1.3 - Cleft Lip +/- Palate Flashcards
What kind of disorder is Cleft Lip +/- Palate?
2
Multi-factorial Inheritance:
Disorder caused by interaction of multiple genes with environmental influences
How frequently do clefts occur?
1 in 595 births
CDC, 2006
How many Clefts are Lip only?
How many of these are Unilateral?
How many are on the Left Side?
25% lip only
80% are unilateral
70% of the time it is on the left)
How many Clefts are Palate only?
25% palate only
How many Clefts are Lip + Palate?
50% lip and palate
In which Ethnicity are clefts most common?
Which Ethnicities are the next common? (3)
Native Americans
Asians -> Caucasians -> African Americans
Which Gender experiences more Combination Clefts (Lip + Palate)?
Males
Which Gender experiences more Severe Forms of cleft?
Males
Which Gender experiences more Palatal Clefts?
Females
What percentage of individuals with Cleft have at least one other abnormality?
14-15%
Varies based on cleft type
What percentage of individuals with Cleft of the Lip Only have at least one other abnormality?
7%
What percentage of individuals with Cleft of the Lip + Palate have at least one other abnormality?
14%
What percentage of individuals with Cleft of the Palate Only have at least one other abnormality?
24%
How does Parental Age affect the risk of Cleft?
No direct effect
How does Birth Order affect the risk of Cleft?
No direct effect
What is the Etiology of Cleft?
2
Cause of birth defect is due to Multifactoral Inheritance:
Predisposition is exasperated by environmental factors
(Genetic + Environmental)
How does Genetics/Family History increase one’s risk of Cleft?
If mother or father has cleft palate and one child already has cleft palate, next child is 17% likely to have cleft palate!
What Environmental Factors/Teratogens increase one’s risk of Cleft?
(4)
Drugs (Valium, dilantin, acutane)
Smoking
Insufficient folic acid
Maternal diabetes
How many Clefts are estimated to be due to Inheritance?
20%
How many Clefts are estimated to be due to Chromosomal Influences?
3-5%
How many Clefts are estimated to be due to Environmental Factors or Unknown?
65%
What is a Complete Cleft?
What does it include? (4)
Goes all the way into nose
//
Lip
Alveolus
Hard palate
Velum
At what point is development interrupted to cause a Complete Cleft?
Before the 9th week
What is a Incomplete Cleft?
Doesn’t go into the nose entirely
At what point is development interrupted to cause a Incomplete Cleft?
During 9th week
What is a Unilateral Incomplete Cleft of the Lip Only?
An incomplete cleft on one side only
What is a Bilateral Incomplete Cleft of the Lip Only?
An incomplete cleft on both sides
What is a Unilateral Complete Cleft of the Lip Only?
A complete cleft on one side only
What is a Bilateral Complete Cleft of the Lip Only?
A complete cleft on both sides
What is a Bilateral Incomplete Cleft of the Palate Only?
A cleft of the palate that does not include the lips or alveolus.
What are the 6 Levels of the Kernahan Striped-Y Classification?
Nose
Nasal Floor
Lip
Alveolus
Hard Palate
Soft Palate
What are two other forms of Cleft?
Soft Palate Only
Holoprosencephaly (Midface Cleft)
What is the Primary Palate?
Lip + alveolar process
How can the Primary Palate be affect by Cleft?
2
Can be complete or incomplete
Unilateral or bilateral
What is the Secondary Palate?
Hard + soft palate (area posterior to incisive foramen)
How can the Secondary Palate be affect by Cleft?
Can be complete or incomplete
What is a Submucous Cleft?
Cleft of soft palate where mucous membrane is intact
What words are associated with Submucous Cleft?
5
Bifid uvula
Furrow along midline
Zona pellucida
Bony notch where posterior nasal spine should be
Anterior insertion of levator muscle
Muscle abnormalities….
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