Cleft Palate

Question 1

Fusion of facial structures happens at what week #?

Answer 1

Week 7

Question 2

Cleft palate results from failure of fusion of what two processes?

Answer 2

Median Nasal Process

and Maxillary Process

Question 3

Is the dental lamina typically involved in cleft lip?

Answer 3

True

Question 4

Predilections for cleft lip?

Answer 4

Bias towards left handers, asians, and males

Question 5

Predilection for isolated cleft palate?

Answer 5

Females.

Question 6

4 reasons for clefting?

Answer 6

socioeconomic
maternal illness
medications
maternal age

Question 7

Lip Repair rule of tens

Answer 7

10 weeks of age
10 lbs
hemoglobin >10
WBC <10

Question 8

Palate Repair

Answer 8

Occurs at 12 months. Speech is most critical driving force.

Residual fistula is common

Question 9

Good chairside screening for speech therapy?

Answer 9

Mirror test

Question 10

What to know about velpharyngeal flap?

Answer 10

Attach part of soft palate to posterior wall of pharynx

Narrow airway to teach child to eliminate nasal speech.

Can cause OSA and mouth breathing, complicates intubation.

Question 11

5 indications for cleft palate patient to get a bone graft?

Answer 11

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

Question 12

Timing for bone graft?

Answer 12

1. Primary - before 2 years old
2. Early secondary - between 2 and 5
3. Mixed dentition early - prior to eruption of the lateral incisor
4. Mixed dentition late - prior to eruption of cuspid
5. Late secondary - after eruption of cuspid older than 12

Question 13

What time is alveolar bone grafting most typically done?

Answer 13

Mixed dentition most often - before lateral incisor if present. Otherwise wait until later