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Paeds > Cleft lip and palate > Flashcards

Cleft lip and palate Flashcards

1
Q

what is the primary palate?

A

lip, alveolus, and palate anterior to incisive foramen

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2
Q

what is the secondary palate?

A

soft and hard palate up to incisive foramen

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3
Q

what are the types of clefts that can occur in the primary palate?

A

unilateral - complete/incomplete

bilateral - complete/incomplete

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4
Q

what are the types of clefts that occur in the secondary palate?

A

complete
incomplete
submucous

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5
Q

what are the types of clefts of the primary and secondary palates?

A

unilateral - complete/incomplete

bilateral - complete/incomplete

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6
Q

what race is CLP more common in?

what side of the face is more commonly affected?

A

caucasians

left

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7
Q

how does CLP occur?

A

isolated deformity or part of a syndrome
genetic reasons
environmental reasons

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8
Q

what genetically causes a CLP to occur?

A

short palatal shelves

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9
Q

what environmental factors can cause a baby to be born with CLP?

A

maternal alcohol and smoking
anticonvulsant or steroid therapy
folic acid deficiency

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10
Q

if there is a family history of CL with or without palatal involvement what are the risks to the child?

A

40% risk of offspring having it

2nd child 1 in 20 chance

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11
Q

if there is a family history of CP what are the risks for the child?

A

20% risk of offspring having it

lesser genetic component - risk of 1in 80 of further offspring being affected

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12
Q

when does the development of the face/upper lip begin?

A

5th and 9th week i.u

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13
Q

what is the lip formed from?

A

fusing of maxillary processes

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14
Q

how is the palate formed and when is it formed?

A

palate is formed from the palatal processes of maxillary processes - 6-11th week i.u

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15
Q

what begins at 7th wee i.u?

A

tooth development

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16
Q

what may clefts cause in dental development?

A

duplication of tooth types, malformed roots and crowns, enamel hypoplasia, absence/ectopic teeth

17
Q

what problems can CLP cause to a baby?

A

feeding/hearing/speech/emotional/dental

18
Q

why is feeding a problem in babies with CLP?

A

cannot create a negative intra oral pressure

- haeberman feeder can fix

19
Q

why is hearing a problem with CLP?`

A

problems with middle ear ventilation of eustacian tube

surgery of palate can impede tube function

20
Q

why do CLP cause problems with speech?

A

affected by fistula
or soft palate not being able to make contact with pharynx
secondary to poor hearing

21
Q

what is electropaltalography?

A

URA with electrodes

22
Q

what procedure can be done at 3 months?

A

lip repair

23
Q

what procedure can be done at 6-12 months?

A

palate repair

24
Q

what can be done between 8 and a half and 10 years?

A

expansion/ alveolar bone graft

25
Q

what treatment will need done when CLP baby enters the permanent dentition?

A

ortho
orthagnathic surgery
plastic surgery

26
Q

what are pre surgery orthopaedics?

A

URA - stop tongue sitting in cleft - encourages shelf growth
aids feeding
approximates cleft segments

27
Q

what is lip strapping used for?

A

controls growth of pre maxilla = facilitates lip closure

28
Q

how is a lip repair done?

A

muscles of lip and alar are dissected out and re opposed
minimal to reduce scarring
if palate is cleft it can be defect is corrected at same time

29
Q

how is palate repair done?

A

6-12 months
oral and nasal cavities are seperated
mobilisation of tissues laterally and displaced across the midline to cover the cleft

30
Q

what is Cleftsis?

A

care until 16years
asses at 9-12 months, 2-5 years, 7-15yrs
aim to maintain primary and secondary teeth and encourage good dental care

31
Q

what problems may arise in the mixed dentition as a result of a CLP?

A 
delayed eruption
hypodontia
reduction of tooth size
abnormalities of tooth size and shape
enamel defects
ortho probs
32
Q

what ortho tx is needed in CLP?

A

presurgical orthopaedics in birth
align max dentition
obturators, palatal lift and EPG appliances

33
Q

before alveolar bone grafting what needs to be done?

A

XLA any deciduous/SN teeth in the cleft
FA to align max/mandib teeth
FA to align skeletal discrepancy for orthagnathic surgery

34
Q

when does alv bone grafting occur?

A

between 8 and a half and ten years - canine roots are a half to two thirds formed

35
Q

what does allowing the canine to erupt into the graft do?

A

fuses the maxilla, provides alar base support

36
Q

what bone is used for a graft?

A

cancellous bone from iliac crest, tibia or cranium

37
Q

what is plastic surgery used to treat?

A

improves nasal aesthetics
lip revision
close residual palatal fistulae

38
Q

why might a rhinoplasty be needed after orthagnathic surgery?

A

underlying bone can affect the contour of the nose

Paeds (13 decks)

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