Cleft lip and palate

806 views

Published on

cleft lip and palate

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
806
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
37
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Cleft lip and palate

  1. 1. Dr. Gutmann1 Cleft Lip and Palate
  2. 2. Dr. Gutmann2 Introduction:Cleft Lip and Palate  Embryology  Epidemiology  Etiology  Genetics  Plastic Surgery  Hearing and speech  Psychology  Orthodontics  Anthropology
  3. 3. Dr. Gutmann3 Embryological facial development Frontal View
  4. 4. Dr. Gutmann4 Embryology(Sperber,1992) 4th - 8th week –closure of Primary Palate(Frazer, 1970) 4th week- Stomodeum(involution of ectomesenchyme) Maxillary and Mandibular processes 5th week- Primary palate formation- fusion of maxillary and frontonasal process. (Lateral and Medial Nasal Swellings/Nasal pits) 6th -10th week –closure of Secondary Palate(Christensen,1992) 6th week- Palatine Shelves/ muscle of soft palate
  5. 5. Dr. Gutmann5 Cleft lip w/- w/o Palate  Cleft anterior to Incisive Foramen(Sperber, 1992)  Mesenchymal cells do not penetrate the Nasolacrimal Grooves Cleft lip w/ palate- Primary Palate defect  Cleft posterior to Incisive Foramen(Langman, 1981) Palatine Shelves do not fuse.
  6. 6. Dr. Gutmann6 Embryological palate development Frontal view
  7. 7. Dr. Gutmann7 Embryological palate development Inferior view
  8. 8. Dr. Gutmann8 Prevalence of Cleft Lip & Palate Country Years Prevalence Author Finland 1948-1975 1.74 Rintala, 1986 Israel 1974-1988 0.97 Tolarova, 1998 USA 1983-1990 1.30 Druschel, 1996 Japan 1948-1954 2.68 Vanderas, 1987 France 1974-1996 1.9 Stoll, 2000 China 1980-1989 1.2 Cooper, 2000 Nigeria 1976-1980 0.37 Iregbulem, 1982
  9. 9. Dr. Gutmann9 Epidemiology  Cleft lip w/ or w/o Palate:0.6-2 : 1,000 Births  Japan 1.7/ Whites- 1.0 / Blacks- 0.4
  10. 10. Dr. Gutmann10  Males: More Cleft Lip w/- w/o Palate Females:More Cleft Palate-later fusion Palatine plates /longer period/greater exposure time(Burdi,1969) (Cooper, 2000) Epidemiology
  11. 11. Dr. Gutmann11 Etiology of Cleft Lip and Palate  Multifocal  Midline facial defect (developmental) Growth hormone defect/Teeth development defect  Genetic(Wyszynski, 1996) - Mendelian/- Multifactorial Twins study (Keush, 1991)- 33%- identical/ 7%- non-identical
  12. 12. Dr. Gutmann12 Etiology of Cleft Lip and Palate (continue) Environmental factors: Humans: Alcohol, smoking, antiepileptic meds Animal experimentation: Cortizol/ Steroids(Richtsmeir, 1994) Bixler, 1991) Anti- Asthmatic/ X-ray (Sa’ad, 1994)
  13. 13. Dr. Gutmann13 Multifactorial inheritance Siblings- (one sibling) Bilateral cleft lip and palate- 5.7% Unilateral cleft lip and palate-4.2% Cleft lip w/o palate- 2.5% (Bixler, 1981/ Fraser, 1970) 2 siblings affected- additional (9.0%) (Wyszynski, 1996) Relatives- (Balgir,1984) First degree- 4% Uncles- 0.6% Cousins(First degree)- 0.4%
  14. 14. Dr. Gutmann14 Frequency Unilateral left to Unilateral right to Bilateral 6:3:1 CL/P male to female 2:1 CP female to male 2:1 CL/P to CL 1.5-3:1 CL to CL/P to CP 21%to 46% to 33% Majority of CL/Ps are isolated Majority of CPs are syndromic )McCarthy(
  15. 15. Dr. Gutmann15 Predicted Occurrence, % )McCarthy( CL/P P One sibling affected 4 2 One parent affected 4 6 One sibling and one parent affected 17 15 Two siblings affected 9 1 One sibling plus family history 4 7
  16. 16. Dr. Gutmann16 Examples of Cleft Palate  Cleft of Back Soft Palate  Cleft of Soft Palate  Cleft of Soft and Hard Palate  Cleft of Soft and Hard Palate and Cleft Lip
  17. 17. Dr. Gutmann17 Examples of Cleft lip: Unilateral and Bilateral  Normal/ Unilateral/ Bilateral
  18. 18. Dr. Gutmann18 Repair of cleft lip
  19. 19. Dr. Gutmann19 Repair of cleft palate

×