CleftPalate and ResonanceDisorder Slide Deck

Question 1

cleft of lip or palate occurs by

Answer 1

10th week of gestation

Question 2

submucous cleft palate

Answer 2

classic triad
1 bifid uvulae
2 zona pellucida
3 notch at posterior nasal spine
(mucosal layer has formed over structures)

Question 3

Veau Classification System

Answer 3

I - cleft palate (soft)
II - cleft palate (hard and soft)
III - unilateral cleft lip
IV - complete bilateral cleft lip

Question 4

Kernahan and Stark

Answer 4

1, 2, 3
looks like a game board where you shade in the correct area

Question 5

LAHSHAL

Answer 5

right lip, right alveolus, right hard palate, midline soft palate, left hard palate, left alveolus, left lip (opposites)

Question 6

incidence of clefting

Answer 6

1:600, lower among african americans, higher in asian and native americans.
cleft palate only is higher in girls. cleft lip and palate higher in boys.

Question 7

causes of clefting

Answer 7

teratogens (drugs, alc)
genetics
malformation syndrome or sequence

Question 8

timing of cleft surgeries (cleft lip/alveolus)

Answer 8

Naso alveolar molding, lip repair 10-12 weeks, revise lip and nose later, bone graph, midface advancement

Question 9

timing of cleft surgeries (cleft secondary palate)

Answer 9

repair at 8-12 months of age, may require velopharyngeal management, bone graft, midface advancement

Question 10

repair of cleft lip

Answer 10

cheiloplasty

Question 11

repair of soft or hard palate

Answer 11

palatoplasty

Question 12

downstream effects

Answer 12

increased middle ear disease
conductive hearing loss
midfacial growth deficiencies
dental/occlusal anomalies
increased risk for resonance disorders
nasal septal defects
early feeding difficulties
increased risk for communication disorders

Question 13

eustachian tube - cleft

Answer 13

length is shorter
angle of connection to muscle is greater
amount of connection to muscle is less
cartilage is shaped differently
less elastin (more floppy)
functionally obstructed

Question 14

downstream effects for communication

Answer 14

abnormal articulatory development
delayed language development
resonance disorder due to velopharyngeal function
voice disorder as a secondary feature
psychosocial effects on communication
secondary academic effects
expectation is normal speech! :)

Question 15

downstream effects for the palate

Answer 15

fistula formation - a hole in palate when surgical wounds don’t heal properly (FAMM flap, tongue flap

Question 16

further downstream effects

Answer 16

teeth, jaw growth,

Question 17

velopharyngeal dysfunction

Answer 17

insufficient tissue, incompetency motoric function, inadequacy?, mislearning?

Question 18

a resonance disorder

Answer 18

nasal sounding speech
turbulent airflow through the nose
weakened consonant sounds
nasal sounding voiced consonants and vowels
nasal and facial grimacing during speech

Question 19

comorbidities

Answer 19

articulation disorder
voice disorder with or without laryngeal pathology