5 - Cleft lip and palate Flashcards
How is CLP classified?
LAHSHAL
What does LAHSHAL stand for?
Lip - alveolus - hard palate - soft palate - alveolus - lip
How does the LAHSHAL classification work?
- capitalise for complete cleft, lower case for partial cleft
- starting on the right state the letters that correspond to the clefts present
What is the ratio of incidence of CL to CP in Scotland?
1:1
What environmental factors influence CLP?
- social deprivation
- smoking
- alcohol
- anti-epileptics
- multivitamins
What is the chance of having a child with CLP if you already have a child with CLP?
5%
What genetic factors influenced CLP?
- syndromes
- FH
- sex
- laterality
- ethnic distinctions
What are the implications of CLP?
- aesthetics
- speech
- dental
- hearing and airway
- other anomalies
How is speech affected by CLP?
- can have hyper-nasal sound
- issues with closive sound
How are the airway and hearing affected by CLP?
- CLP develops from errors in neural crest migration
- ear development and airway are controlled by neural crest migration as well
Who is involved in the MDT for CLP?
- dental team
- SALT
- surgeon
- ENT
- airways
- psychology
- CNS
What is the CLP patient journey?
3 months - lip closure
6-12 months - palate closure
8-10 years - alveolar bone graft
12-15 years - orthodontics
18-20 years - surgery
What are the compulsory treatments for CLP patients?
- lip surgery, palate surgery and bone graft
- if parents refuse, social services are involved
- subsequent treatments are only offered in patient/parents consent
What is the lip surgery for CLP?
- repair of obicularis oris
- allows muscles to move normally
- aesthetic only
- at 6 months
When is the palate surgery for CLP?
- cannot be before 6 months as babies are obligate nasal breathers until 6 months, the surgery would block their airway
- must be completed before 12 months as babies begin to babble, allows normal speech
