Neonatology - Cleft Lip And Palate

Question 1

Cleft lip Definition

Answer 1

Congenital condition where there is a split or open section of the upper lip. This opening can occur at any point along the top lip, and can extend as high as the nose.

Question 2

Cleft palate

Answer 2

Defect exists in the hard or soft palate at the roof of the mouth. This leaves an opening between the mouth and the nasal cavity. Cleft lip and cleft palate can occur together or on their own.

Question 3

Aetiology

Answer 3

Idiopathic

Question 4

Risk factors

Answer 4

• FHx - slight increased risk however does not follow a traditional inheritance pattern such as CF
• 3 in 10 cases of cleft lip/palate are assosciated with another underlying syndrome

Question 5

Treatment

Answer 5

FIRST LINE = First priority is to ensure that the baby can eat and drink
- this may involve specially shaped bottles and teats
GOLD STANDARD = Surgical correction
- leaves subtle scar but is generally very successful, giving full functionality to the child.
- Cleft lip surgery is usually performed at 3 months, whilst cleft palate surgery done at 6-12 months

Question 6

Complications

Answer 6

• Significant problems with feeding, swallowing and speech
• Significant psycho-social implications, including affecting bonding between mother and child
• Children with cleft palates more prone to hearing problems, ear infection and glue ear