Cleft Lip and Palate

Question 1

The ________ is the most common malformation in the oral
and maxillofacial region.

Answer 1

Cleft lip and palate

Question 2

What problem does the scar tissue that forms in the palate after surgical procedures?

Answer 2

Restricted growth of maxilla

Question 3

Development of the upper lip is characterized by fusion of the
_______ with the _________ (4
to 7 Weeks of Gestation)

Answer 3

maxillary processes and medial nasal prominences.

Question 4

Cleft Lip develops when there is failure of fusion of medial nasal
process and maxillary processes in __-___ wk of gestations

Answer 4

4-7 weeks

Question 5

What muscle is most affected in cleft lip? Oriented parallel to edge of cleft?

Answer 5

Orbicularis oris

Question 6

What muscle is most affected in cleft palate? Oriented longitudinally

Answer 6

Levator veli palatini

Question 7

What muscle/ part of the oral cavity is altered causing escape of air into nasal cavity and problems during speech and swallowing?

Answer 7

Velum/Soft palate

Question 8

Primary palatal repair surgery that is performed to close the palatal cleft defect results in scar tissue formation of the soft palate (velum). This results in compromised function of the velopharyngeal mechanism.

During VPI, the velopharyngeal mechanism is incapable of separating the oral and nasal cavities during swallowing and speech.

Answer 8

Velopharyngeal incompetence

Question 9

What people group are more likely to have cleft lip and palate?1-4

Answer 9

Native americans, Asians, Caucasians, Africans

Question 10

Left or right side more common for cleft lip and palate?

Answer 10

Left

Question 11

• _________ is a treatment option provided for patient’s with complete cleft lip and palate (both unilateral and bilateral).

*treatment begins in the first week of life and lasts until the patient is going to undergo primary lip repair surgery( i.e in 3 to 4 months time).

• The main goal of treatment is to reduce the severity of the cleft prior to the Primary lip surgery by closing the gaps between the lips/alveolar ridge and also improving the symmetry of the nose.
• The treatment greatly helps the surgeon to perform the primary lip repair with more ease as there is less tension across the cleft margins following the Treatment. Subsequently, the patient has minimal postoperative scar and very favorable aesthetic result following the primary lip surgery.

Answer 11

Naso-alveolar molding

Question 12

What is the most commonly used flap to achieve proper lip position in cleft lip?

Answer 12

Millard’s rotation advancement flap

Question 13

What is the most common procedure done to close cleft palate?

Answer 13

Von Langenbeck Palatoplasty

Question 14

• __________ may be recommended to resolve
  velopharyngeal incompetence after patients prove unable to
  achieve significant speech improvements through speech therapy
  alone.
• Other requirements to qualify for the surgery include a short and
  immobile or easily fatigued palate.
  The goals of surgery are to eliminate the symptoms of
  hypernasality and eliminate audible nasal emissions without
  causing complete obstruction of the velopharyngeal port,
  allowing for nasal breathing and nasal resonance.
• has been the most common method for
  secondary management of VPI .

Answer 14

Pharyngoplasty

Question 15

• Done before eruption of the permanent canine
• Usually when the root of the canine is 1/3 to 2/3 formed
• Usually between ages 9 – 11 Yrs
• In CLP dental age is usually behind chronological age
• 3 layered closure (Nasal Layer, Bone graft and Oral Layer)
• Provide bone for the eruption and/or orthodontic repositioning of teeth
• Closure of oro-nasal fistulas
• Support and elevation of the alar base
• Stabilization of the pre-maxilla in bilateral cases
• Provide continuity of the alveolar ridge

Answer 15

Secondary alveolar bone grafting