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Cleft lip and palate

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Mahmoud Motawea
Mahmoud Motawea

Cleft lip and palate are congenital conditions caused by the failure of fusion between embryonic processes in the oral region during weeks 4-8 of development. Cleft lip involves the failure of fusion between the frontonasal and maxillary processes, appearing as an incomplete or complete division of the upper lip. Cleft palate is a failure of fusion between the palatal processes, appearing as a cleft of the soft palate, hard palate, or a complete cleft. Treatment involves surgical repair to restore oral competence and function.

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Cleft lip and palate
Cleft Lip &Palate Presented by : Dr. Mahmoud Motawea
Embryological considerations Oral region develops during the 4th to 8th weeks The oral membrane is surrounded by 5 processes Frontonasal part Maxillary part Mandibular part
Etiology Familial risk Environmental factors: Steroids, irradiation, viral infection (rubella), alcohol intake. Syndromic: Pierre Robin syndrome
Definition Cleft lip : Failure of fusion between the median part of frontonasal process and one or both lateral maxillary processes in developing face.
Types I) Lateral or Median II) Unilateral or Bilateral III) Complete or Incomplete
Complications Flaring & flatness of nares on the affected side if complete. Disfigurement. Abnormal teeth growth Nasal tone.
Treatment Millards operation: Time : 3 -6 months. Pre-requisities : rule of 10s Goals of repair: cosmosis, orbivularis oris function Alveolus repair
Definition Cleft palate : arrest of fusion between the two palatal processes and possibly with the premaxilla
Types Cleft uvula. Cleft soft palate. Cleft soft and hard palate (complete) Complete cleft + one side of premaxilla (Bipartite cleft). Complete cleft + both sides of premaxilla
Complications lmpairment of suckling: due to inability to create -ve intra-oral pressure. lmpaired speech: Due to lnadequate velopharyngeal mechanism Nasaltone is due to naso-oral communication. Hearing loss. lmpairment of dentation if the alveolar margin is reached. Impared eustachian tube finction: otitis media Distortion of facial growth. Recurrent chest infection (due to reflux into nose).
Treatment Time : 9-12 months. Pre-requisities : Chest condition, feeding precautions Goals of repair: competent velpharyngeal function, closure of defect in layers
Cleft lip and palate

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Cleft lip and palate

  • 2. Cleft Lip &Palate Presented by : Dr. Mahmoud Motawea
  • 3. Embryological considerations Oral region develops during the 4th to 8th weeks The oral membrane is surrounded by 5 processes Frontonasal part Maxillary part Mandibular part
  • 4. Etiology Familial risk Environmental factors: Steroids, irradiation, viral infection (rubella), alcohol intake. Syndromic: Pierre Robin syndrome
  • 5. Definition Cleft lip : Failure of fusion between the median part of frontonasal process and one or both lateral maxillary processes in developing face.
  • 6. Types I) Lateral or Median II) Unilateral or Bilateral III) Complete or Incomplete
  • 7. Complications Flaring & flatness of nares on the affected side if complete. Disfigurement. Abnormal teeth growth Nasal tone.
  • 8. Treatment Millards operation: Time : 3 -6 months. Pre-requisities : rule of 10s Goals of repair: cosmosis, orbivularis oris function Alveolus repair
  • 9. Definition Cleft palate : arrest of fusion between the two palatal processes and possibly with the premaxilla
  • 10. Types Cleft uvula. Cleft soft palate. Cleft soft and hard palate (complete) Complete cleft + one side of premaxilla (Bipartite cleft). Complete cleft + both sides of premaxilla
  • 11. Complications lmpairment of suckling: due to inability to create -ve intra-oral pressure. lmpaired speech: Due to lnadequate velopharyngeal mechanism Nasaltone is due to naso-oral communication. Hearing loss. lmpairment of dentation if the alveolar margin is reached. Impared eustachian tube finction: otitis media Distortion of facial growth. Recurrent chest infection (due to reflux into nose).
  • 12. Treatment Time : 9-12 months. Pre-requisities : Chest condition, feeding precautions Goals of repair: competent velpharyngeal function, closure of defect in layers

Editor's Notes

  1. 惡愕 悋 悋惘忰 悋惘忰 悋愕悋 惺 Im Mahmoud Motawea, resident of general surgery Tanta university presenting my thesis about