Cleft lip and palate

Question 1

What causes cleft lip?

Answer 1

When one or both medial nasal processes don’t fuse with the maxillary process

Question 2

What causes cleft palate?

Answer 2

1. growth defect in palatal shelves
2. delay in shelf elevation
3. failure to fuse

Question 3

Which areas can cleft affect?

Answer 3

1. lip
2. anterior palate
3. posterior palate
4. soft palate

Question 4

What causes submucous cleft palate?

Answer 4

lack of normal fusion of muscles in soft palate

Question 5

What are the features of submucous cleft palate?

Answer 5

palate may look unaffected, but the muscles needing to lift the palate for speech are abnormal

Question 6

What are the classic signs of submucous cleft?

Answer 6

1. split uvula
2. bony gap at back of hard palate
3. midline of soft palate looks thin

Question 7

What is the incidence of cleft lip and/or palate?

Answer 7

1 in 700 in UK per year

Question 8

What is the incidence of cleft palate alone?

Answer 8

1 in 2500, greater in females

Question 9

What is the incidence of cleft lip and palate?

Answer 9

1 in 800, 2:1 male:female

Question 10

What causes cleft?

Answer 10

largely unknown, but thought to be combination of genetics and environment

Question 11

What contributory factors have been implicated in cleft?

Answer 11

1. heavy smoking in early stages of pregnancy
2. heavy alcohol consumption early stages of pregnancy
3. folic acid deficiency early stages of pregnancy

Question 12

How many children with cleft have an associated genetic syndrome?

Answer 12

approx 10%

Question 13

What genetic conditions are linked to cleft?

Answer 13

1. Van Der Woude syndrome
2. Pierre Robin sequence
3. Stickler’s syndrome
4. 22q11 deletion syndrome

Question 14

What happens with velopharyngeal dysfunction (VPD)?

Answer 14

soft palate may not completely close off throat as it should in speech production