Cleft Lip And Palate

Question 1

What is the LAHSHAL classification?

How differ between LHS and RHS?

Answer 1

Assign a letter to where there is an issue

Lip, alveolus, hard and soft palate for RHS = LAHS

Lip, alveolus, hard and soft palate for LHS = SHAL

Question 2

What is often the aetiology of CLP?

Answer 2

Genetic
- family history big part
- ethnic distribution
- male : female

Environment
- socioeconomic status
- smoking
- alcohol
- anti-epileptic medication during pregnancy

Question 3

Early life complication of CLP?

Answer 3

Baby cannot feed properly due to inability to form proper oral seal
- mother must be seen within 24 hours to show how to feed

Question 4

Why is speech an issue with CLP?

Answer 4

Cleft in the soft palate prevents soft palate closing off nasopharynx during speech

Question 5

How can CLP affect hearing

Answer 5

Poor neural crest migration can lead to hearing defects and malformation of the ear

Question 6

Give an overview of the patient journey through CLP tx

Answer 6

Lip closure - 3-6 months

Palate closure - 6-12 months

Alveolar bone graft - 8-10 years

Definitive orthodontics - 12-15 years

Surgery 18 - 20 years

Question 7

Why is palate closed after lip?

Answer 7

Babies are obligate nasal breathers, if you close palate then airway often closed first

Question 8

What are some common dental implications of CLP?

Answer 8

associated with dental abnormalities
- hypodontia - mainly of laterals
- ectopic / impacted teeth
- crowding of teeth
- caries