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Oral Surgery 2 > Cleft Lip and Palate > Flashcards

Cleft Lip and Palate Flashcards

1
Q

at what week does fusion of facial structures occur?

A

week 7

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2
Q

cleft lip is due to failure of what?

A

fusion between median nasal process and maxillary process

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3
Q

patients with cleft lip with or without cleft palate have their lip/alveolus contiguous without what?

A

any vestibule

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4
Q

what is involved in patients with cleft lip with or without cleft palate?

A

dental lamina

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5
Q

incidence of cleft lip with or without cleft palate in WHITE population

A

1:1000

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6
Q

incidence of cleft lip with or without cleft palate in African American population

A

1:2000

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7
Q

incidence of cleft lip with or without cleft palate in Asian population

A

1:500

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8
Q

incidence of cleft lip with or without cleft palate in males vs females

A

2 M: 1 F

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9
Q

incidence of cleft lip with or without cleft palate occurring on left vs right

A

2 left: 1 right

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10
Q

incidence of isolated cleft palate

A

1:2000

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11
Q

incidence of isolated cleft palate in females vs males

A

2 F: 1 M

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12
Q

racial predilection in patients with isolated cleft palate

A

none

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13
Q

etiology of clefting

A
  1. environmental

2. genetic

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14
Q

environmental etiologies of clefting

A
  1. socioeconomic
  2. maternal illness
  3. medications
  4. maternal age
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15
Q

percent of 2 non-cleft parents and 1 cleft child?

A

4%

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16
Q

percent of 1 cleft parent and no cleft child?

A

7%

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17
Q

percent of 1 cleft parent and 1 cleft child?

A

17%

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18
Q

cleft palate team consists of whom?

A
  1. pediatrictian
  2. plastic surgeon
  3. OMFS
  4. pediatric dentist
  5. orthodontist
  6. speech pathologist
  7. geneticist
  8. social service counseling
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19
Q

primary care of cleft child

A
  1. early consult with surgeon
  2. family counseling
  3. feeding
  4. middle ear disease
  5. other medical problems
20
Q

feeding for cleft child

A
  1. modified nipple

2. breast feeding

21
Q

what percent of cleft babies have cardiac problems?

A

10%

22
Q

rule of “tens” for lip repair on cleft child

A
  1. 10 weeks of age
  2. 10 lbs
  3. hemoglobin >10
  4. WBC <10
  5. orthodontic molding of segments
23
Q

orthodontic molding of segments

A

“bandaid traction”

24
Q

palate repair of cleft child

A

soft tissue closure of palatal defect

25
Q

what age can a cleft child get their palate repair?

A

12 months

26
Q

what is the most critical driving force for palate repair?

A

speech

27
Q

what is common with palate repairs?

A

residual fistula at anterior of palate and in vestibule

28
Q

T/F: speech evaluation/therapy is ongoing throughout child’s life

A

true

29
Q

why is speech evaluation/therapy ongoing throughout a cleft child’s life?

A

nasal speech is a problem

30
Q

what is secondary to velopharyngeal incompetence?

A

nasal airway remains open during speech and air escapes

31
Q

how is speech evaluated?

A

by nasopharyngoscopy, or nasal airflow studies

32
Q

good chairside screening of speech evaluation/therapy is what?

A

“mirror test”

33
Q

what may improve with speech evaluation/therapy?

A

velopharyngeal flap

34
Q

velopharyngeal flap

A

attaches part of soft palate to posterior wall of pharynx

35
Q

how can cleft child eliminate nasal speech?

A

narrow airway so child can learn to close off during speech

36
Q

what might fixing velopharyngeal incompetence to competence lead to?

A
  1. mouth breathing

2. OSA

37
Q

velopharyngeal flap complicates what?

A

intubation for surgery, particularly when nasal intubation is needed for orthognathic surgery

38
Q

indications for alveolar bone graft

A
  1. produce continuous arch for stability
  2. improve osseous support of teeth adjacent to cleft
  3. allow bone for maxillary cuspid to erupt into
  4. support ala of nose
  5. close oronasal fistula
39
Q

primary alveolar bone graft

A

<2 years old

40
Q

early secondary alveolar bone graft

A

2-5 yrs

41
Q

early mixed dentition secondary alveolar bone graft

A

prior to eruption of lateral incisor: 6-8

42
Q

late mixed dentition secondary alveolar bone graft

A

prior to eruption of cuspid: 8-12

43
Q

late secondary alveolar bone graft

A

after eruption of cuspid: >12

44
Q

what is the most commonly selected time for alveolar bone graft?

A

mixed dentition grafting

45
Q

what does mixed dentition grafting allow?

A

allows grafting in conjunction with tooth eruption which produces best bone form

46
Q

if lateral incisor is present, particularly if in distal segment, when should grafting be considered?

A

early

47
Q

if lateral is absent, or pt is small, or cleft is large, when should grafting be considered?

A

delay until later

Oral Surgery 2 (13 decks)

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