Cleft Palate And Lip Flashcards
(36 cards)
Cleft palate and lip palate
Physical Challenges of Clefts Through the Lifespan
Development of the Face and Palate
Cleft Lip and Palate Classification Systems
Clinical Features of Clefts
Etiologies of Clefts
Incidence of Clefts
Sex and Racial Differences
The Cleft Palate Team and General Management Issues Through The Lifespan
Communication Problems Associated with Clefts
Craniofacial anomalies
*Congenital malformations involving the head
and face
Clefts
Abnormal openings in anatomical structures
Velopharyngeal Incompetence (VPI)
Velopharyngeal Mechanism does not close adequately
Clefts interfere with basic biological functioning and communication
Birth
Obstruction of breathing
*Difficulty with food intake
3 months
3 months
*Clefts of the Lip are surgically closed
*Monitored for ear infections
9-12 months
9-12 months
*Surgeons close clefts of the palate
*Secondary surgery may be required later
2 years
2 years
*Correction of dentition
Later orthodontic treatment
Facial Development
Facial Development
*5-8 weeks gestation: Face/anterior aspects
*Mandibular processes: Mandible/lower lip
*Frontonsal processed: Nasomedian processes and lateral nasal processes
*Olfactory Pits
*Maxillary processes
*Clefts of the lip: Fusion is
interrupted or teratogens
Development of the Secondary Palate
Development of the Secondary Palate
*8-12 weeks gestation: Processes of hard and
soft palate fuse
*Palatal Shelves
*Nasal Septum
*Clefts of the palate. Fusion of palatal shelf is interrupted
Veau System
Veau System
*Quick general Reference
*Nature and extent of Clefts
In this system, you classify clefts into four different classes.
1) Cleft of the soft palate only.
2) Cleft of the hard and soft palate
3) Complete unilateral cleft of the soft and hard palate and on the lip and alveolar ridge on one side.
4) Complete bilateral cleft of the soft and hard palate and/or the lip and alveolar ridge on both sides.
Kernahan’s Striped Y-
Kernahan’s Striped Y-a visual identification system based on location, and developed by the American Cleft Palate Association (ACPA) focuses on the primary and secondary palates.
Clefts are commonly classified
*Unilateral or bilateral cleft of the lip
*Unilateral or bilateral cleft of the palate
*Bilateral cleft or the lip and palate
*Submucous Cleft
*Bifid Uvula
Cleft of the lip
Involves vermillion of the upper lip and can extend to nostril
Incomplete cleft
Complete cleft
Flattened nose, flaring nostril
Columella short, misaligned
Most commonly on left side (unilateral)
If bilateral, usually cleft palate also
Isolated cleft of the lip is rare
Unilateral complete cleft of lips and palate extend
Unilateral complete cleft of lip and palate extends
*External portion of upper lip
*Through alveolus
*Through hard and soft palate
Clefts of secondary palate alone vary in severity
Bilateral cleft of the upper lip
Most severe because of lack of tissue
Features
*Lip and alveolar processes clefted under each nostril
*Abnormal position of
**Prolabium, alveolar processes, premaxilla
*Columella, usually absent
**Tip of nose attaches to lip
Nasal Septum not attached to palatal shelves
Submucous cleft
Cleft of the muscular region of the soft palate Thin layer of mucosal tissue covers cleft
May not be detected until later
Bifid Uvula
Zona pellucida
Notch on posterior border of hard palate Velopharyngeal Incompetence
Genetic Disorders
Genetic Disorders
*Account for substantial percentage of clefts Syndromes
*Pierre Robin Syndrome (Robin sequence)
*Treacher Collins Syndrome
*Velocardiofacial Syndrome
*Apert Syndrome
Chromosomal Aberrations
*Trisomy 13
*Multiple Congenital Abnormalities
Pierre Robin syndrome
Micrognathia
Isolated cleft of the hard and soft palate Congenital Heart Problems
Digital Abnormalities
Conductive Hearing Loss
Retracted and elevated tongue
Delayed language
Teacher Collins syndrome
Malar hypoplasia
Conductive hearing loss
Cleft palate
Projection of scalp hair onto the cheek Communication Problems
Velocardiofacial syndrome
Language deficits
Learning Disabilities
Cleft Palate
Small stature with broad, flatten nose Underdeveloped cheek bones
Heart Problems
Communication problems
Apert syndrome
Craniosynostosis
Syndactyly
High and narrow arched palate Clefts occur is 30% of
People with Apert
Expressive language
delay
Chromosomal aberration
Trisomy 13 results in cleft lip with or without cleft palate in 60-70% of cases
Teratogenically Induced Disorders
Teratogenically Induced Disorders
Recognized teratogens
**Dilantin, thalidomide, excessive aspirin use,
excessive use of alcohol, caffeine, nicotine
**X-rays, viruses, environmental substances
