Cleft lip and palate Flashcards

1
Q

Definition of cleft lip/palate

A

Facial clefts are deformations of the face caused by relative tissue deficits along linear
anatomical planes.

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2
Q

Differentials

A
- Normal Philtrum
• Amniotic bands
• Facial mass
• Teratoma
• Frontal encephalocele
• Hemangioma
• Holoprosencephaly
• Trisomy 13/18
• Syndrome (over 300 with facial cleft as part)
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3
Q

Epidemiology of cleft lip

A
  1. 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)

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4
Q

Classification of cleft lip/palate

A

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

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5
Q

Medications that can cause cleft lip/palate

A

retinoic acid,
valproic acid,
hydantoin,
Methotrexate

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6
Q

Other risk factors for cleft lip/palate

A

-Genetic factors
-Cigarette smoking
• Alcohol
• Folate deficiency
• Maternal obesity

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7
Q

Detection rate

A

<30% detected antenatally

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8
Q

Management if identified

A
  • 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
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