Cleft Types & Phenotypic Features Flashcards
Cleft
An abnormal opening or fissure in an anatomical structure that is normally closed. Generally, all structures present but not fused
Hypoplastic
Underdevelopment of a tissue or organ
Incomplete primary palate
It can be as minor as notch in the lip or extend to part of the alveolus but the cleft does not extend to the incisive foramen
Primary Palate
Structures anterior to the incisive foramen
Secondary palate
Structures posterior to the incisive foramen
Incomplete secondary palate
Any cleft of the secondary palate that does not reach the incisive foramen
Complete primary palate
The cleft extends through the entire lip, nasal sill, alveolus to the incisive foramen
Complete Secondary palate
Cleft extends from the uvula, velum, continues through the hard palate all the way to the incisive foramen
Premaxilla
The triangular-shaped bone that is bordered on either side by the incisive suture lines; this bony segment normally contains the central and lateral maxillary incisors.
Prolabium
What the philtral tissue is called when it becomes isolated by a bilateral cleft of the lip
Premaxillary Segment
What the premaxilla is called when it becomes isolated by a complete bilateral cleft of the primary palate. Can be protruded and/or rotated.
Form Fruste
Microform cleft
A partial cleft lip where the overlying skin is intact but the underlying muscle, nasal cartilage and oral sphincter function can be affected.
Orientation and affect on muscles
With unilateral cleft lip…
The orbicularis oris inserts at the columella medially and ala laterally on the cleft side.
The columella is displaced to the noncleft side.
Nasal ala on the side of the cleft is displaced laterally, inferiorly, and posteriorly.
Nasal tip is deflected towards the noncleft side
Orientation and affect on muscles
With bilateral cleft lip…
Orbicularis oris attaches at the lateral cleft margins bilaterally at the nasal ala
• If the premaxilla is also clefted bilaterally, the premaxillary segment may be protruded/rotated
• Symmetrical nasal deformities
Laterally displaced ala – widely flared
Extremely short columella
Cleft Lip & Palate: Orientation & Affect on muscles
With cleft palate, structures fail to meet in midline and attach to other structures.
The levator veli palatine and palatopharyngeus muscles insert onto the hard palate. These substitute attachments prevent muscles from becoming functional or form fully
The palatine aponeurosis is hypoplastic or absent
The musculus uvula muscles are often hypoplastic or absent
Vomer may attach to the larger of the two palatal segments in a unilateral cleft. It can also not be attached to either, particularly when it is a bilateral complete cleft of the lip and palate or a very wide complete cleft of the secondary palate
Submucous Cleft Palate
A congenital defect that affects the structures on the nasal side of the palate, whereas the structures on the oral surface are intact; can affect both the hard and soft palate.
Overt Submucous Cleft Palate
One that can be seen on the oral surface; bifid or hypoplastic uvula, notch in the posterior border of the hard palate, zona pellucida
Occult Submucous Cleft
defect of velum not apparent on the oral surface
Simonart’s Band
A strand of soft tissue in the area of the cleft lip that is due to partial yet incomplete, embryonic fusion of the lip.
Palatal Fistula
A hole in the palate secondary to a dehiscence or break down of the surgical repair.
Nasolabial Fistula (alveolar fistula)
A fistula in the alveolus, under the lip, that is often deliberately left by the surgeon during the initial repair to allow for maxillary growth. It is later closed by the bone graft
Oblique Cleft
Begins at the mouth and can affect facial bones, nasal structures, orbits and ears
Midline Cleft
Varies in severity and are often associated with other midline anomalies