Cleft lip and palate Flashcards
Definition of cleft lip/palate
Facial clefts are deformations of the face caused by relative tissue deficits along linear
anatomical planes.
Differentials
- Normal Philtrum • Amniotic bands • Facial mass • Teratoma • Frontal encephalocele • Hemangioma • Holoprosencephaly • Trisomy 13/18 • Syndrome (over 300 with facial cleft as part)
Epidemiology of cleft lip
- 15 % of live births
* 80% of cleft lip has an associated cleft palate*
More common in asian ethnicity
30% syndromic (50% if isolated cleft palate)
Classification of cleft lip/palate
Classification
Type I Unilateral cleft lip
Type II Unilateral cleft lip and palate
Type III Bilateral cleft lip and palate
Type IV Midline cleft lip and palate
Medications that can cause cleft lip/palate
retinoic acid,
valproic acid,
hydantoin,
Methotrexate
Other risk factors for cleft lip/palate
-Genetic factors
-Cigarette smoking
• Alcohol
• Folate deficiency
• Maternal obesity
Detection rate
<30% detected antenatally
Management if identified
- Detailed anatomy scan
- Offer amniocentesis- significant risk of aneuploidy
- Preparation for delivery
a. Plastic surgeon, ENT, Dentist, speech and language therapist, social work, psychiatrist, genetic counsellor - Surgery
a. Repair of cleft lip at 2-3 months
b. Repair of cleft palate at 9-18 months