Cleft Lip and Cleft Palate - 2

Prepared by :LOBNA HASSAN
Under supervision of dr prof :

Madeha ameen
 Definition
 Cleft lip and palate are birth defects that affect the
upper lip and the roof of the mouth.

congenital deformity caused by abnormal facial development
during gestation. A cleft is a
fissure or opening—a gap. It is the non-fusion of the body's
natural structures that form before birth
Causes
 Problems with genes passed down from one or both parents
 , drugs, viruses
 Enviromental factor/
1. Mother exposed to hypoxia during early prgnancy
2. Maternal smoking*alcohol abuse
3. Hypertension treatment
4. Diet and vitamin intake VIT A
5. Anticonvulsant drugs
symptoms
 Change in nose shape (amount of distortion varies)
 Failure to gain weight
 Feeding problems
 Flow of milk through nasal passages during
feeding
 Misaligned teeth
 Poor growth
 Recurrent ear infections
 Separation of the lip alone
 Separation of the palate
 Separation of the lip and palate
 Speech difficulties

]
 Lip cleft can occur as a one sided (unilateral) or

two sided (bilateral). It is due to the failure of
fusion of the maxillary and medial nasal processes
(formation of the primary palate).
Same girl, age 8. Note how the scar almost gon

6 month old girl before going into surgery. The same girl, 1 month after the surgery.
Medical management team
 Treating cleft lip or cleft palate takes a team of different
types of specialists (in this case, people who are experts in
helping kids with clefts). This team includes
 a plastic surgeon,
 a speech-language pathologist,
 an orthodontist,
 an otolaryngologist (a doctor trained in ear, nose, and
throat problems — say oh-toh-lar-un-gah-lo-jist),
a dentist,
 a geneticist,
 a social worker,
 a psychologist,
 an audiologist
 Cleftlip is usually repaired by the time a baby is 3
to 6 months old. During surgery on the cleft lip,
the doctor closes the gap in the lip and corrects the
nostril. A person who has cleft lip repaired as an
infant will have a scar on the lip under the nose
 Cleft palate is usually repaired at age 9 to 12
months. During surgery on cleft palate, doctors
close the hole between the roof of the mouth and
the nose and reconnect the muscles in the soft
palate. Palate cleft can occur as complete
(soft and hard palate, possibly including a gap in the jaw)
or incomplete
a 'hole' in the roof of the mouth, usually as a cleft soft palate).
 After surgery, a kid will get regular hearing tests to
check for hearing problems caused by fluid
building up in the ears. Because of this fluid build-
up, some kids get special tubes put in their ears to
help them hear well. Kids may also need speech
therapy when they start talking. Some kids with
cleft palate might even need another operation on
their palate to improve their speech
 Lots of kids, including those with cleft lip or palate, need
orthodontics or braces after their permanent teeth grow in.
Braces can straighten crooked teeth. Kids with cleft lip
and cleft palate may also need a bone graft when they're
about 8 years old. In a bone graft, a surgeon takes some
bone, usually from the person's hip, and uses it to fill in
the gap in the upper gum area. This allows the upper gum
area to hold the permanent teeth better and keep the upper
jaw steady
 As kids with cleft lip or cleft palate grow older and
become teenagers, some may want to have their
scars made less noticeable, their jaws aligned, or
their noses straightened. Operations to do these
can improve a person's bite, speech and breathing,
and appearance
 Living With Cleft Lip or Cleft Palate
 Some kids with severe cleft lip or cleft palate have
a flattened nose or small jaw. Other kids with just
cleft palate may look just like everyone else.
Either way, kids with cleft lip or cleft palate want
to be treated like everyone else. A person might
have cleft lip, but also have beautiful eyes, a great
sense of humor, or a terrific slam-dunk
 If you have cleft lip or cleft palate, there may be
some things about your face you can't change and
some that you can. Doctors can do amazing things
to make you feel good about the way you look on
the outside, and you can do things to make
yourself feel good about the way you are on the
inside
 Even with the many successful operations and treatment
for cleft lip and palate, some kids have a hard time
growing up with this condition. They may have classmates
who tease or bully them or who are just curious and want
to know more about it. In either case, kids with clefts can
get help handling these situations by speaking with their
parents, teachers, or counselors, and of course, any
member of their cleft palate team. The good news is that
most kids with cleft lip or cleft palate grow up to be
healthy, happy adults
complication
 Dental cavities
 Displaced teeth
 Hearing loss
 Lip deformities
 Nasal deformities
 Recurrent ear infections
 Speech difficulties
Nursing interventions
 Feeding my baby with cleft palate
 After the surgery for cleft lip
 After the surgery for cleft palate:
 Diet after surgery
 Activity after surgery
 Psychosocial issues
Having a cleft palate/lip does not inevitably lead to
a psychosocial problem. Most children who have their clefts repaired
early enough are able to have a happy youth and a healthy social life.
howeveris important to remember that adolescents with
cleft palate/lip are at an elevated risk for developing psychosocial
those relating to self concept, peer relationships

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Cleft Lip and Cleft Palate - 2

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Prepared by :LOBNA HASSAN

Under supervision of dr prof :

 Lip cleft can occur as a one sided (unilateral) or

Same girl, age 8. Note how the scar almost gon

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