Cleft Palate Assessment Flashcards
When do clefts occur? Is there only one?
When programmed fusion of lip or palatal tissue is disrupted along lines of fusion. One or both types can be present depending on cause of disruption.
Clefts of upper lip can be…
Unilateral- one side of upper lip is cleft
Bilateral- both sides of upper lip are clef
Clefts of the lip and palate may be…
Incomplete- Less than all of the possible lip (prepalate) or palate structures are cleft
Complete- All of possible pre palate or palate structures are cleft
What are the different severities of cleft of lip?
From minimal notch in vermilion of lip (incomplete)
Cleft that extends all the way through lip tissue, alveolar ridge, and to incisive foramen (complete)
Severity of cleft of palate?
Vary
Least is notch in uvula- bifid (incomplete)
Worst is cleft through all of hard and soft including uvula (complete)
Is there ever just a cleft of the hard palate alone?
No. Because of anterior to posterior fusion of bones of hard palate.
Prevalence by race?
BLack lowest, indian tribe highest
Is one side cleft lip more prevalent? Does unilateral or bilateral happen more?
Yes, left is 70 percent. Unilateral!
Who has a prevalence of having other associated anomalies??
Those with cleft palate only.
What causes clefting? Two categories
Unknown etioligies, and known
Unknown etioligies are…
spontaneously mutated genes, recessive inheritance…
Known etioligies
genetic d/os, teratogenic influences drugs, mechanical factors in womb, chromosome abnormalities (stickler, williams, treacher..)….
What do we assess in cleft palate?
Oral peripheral exam Feeding Hearing status (eustachian tube dysfunction, ear infection) Psychosocial- provided 1:1 facetime Language Speech Resonance and Voice Bx/Personality
What needs to be assessed speech wise?
16 pressure consonants stops, fricatives, affricates
Vowels are easiest, consonants nasal-stop plosives-fricatives…affricates
Obligatory errors due to structures not being there, compensatory errors to make up for missing structures…move to other places in cavity
What should be assesesed in terms of resonance? How?
hypernasality, hyponasality, mixed…
Can use perceptual or instrumental assessment
Make sure high vowels assessed for hypernasality
Nasal stethoscope - glass bulb to hear nasality
Detail reflector- mirror under nose for fogging
Nasometer- headpiece with nasal microphones measures oral nasal airflow
Nasopharyngoscopy- most don’t. may use with ent dr.
