Congenital Anomalies

Question 1

What is the reason behind UNILATERAL CLEFT LIP?

Answer 1

failure of fusion of frontonasal & right OR left maxillary processes

Question 2

What is the cause behind BILATERAL cleft lip?

Answer 2

failure of fusion of frontonasal & BOTH maxillary processes

Question 3

What is the reason behind cleft PALATE?

Answer 3

failure of fusion of both maxillary processes

Question 4

What type of congenital abnormality of orofacial structures has the highest incidence rate?

Answer 4

cleft lip & palate

Question 5

What is the etiology of cleft abnormalities?

Answer 5

• familial
• RUBELLA INFECTION
• protein & vitamin deficiency
• chromosomal

Question 6

What is the classification of cleft lip & palate?

Answer 6

• cleft lip alone
• cleft of primary palate (infront of incisive foramen)
• cleft of secondary palate (behind incisive foramen hard & soft palate)
• cleft of both primary & secondary palates
• cleft lip & cleft palate

Question 7

What are the types of cleft of primary palate?

Answer 7

COMPLETE: absence of pre-maxilla
INCOMPLETE: unilateral, bilateral, or median

Question 8

What are the types of cleft of secondary palate?

Answer 8

COMPLETE: nasal septum & vomer are separated from palatine process
INCOMPLETE: nasal septum is fused with one side

Question 9

What are the classifications of cleft lip?

Answer 9

INCOMPLETE -> doesn’t extend into nose
COMPLETE -> extends into nasal floor

SIMPLE -> only cleft in lip
COMPOUND -> cleft lip with cleft of alveolus

Question 10

What is the primary management of cleft lip/palate?

Answer 10

GENERAL

• antenatal diagnosis
• feeding
• airway

OPERATIVE

• timing
• TTT of cleft lip
• TTT of cleft palate

Question 11

What is the secondary management for cleft lip/palate?

Answer 11

• hearing problems
• speech problems
• dental problems
• SECONDARY SURGERIES for lip & nasal deformities

Question 12

What are the timings of primary procedures for cleft lip alone?

Answer 12

Unilateral OR bilateral -> one operation at 6 MONTHS

Question 13

what are the timings of primary procedures for cleft palate alone?

Answer 13

SOFT PALATE ONLY -> one surgery at 6 months

SOFT & HARD PALATE -> 2 surgeries (soft at 6 months & hard at 15-18 months)

Question 14

What are the timings of primary procedures for cleft lip & palate?

Answer 14

Unilateral OR bilateral -> 2 operations

• cleft lip & soft palate at 6 MONTHS
• hard palate & gum at 15-18 MONTHS

Question 15

How is the palate reconstructed?

Answer 15

PALATOPLASTY

Question 16

What is the most common congenital anomaly of the urethra?

Answer 16

HYPOSPADIAS

Question 17

What are the characteristic features of hypospedias?

Answer 17

• external meatus opens on underside of penis or perineum
• ventral aspect of prepuce is poorly developed (HOODED)
• deformity of erect penis due to CHORDEE instead of urethra

Question 18

What is the most common type of hypospadias?

Answer 18

GLANDULAR

- ectopic meatus is on glans penis

Question 19

Meatus placed on underside of the glans & the body of penis will result in which type of hypospadias?

Answer 19

CORONAL HYPOSPADIAS

Question 20

meatus opens on underside of penile SHAFT will result in?

Answer 20

PENILE & PENSCROTAL HYPOSPADIAS

Question 21

What type of hypospedias makes it difficult to determine sex of child?

Answer 21

PERINEAL HYPOSPADIAS

- most severe

Question 22

What is the aim of treatment of hypospadias and when is it best performed?

Answer 22

• improve sexual function
• correct problems wit urinary system
• cosmetic reasons

BEFORE AGE OF ONE YEAR

Question 23

What is the procedure of treatment of hypospadias?

Answer 23

• removal of the chordee
• urethral reconstruction using the foreskin

CONTRA INDICATION FOR CIRCUMCISION