Cleft Lip/Palate & Obturators Flashcards
Cleft Lip formation occurs when?
4-7 weeks of gestation
Cleft Palate formation occurs when?
6-9 weeks of gestation
Fusion of the palate generally occurs in what direction?
Anterior to posterior
Lips Fuse first
**Veau Classification of CLP
Class 1: only soft palate
Class 2: Involves Hard & Soft palate, no alveolar process. Up to incisive foramen
Class 3: Involves Alveolus, H&S palate (unilateral). Including the lip
Class 4: Bilateral involvement of alveolus and H&S palates
Incidence of CLP in the US
approximately 1 in 725
**What are the incidences of CLP vs Isolated CL and CP?
45-50% CLP
30% CP
20-25% CL
Four Stages of Multidisciplinary Treatment
1) 0-18mo: Focus on Weight Gain
2) 18mo-6yo: Development of primary dentition
3) 6-12: Development of mixed dentition
4) 12+: Development of permanent dentition
Typical Clinical Presentation of Cleft Infants
1) Birth weight <50% percentile (~25% of cleft kids)
2) General development on the low end
3) 25% demonstrate significant feeding problems
4) Impaired weight gain
5) Cleft + Syndrome = greatest risk of low birth weight & feeding problems
**Four major Advantages of Obturators
1) False palate to improve feeding/nutrition
2)Stabilize maxilla after lip closure, preventing arch collapse
3) Orthopedic molding of cleft segments into approximation
4)Immediate involvement of the team with the patient
**Feeding Benefits of Obturator (4)
1) Reduce nasal discharge
2) Reduce feeding time
3) Improve Weight Gain
4) Psychological benefits for parents
Microforms of clefting include
1) Congenital Lip pits
2) Bifi uvula
Global cleft lip & palate incidence
0.28-3.74 per 1000 live births
Does Cleft Lip or Cleft Palate vary across different nationalities?
There are differences in incidence of Cleft Lip across different nationalities, but NOT for Cleft Palate or CLP.
Sequence of cleft treatment
10days-3mo: first obturator
3mo: cheiloplasty, new obturator
18mo: palatoplasty
monitor monthly
