin syndrome .
    COMPLICATIONS
    ● Difficulty in Feeding:
    ● Cleft Palate may cause formula or breast milk to be accidently taken up
    into the nasal cavity
    ● Inability to create negative pressure inside oral cavity
    ● Frequent nasal regurgitations
    ● inefficient handling of secretions and foodstuffs
    ● Upper respiratory tract infections
    ● Dental problems:
    ● Congenitally Missing teeth, Hypodontia , crowding
    ● Poor periodontal support, early loss of teeth
    ● Nasal Deformity , Esthetic
    ● Hearing issue & Recurrent otitis media
    ● Speech Difficulties: Velopharyngeal Insufficiency (VPI)
    Diagnosis
    ● Ultrasound imaging: Currently ultrasound images of clefts of the lip can
    be visualized as early as 16 weeks.
    ● Clinically evident at the birth
    ● MRI: evaluation of associated extra/intracranial abnormalities
    Treatment planning & Timing
    ● Use special nipples to allow the baby for feeding properly
    ● Primary cleft lip repair : After 10 weeks (3 months)
    ● Cleft palate repair : 9–18 months
    ● Pharyngeal flap or pharyngoplasty: 3–5 years or later
    based on speech development
    ● Maxillary/alveolar reconstruction with bone grafting: 6–9
    years based on dental development
    ● Cleft orthognathic surgery: 14–16 years in girls, 16–18
    years in boys
    ● Cleft rhinoplasty: After age 5 years but preferably at
    skeletal maturity; after orthognathic surgery when possible
    ● Cleft lip revision: Anytime once initial remodeling and scar
    maturation is complete but best performed after age 5 years
    Cleft Lip Repair Cleft Palatal Repair Pharyngeal flap or pharyngoplasty

    Maxillary/alveolar reconstruction with bone grafting Cleft rhinoplasty Cleft lip revision
    Cleft orthognathic surgery
    Thanks

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