Cleft Flashcards
Clefts arise from
Failure in growth or fusion during craniofacial development
Cleft lip is always
Anterior
Cleft palate may be
Ant or post or both
Class I cleft lip
Unilateral notching of the vermillion border, not extending into lip
Class II cleft lip
UL cleft extending into the lip
Incomplete
Class III cleft lip
UL cleft involving the floor of the nose (complete
Class IV cleft lip
Any bilateral cleft of the lip
Class I cleft palate
Isolated soft palate cleft only
Class II cleft palate
UL soft and hard palate cleft
Class III cleft palate
UL cleft involving soft/hard palate through the alveolus usually involves lip too
Class IV cleft palate
Same as Class II but bilateral
Cleft lip partial or complete lack
Of fusion of the maxillary prominence with the medial nasal prominence
- unilateral
- bilateral
Cleft palate lack of fusion
Of palatine shelves
Smallness of shelves
Failure of shelves to elevate
Inhibitoni of shelf fusion
Failure of tongue dropping
Etiology of CLP
Multifactoral
Environmental
-smoking, diabetes, anticonvulsant, teratogens
Genetic
Syndromic cleft lip +/- Palalte chromosomal anomalies
Trisomy 13, 18, 21, 22q11 deletion syndrome
Syndromic cleft lip +/- Palalte inherited syndromes
Sticklers
Treacher Collins
Van der would’ve
Syndromic cleft lip +/- Palalte noninhertied syndrome
Pierre robin sequence
1/3 of CLP cases are assocaited
With syndromes
Over 400
CL more frequent in
Males
Lip adhesion surgery
Reduces tension on final scar after definitive repair
Additional surgery
Alveolar bone grafting
Clefts through alveolar ridge may have residual oronasal fistula and bony defect through the ridge nose and palate
This will be corrected with secondary alveolar bone graft later
Children with CLP high
Risk for caries
Higher in max anterior regions
Higher in bilateral clefting
Children with CLP have poor
OH
Children with CLP have
PD that progresses faster
