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Organic Disorders > Cleft Palate And Lip > Flashcards

Cleft Palate And Lip Flashcards

1
Q

Cleft palate and lip palate

A

Physical Challenges of Clefts Through the Lifespan
 Development of the Face and Palate
 Cleft Lip and Palate Classification Systems
 Clinical Features of Clefts
 Etiologies of Clefts
 Incidence of Clefts
 Sex and Racial Differences
 The Cleft Palate Team and General Management Issues Through The Lifespan
 Communication Problems Associated with Clefts

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2
Q

Craniofacial anomalies

A

 *Congenital malformations involving the head
and face

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3
Q

Clefts

A

Abnormal openings in anatomical structures

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4
Q

Velopharyngeal Incompetence (VPI)

A

Velopharyngeal Mechanism does not close adequately
 Clefts interfere with basic biological functioning and communication

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5
Q

Birth

A

Obstruction of breathing
 *Difficulty with food intake

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6
Q

3 months

A

 3 months
 *Clefts of the Lip are surgically closed
 *Monitored for ear infections

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7
Q

9-12 months

A

9-12 months
 *Surgeons close clefts of the palate
 *Secondary surgery may be required later

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8
Q

 2 years

A

 2 years
 *Correction of dentition
 Later orthodontic treatment

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9
Q

 Facial Development

A

 Facial Development
 *5-8 weeks gestation: Face/anterior aspects
 *Mandibular processes: Mandible/lower lip
 *Frontonsal processed: Nasomedian processes and lateral nasal processes
 *Olfactory Pits
 *Maxillary processes
 *Clefts of the lip: Fusion is
 interrupted or teratogens

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10
Q

Development of the Secondary Palate

A

Development of the Secondary Palate
 *8-12 weeks gestation: Processes of hard and
soft palate fuse
 *Palatal Shelves
 *Nasal Septum
 *Clefts of the palate. Fusion of palatal shelf is interrupted

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11
Q

Veau System

A

Veau System
 *Quick general Reference
 *Nature and extent of Clefts
 In this system, you classify clefts into four different classes.
 1) Cleft of the soft palate only.
 2) Cleft of the hard and soft palate
 3) Complete unilateral cleft of the soft and hard palate and on the lip and alveolar ridge on one side.
 4) Complete bilateral cleft of the soft and hard palate and/or the lip and alveolar ridge on both sides.

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12
Q

Kernahan’s Striped Y-

A

Kernahan’s Striped Y-a visual identification system based on location, and developed by the American Cleft Palate Association (ACPA) focuses on the primary and secondary palates.

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13
Q

Clefts are commonly classified

A

*Unilateral or bilateral cleft of the lip
 *Unilateral or bilateral cleft of the palate
 *Bilateral cleft or the lip and palate
 *Submucous Cleft
 *Bifid Uvula

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14
Q

Cleft of the lip

A

Involves vermillion of the upper lip and can extend to nostril
 Incomplete cleft
 Complete cleft
 Flattened nose, flaring nostril
 Columella short, misaligned
 Most commonly on left side (unilateral)
 If bilateral, usually cleft palate also
 Isolated cleft of the lip is rare

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15
Q

Unilateral complete cleft of lips and palate extend

A

 Unilateral complete cleft of lip and palate extends
 *External portion of upper lip
 *Through alveolus
 *Through hard and soft palate
 Clefts of secondary palate alone vary in severity

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16
Q

Bilateral cleft of the upper lip

A

Most severe because of lack of tissue
 Features
 *Lip and alveolar processes clefted under each nostril
 *Abnormal position of
 **Prolabium, alveolar processes, premaxilla
 *Columella, usually absent
 **Tip of nose attaches to lip
 Nasal Septum not attached to palatal shelves

17
Q

Submucous cleft

A

 Cleft of the muscular region of the soft palate  Thin layer of mucosal tissue covers cleft
 May not be detected until later
 Bifid Uvula
 Zona pellucida
 Notch on posterior border of hard palate  Velopharyngeal Incompetence

18
Q

Genetic Disorders

A

Genetic Disorders
 *Account for substantial percentage of clefts  Syndromes
 *Pierre Robin Syndrome (Robin sequence)
 *Treacher Collins Syndrome
 *Velocardiofacial Syndrome
 *Apert Syndrome
 Chromosomal Aberrations
 *Trisomy 13
 *Multiple Congenital Abnormalities

19
Q

Pierre Robin syndrome

A

Micrognathia
 Isolated cleft of the hard and soft palate  Congenital Heart Problems
 Digital Abnormalities
 Conductive Hearing Loss
 Retracted and elevated tongue
 Delayed language

20
Q

Teacher Collins syndrome

A

Malar hypoplasia
 Conductive hearing loss
 Cleft palate
 Projection of scalp hair onto the cheek  Communication Problems

21
Q

Velocardiofacial syndrome

A

Language deficits
 Learning Disabilities
 Cleft Palate
 Small stature with broad, flatten nose  Underdeveloped cheek bones
 Heart Problems
 Communication problems

22
Q

Apert syndrome

A

Craniosynostosis
 Syndactyly
 High and narrow arched palate  Clefts occur is 30% of
 People with Apert
 Expressive language
 delay

23
Q

Chromosomal aberration

A

Trisomy 13 results in cleft lip with or without cleft palate in 60-70% of cases

24
Q

Teratogenically Induced Disorders

A

Teratogenically Induced Disorders
 Recognized teratogens
 **Dilantin, thalidomide, excessive aspirin use,
 excessive use of alcohol, caffeine, nicotine
 **X-rays, viruses, environmental substances

25
Q

Mechanically Induced Abnormalities

A

Mechanically Induced Abnormalities
 **Impinge on embryo
 **Amniotic rupture
 **Intrauterine crowding

26
Q

Incidence of clefts

A

Occur in one of every 750 live births
Cleft of lip with or without cleft palate occur more often than cleft palate alone
Submucous clefts
*One in every 1,200 births

27
Q

Sex and racial differences

A

Clefts of lip with or without palate
 *Twice as frequent in males
 *More severe
 Clefts of palate alone
 *More frequent in females
 Submucous clefts
 *Similar frequency in males and females
 In the U.S., Native Americans have highest incidence rates

28
Q

Cleft palates team and general management

A

 Clinical Management of persons with clefts requires cooperation among many professionals
 Key professions include:
 *Surgeons
 *Dental Specialists
 *Speech-Language-Pathologists
 *Audiologists

29
Q

Surgical Management of Clefts

A

Surgical Management of Clefts
 Palatoplasty
 **Primary Surgical Correction
 **Secondary Surgical Correction
 Dental Management of Clefts

30
Q

Orthodontics

A

Orthodontics
 **Prosthodontics
 *Prosthodontic Obturator
 *Speech bulb

31
Q

Audiological Management of Clefts

A

Audiological Management of Clefts
 *Higher incidence of hearing disorder, middle
ear disease
 *Eustachian Tube Dysfunction

32
Q

Tensor veli palatini

A

Tensor veli palatini
 MYRINGOTOMY
 *Ventilating tubes inserted
 Screen hearing every 3-6 months
 Pyschosocial Management of Clefts
 *Provide appropriate treatment or referral

33
Q

Communication problems associated with cleft

A

80% expected to develop good speech
 Voice Disorders
 *Vocal hyperfunction as compensatory
 *Bilateral vocal nodules
 *Soft-Voice Syndrome
 Assessment
 *Case history, personality, phonation, modification
 Treatment
 *Reduce hyperfunction, eliminate hard glottal attacks, habituating new voice

34
Q

Resonance Disorders

A

Resonance Disorders
 *Hypernasality most common
 *Hyponasality
 *Assessment
 **Standardized rating scales, noninstrumental methods, nasaometer, multiview, videofluoroscopy
 Treatment
 *Behavioral treatment doesn’t work alone
 *Continuous Positive Airway Pressure (CPAP)

35
Q

Nasal Emissions

A

Nasal Emissions
 Compensatory Articulation errors
 Assessment
 *Articulation tests, specialized tests for VPI, phonological processes
 Treatment
 *Intervention before first surgery
 *Increase consonant inventory, difference between oral/nasal sounds, eliminate excessive use of glottal stops, electropalatograpy

36
Q

Language Disorders

A

May have language delays or less well-developed language
 Assessment
 *Should be routinely examined
 *Include environmental factors, motor/mental development, hearing acuity
 Treatment
 *Not specialized for individuals with cleft
 *Prevention
 *Familycounseling,aggressivetreatmentof middle ear disease, language enrichment programs

Organic Disorders (6 decks)

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