Clefts

Question 1

When does the face develop

Answer 1

Between weeks 4-10

Question 2

When do cleft lip deformities form and what fails to fuse

Answer 2

3rd to 7th weeks

Medial nasal processes and the maxillary prominence

Question 3

When do cleft palates form and what fails to fuse

Answer 3

5th to 12th weeks
Primary palate - failure of frontonasal prominence and maxillary prominence
Secondary - failure of the fusion of maxillary prominences

Question 4

Cleft lip incidence

Answer 4

1:1000 in Caucasian, 1:2000 in black, 1:500 in Asian
More common in boys
More common on left

Question 5

Cleft palate incidence

Answer 5

1:2000 in caucasians
Isolated cleft palate more common in girls
Isolated cleft palate more likely to be syndromic

Question 6

Most common syndrome with associated cleft lip +/- palate

Answer 6

Van der woode
IRF6 gene muation
Autosomal dominant
Lower lip sinus tracts + cleft lip/palate

Question 7

Micrognathia, glossoptosis, and respiratory distress

Answer 7

Pierre robin sequence

Question 8

Cleft lip inheritance

Answer 8

Unaffected parents + one affected child - 4%
Unaffected parents + two affected kids - 9%
One affected parent + no affected kids - 4%
One affected parent + one affected kid - 17%

Question 9

Cleft palate inheritance

Answer 9

Unaffected parents + one affected child - 2%
Unaffected parents + two affected kids - 1%
One affected parent + no affected kids - 6%
One affected parent + one affected kid - 15%

Question 10

Calnan’s triad submucous cleft

Answer 10

Midline clear zone (zona pellucida)
Bifid uvula
Palpable notch of posterior palate